key: cord-318114-q29zax2j
authors: Bara, Gregor A.; de Ridder, Dirk; Maciaczyk, Jaroslaw
title: Can neuromodulation support the fight against the COVID19 pandemic? Transcutaneous non-invasive vagal nerve stimulation as a potential targeted treatment of fulminant acute respiratory distress syndrome
date: 2020-07-18
journal: Med Hypotheses
DOI: 10.1016/j.mehy.2020.110093
sha: 
doc_id: 318114
cord_uid: q29zax2j

The COVID-19 pandemic has rapidly spread all over the world and caused a major health care crisis. About 20% of patients develop severe disease and require hospitalisation, which is associated with a high mortality rate of up to 97% in those being ventilated and respiratory failure being the leading cause of death. Despite many therapeutic agents being under current investigation there is yet no panacea available. With increasing rates of infection throughout the world, there is an urgent need for new therapeutic approaches to counteract the infection. As the nervous system has shown to be a strong modulator of respiratory function and the immune response, we want to highlight pathways involved in regulation of respiratory function, the neuro-immune axis as well as the rationale for a potential targeted treatment of fulminant acute respiratory distress syndrome via transcutaneous non-invasive vagal nerve stimulation in critically-ill COVID-19 patients.

Can neuromodulation support the fight against the COVID19 pandemic? Transcutaneous non-invasive vagal nerve stimulation as a potential targeted treatment of fulminant acute respiratory distress syndrome Gregor This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Dear Dr. Manku, I am writing to submit our manuscript entitled, "Can neuromodulation support the fight against the COVID19 pandemic? Transcutaneous non-invasive vagal nerve stimulation as a potential targeted treatment of fulminant acute respiratory distress syndrome" for consideration as a clinical opinion in your very much respected journal.

We discuss the current threat of the COVID-19 pandemic and present an innovative approach for targeted treatment of the disease. We underscore the underlying physiology of the strong interconnection of the immune system and the nervous system. We present vagus nerve stimulation as a potential non invasive treatment and present clinical data to undermine the hypothesis.

We draw the conclusion that vagus nerve stimulation may be a supporting treatment in the therapy continuum of COVID-19 patients by combined modulation of respiratory function as well as the neuro-immune axis.

Each of the authors confirms that this manuscript has not been previously published and is not currently under consideration by any other journal. Additionally, all of the authors have approved the contents of this paper and have agreed to the submission policies.

I am happy to answer any further questions and can be contacted as follows:

email: gregor.bara@ukbonn.de mobile: +49-172-5831998 I am very much looking forward to your response.

Yours sincerely,

Hypothesis:

Can neuromodulation support the fight against the COVID19 pandemic

Bara 1 , Dirk de Ridder 2 , Jaroslaw Maciaczyk 1,2 1. Stereotactic and Functional Neurosurgery

None for all authors.