Efeito da estimulação elétrica transcutânea do nervo vago no painel inflamatório e evolução clínica dos pacientes com COVID-19: ensaio clínico, controlado, randomizado e cego

Abstract

COVID-19 is a pathology that affected the whole world and presents a significant increase in the inflammatory process. The search for treatment took place with many scientists around the world and the use of Transcutaneous auricula Vagus Nerve stimulation (tAVNS) for this purpose also occurred. Thus, the aim of this study is to evaluate the effects of transcutaneous electrical vagus nerve stimulation on inflammatory markers and clinical evolution from patients with COVID-19. A randomized, blinded study was conducted with 14 sessions (twice a day) for active or sham taVNS in 52 patients, with stimulation in the left tragus region (alternating current ranging from 5 kHz to 25Hz, intensity ranging from 3 - 7 mA, for a period of 90 minutes in the morning and 90 minutes in the afternoon or evening, interval of 6 to 8 hours between each stimulation). Interleukin-6 (IL-6), interleukin-10 (IL-10), cortisol and C-reactive protein (CRP) in blood plasma and clinical evolution were evaluated. It was found after treatment, serum CRP levels (23.9%, 95% CI 46.3 to 1.4) and IL-6 (-37.7%, 95% CI -57.6 to -17.7) were statistically lower in the active group when compared to the sham group. Other inflammatory markers did not show significant results. There were no changes in clinical symptoms, except for a decrease in depression levels (-2.85, 95% CI -5.44 to -0.27) in the active group. Therefore, it is possible that taVNS is a viable and safe technique in acute cases of COVID-19, acting on the levels of CRP, IL-6, and depression. A larger sample and follow-up are needed to confirm the findings of this study.