Author: Amira Mohamed Taha1,2, Amr Elrosasy3,2, Ahmed S Mohamed4,2, Ahmed Elmorsy Mohamed5,2, Abdallah Bani-Salameh6,2, Abdelmonem Siddiq7,2, Shirin Cadri8,2, Ahmed Elshahat9,2, Atef A Abdelmonteser10,2, Moaz E Abouelmagd2,11
Affiliation: <sup>1</sup> Neurology, Faculty of Medicine, Fayoum University, Fayoum, EGY.
<sup>2</sup> Neurology, Medical Research Group of Egypt (MRGE), Arlington, USA.
<sup>3</sup> Ophthalmology, Faculty of Medicine, Cairo University, Cairo, EGY.
<sup>4</sup> Internal Medicine, Faculty of Medicine, Merit University, Mansoura, EGY.
<sup>5</sup> Neurology, Faculty of Medicine, Tanta University, Tanta, EGY.
<sup>6</sup> Medicine, Jordan University of Science and Technology, Irbid, JOR.
<sup>7</sup> Therapeutics, Faculty of Pharmacy, Mansoura University, Mansoura, EGY.
<sup>8</sup> Internal Medicine, Universitatea de Medicină și Farmacie "Grigore T. Popa" Iași, Iași, ROU.
<sup>9</sup> Internal Medicine, Al-Azhar University, Cairo, EGY.
<sup>10</sup> Medicine and Surgery, Al-Azhar University, Cairo, EGY.
<sup>11</sup> Neurology, Faculty of Medicine, Cairo University, Cairo, EGY.
Conference/Journal: Cureus
Date published: 2024 Oct 1
Other:
Volume ID: 16 , Issue ID: 10 , Pages: e70613 , Special Notes: doi: 10.7759/cureus.70613. , Word Count: 223
The international healthcare community has encountered several difficulties because of the COVID-19 pandemic brought on by SARS-CoV-2. COVID-19 can lead to an abnormal immune response that features excessive inflammation, so targeting the vagus nerve through non-invasive vagus nerve stimulation (nVNS) may hold promise as an intervention. This meta-analysis aimed to examine the outcomes of using nVNS on different inflammatory biomarkers in COVID-19 patients. Up until May 2023, we performed a review of online databases. We included randomized controlled trials (RCTs) that discussed how nVNS affected patients with COVID-19's clinical outcomes. Using the Revman 5.4 software (Cochrane, London, United Kingdom), a meta-analysis was carried out to find the pooled mean difference (MD), with 95% confidence intervals (CIs), of nVNS effects on different inflammatory biomarkers, including interleukin-10 (IL-10), C-reactive protein (CRP), IL-6, and cortisol levels. The review included four RCTs involving 180 COVID-19 patients. Following nVNS treatment, there was a significant increase in IL-10 levels (MD = 1.53, 95% CI: 0.77, 2.29; p < 0.001). CRP levels (MD = -2.24, 95% CI: -4.52, 0.05; p = 0.06), IL-6 levels (MD = 4.07, 95% CI: -3.16, 11.32; p = 0.27), cortisol levels (MD = 1.45, 95% CI: -11.67, 14.57; p = 0.83), and D-dimer levels (MD = -0.47, 95% CI: -1.31, 0.38; p = 0.28) did not differ significantly. These findings suggest that nVNS may positively impact certain inflammatory markers in COVID-19 patients, suggesting that nVNS could be a beneficial adjunctive treatment.
Keywords: covid-19; inflammation; nvns; systemic inflammatory markers; vagus nerve stimulator.
PMID: 39493183 PMCID: PMC11528624 DOI: 10.7759/cureus.70613