Taha Amira Mohamed, Elrosasy Amr, Mohamed Ahmed S, Mohamed Ahmed Elmorsy, Bani-Salameh Abdallah, Siddiq Abdelmonem, Cadri Shirin, Elshahat Ahmed, Abdelmonteser Atef A, Abouelmagd Moaz E
Neurology, Faculty of Medicine, Fayoum University, Fayoum, EGY.
Neurology, Medical Research Group of Egypt (MRGE), Arlington, USA.
Cureus. 2024 Oct 1;16(10):e70613. doi: 10.7759/cureus.70613. eCollection 2024 Oct.
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.
由于严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引发的2019冠状病毒病（COVID-19）大流行，国际医疗界遇到了一些困难。COVID-19可导致以过度炎症为特征的异常免疫反应，因此通过非侵入性迷走神经刺激（nVNS）靶向迷走神经可能有望成为一种干预措施。这项荟萃分析旨在研究在COVID-19患者中使用nVNS对不同炎症生物标志物的影响。截至2023年5月，我们对在线数据库进行了综述。我们纳入了讨论nVNS如何影响COVID-19患者临床结局的随机对照试验（RCT）。使用Revman 5.4软件（英国伦敦考科蓝协作网）进行荟萃分析，以找出nVNS对不同炎症生物标志物（包括白细胞介素-10（IL-10）、C反应蛋白（CRP）、IL-6和皮质醇水平）影响的合并平均差（MD）及95%置信区间（CI）。该综述纳入了四项涉及180例COVID-19患者的RCT。nVNS治疗后，IL-10水平显著升高（MD = 1.53，95% CI：0.77，2.29；p < 0.001）。CRP水平（MD = -2.24，95% CI：-4.52，0.05；p = 0.06）、IL-6水平（MD = 4.07，95% CI：-3.16，11.32；p = 0.27）、皮质醇水平（MD = 1.45，95% CI：-11.67，14.57；p = 0.83）和D-二聚体水平（MD = -0.47，95% CI：-1.31，0.38；p = 0.28）无显著差异。这些发现表明，nVNS可能对COVID-19患者的某些炎症标志物产生积极影响，提示nVNS可能是一种有益的辅助治疗方法。
