Case Report: Successful Treatment of COVID-19 ARDS with Transcutaneous Vagus Nerve Stimulation

We report two individuals who successfully recovered from COVID-19-induced ARDS after being treated with transcutaneous auricular vagus nerve stimulation (taVNS). In the first case, taVNS was started after eleven hospital days of continual deterioration despite mechanical ventilation along with supportive therapy of steroids, antibiotics, and immunoglobulins. On the twelfth day of hospitalization, taVNS was begun four times daily, resulting in sudden improvement in oxygenation. There was a concomitant reduction of c-reactive protein from 109.6 μg/mL to 10 μg/mL. After nine days of taVNS therapy, the patient's improved respiratory function improved enough that she was able to be extubated. No additional treatments had been added or changed during this time. After twenty-seven days of hospitalization, the patient was discharged to home without supplemental oxygen. The second case involves taVNS therapy in the home setting. After nineteen days of progressive deterioration, the patient's oxygen saturation declined to 90% on room air before taVNS treatment was instituted. After tens days of taVNS treatment three times daily, his oxygen saturation had climbed to 97%, and by day 25 of VNS therapy, the patient felt he was fully recovered. taVNS is capable of improving regulation of the inflammatory response in other clinical conditions such as autoimmune disorders in humans and septic shock in animal models. We suggest that transcutaneous auricular vagus nerve stimulation is potent enough to improve the clinical course of COVID-19 associated ARDS because of its potential to minimize the clinical deterioration associated with the immunological surge known as the cytokine storm. taVNS is a safe and potentially efficacious treatment for COVID-19 ARDS.