New studies show that COVID can affect patients during two distinct phases of the disease process: the acute stage, characterized by fever, heart or lung problems, and the post-COVID phase, in which neuropsychiatric symptoms, like fatigue, anxiety and depression, can occur.
NeuroCOVID, as the second phase is called, is characterized by one or a combination of symptoms like vertigo, loss of smell, headaches, fatigue and irritability as well as anxiety and depression. One in five COVID patients will develop these symptoms – a much higher rate than in patients with the flu or a lung infection.
This finding drew the attention of Mark George, M.D., a world expert in brain stimulation and depression and professor of psychiatry, radiology and neuroscience; Bashar Badran, Ph.D., a leading researcher in the field of vagus nerve stimulation therapy and assistant professor in the College of Medicine; and Steve Kautz, Ph.D., professor and director of the Center of Biomedical Research Excellence in Stroke Recovery (COBRE).
The trio of researchers works closely together with the National Center for Neuromodulation for Rehabilitation Research and COBRE, both housed at the MUSC College of Health Professions, studying brain stimulation.
George, Badran, and Kautz received funding from the National Institutes of Health-funded Delaware Clinical and Translational Research Program to address neuroCOVID symptoms in patients. Their study, set to begin in late November, will use a revolutionary noninvasive technique to stimulate the vagus nerve and reduce inflammation in 20 participants who report having neuroCOVID symptoms.
By reducing inflammation, which is known to cause a host of problems in the body, the team hopes some or all of the symptoms participants are experiencing will subside.
“When your body tries to fight off COVID, there’s sometimes an inflammatory cascade that can kick in, almost like when you’ve touched poison ivy, and there’s an inflammatory response on your skin that keeps going and spreading,” said George. “A lot of people feel that the inflammation is what’s causing those symptoms to occur post-COVID. If we can reduce inflammation, we have a chance of reducing that.”
Probably the most innovative part of the study is the way it’s conducted with participants. For years, stimulating the vagus nerve to reduce inflammation has required an invasive in-office procedure. Using new technologies, pioneered and largely developed by Badran, the group has found a way to stimulate the same nerve using electrical impulses delivered through an earbud that patients can insert on their own, without leaving home.
“When we first began learning more about neuroCOVID, and we began thinking about using this noninvasive technique to stimulate that vagus nerve, we also thought, ‘What if we created a kit to see if people could do this totally at home?'” George said. “We don’t know if inflammation is the cause of all of these symptoms, but we won’t know if we don’t stimulate that vagus nerve. We’re casting a broad net to see what will help. Either way, this is a new page in how we treat people and address rehab and recovery from COVID.”
The study, which is entirely voluntary, is open to patients of any age or health background who have experienced neuroCOVID symptoms. All reporting and treatments are done online with no in-person visits. Patients receive a kit with tablets for video conferencing, an ear stimulator and tools to send blood pressure, pulse and oxygen saturation levels to researchers in real time.
“We talk to patients on the phone. We Zoom or conference with them, conduct informed consent over video and then, we send them all the materials they need at home,” said George. “This is all new and novel, and if it works, we’re not only addressing neuroCOVID symptoms; we’re exploring a new way to do medicine and rehab. Having people receive their treatments at home, under doctors’ supervision, is so much better in this age of COVID.”