A pilot randomized controlled trial found that handheld non-invasive vagal nerve stimulation (tcVNS) was well tolerated in Long COVID patients and showed trends toward improvement in depression, fatigue, and autonomic symptoms, though differences were not statistically significant.
- 18 Long COVID patients completed a 12-week trial comparing handheld vagal nerve stimulation to no treatment
- The device was safe and well tolerated with no reported adverse events
- Improvements in depression, fatigue, and autonomic symptoms were observed but not statistically significant
How this compares to prior research
Long COVID affects at least 10% of acute COVID-19 patients with symptoms lasting beyond 90 days. The exact cause remains unknown, but theories include persistent viral particles, immune dysfunction, and autonomic nervous system imbalance involving the vagus nerve. Given the vagus nerve\’s role in regulating inflammation, vagal nerve stimulation has emerged as a potential treatment approach, though no therapies have been approved for this condition.
Long COVID prevalence estimates, global population, 1980–1989
Key findings
- All 18 randomized patients (8 treatment, 10 control) completed the full 12-week study period
- Participants using tcVNS showed improvements in PHQ-9 depression scores, PROMIS fatigue scores, and COMPASS-31 autonomic symptom scores compared to controls
- Cortisol and DHEA hormone levels increased less in the tcVNS group compared to the control group
What this means in practice
- Ask your doctor about vagal nerve stimulation if you have persistent Long COVID symptoms affecting daily function
- Consider that autonomic nervous system dysfunction may be contributing to your Long COVID symptoms
- Note that this treatment was safe and well tolerated, though larger studies are needed to confirm effectiveness
Frequently asked questions
What is non-invasive vagal nerve stimulation?
It is a handheld device that stimulates the vagus nerve through the skin of the neck without surgery. Participants used it for two minutes, three times daily.
How many people have Long COVID?
Long COVID may impact at least 10% of patients with acute SARS-CoV-2 infection, with symptoms persisting beyond 90 days after initial infection.
Are there approved treatments for Long COVID?
No, Long COVID currently has no approved treatments and very low rates of complete recovery, making new therapeutic approaches important to explore.
Key terms explained
tcVNS
Transcutaneous cervical vagal nerve stimulation, a non-invasive method of stimulating the vagus nerve through the skin of the neck
PASC
Post-acute sequelae of SARS-CoV-2 infection, the medical term for Long COVID symptoms persisting beyond 90 days
Autonomic nervous system
The part of the nervous system that controls involuntary body functions like heart rate, digestion, and inflammation
Source: The Use of a Handheld Non-Invasive Vagal Nerve Stimulation (nVNS) Device for the Treatment of Long COVID: A Pilot Randomized Controlled Trial. · DOI: doi: 10.1177/21501319261473073