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Percutaneous Auricular Nerve Stimulation for Treating Post-COVID Fatigue (PAuSing-pCF)

Germann, M.; Maffitt, N. J.; Burton, O. A.; Ashhad, A.; Baker, A. M. E.; Cherlin, S.; Shahmandi, M.; Charlton, N.; Baker, A. S.; Zaaimi, B.; Ng, W.-F.; Soteropoulos, D. S.; Baker, S. N.; Wason, J. M. S.; Baker, M. R.

2026-01-02 neurology
10.64898/2025.12.30.25343085 medRxiv
Show abstract

Even mild SARS-CoV-2 infection can lead to post-COVID syndrome, 70% of such patients have post-COVID fatigue (pCF). Many physiological abnormalities observed in pCF could be explained by reduced vagus nerve activity. The vagus nerve, central to metabolic and inflammatory homeostasis, can be activated non-invasively by transcutaneous auricular vagus nerve stimulation (taVNS). Can taVNS improve symptoms in pCF? Data were collected from a randomized study including 114 individuals with pCF. They completed 16 weeks of daily home-based active, sham, or placebo taVNS. Data on subjective fatigue, captured by a Visual Analogue Scale (VAS), and objective measures of cortical excitability, muscle fatigue and autonomic function were collected. In participants meeting minimum adherence ([≥]1 h/day on [≥]50% of days), VAS and peripheral fatigue improved significantly after 8 weeks of active (but not sham or placebo) taVNS (11.9 {+/-} 17.8 points improvement, p=0.003, N=24). These results support taVNS as a potential therapy for pCF.

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