Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Dec;13(6):894-899.
doi: 10.1007/s12265-020-10031-6. Epub 2020 May 26.

Implications for Neuromodulation Therapy to Control Inflammation and Related Organ Dysfunction in COVID-19

Marat Fudim  1 , Yawar J Qadri  2 , Kamrouz Ghadimi  2 , David B MacLeod  2 , Jeroen Molinger  2 , Jonathan P Piccini  3   4 , John Whittle  2 , Paul E Wischmeyer  2 , Manesh R Patel  3 , Luis Ulloa  5
Affiliations
Review

Implications for Neuromodulation Therapy to Control Inflammation and Related Organ Dysfunction in COVID-19

Marat Fudim et al. J Cardiovasc Transl Res. 2020 Dec.

Abstract

COVID-19 is a syndrome that includes more than just isolated respiratory disease, as severe acute respiratory syndrome-coronavirus 2 (SARS-CoV2) also interacts with the cardiovascular, nervous, renal, and immune system at multiple levels, increasing morbidity in patients with underlying cardiometabolic conditions and inducing myocardial injury or dysfunction. Emerging evidence suggests that patients with the highest rate of morbidity and mortality following SARS-CoV2 infection have also developed a hyperinflammatory syndrome (also termed cytokine release syndrome). We lay out the potential contribution of a dysfunction in autonomic tone to the cytokine release syndrome and related multiorgan damage in COVID-19. We hypothesize that a cholinergic anti-inflammatory pathway could be targeted as a therapeutic avenue. Graphical Abstract .

Keywords: ACE2; COVID-19; SARS-CoV2; Vagus; Vagus nerve stimulation.

PubMed Disclaimer

Conflict of interest statement

Marat Fudim consults for AxonTherapies, Daxor, Edwards, and Galvani, and received non-monetary support from Parasym. Kamrouz Ghadimi consults for Uptodate® for coagulation and blood management; receives grant support from NIH T32GM008600 and Duke Health; has previous support from Octapharma. Jonathan Piccini receives grants for clinical research from Abbott, American Heart Association, Association for the Advancement of Medical Instrumentation, Bayer, Boston Scientific, NHLBI, and Philips, and serves as a consultant to Abbott, Allergan, ARCA Biopharma, Biotronik, Boston Scientific, LivaNova, Medtronic, Milestone, Myokardia, Sanofi, Philips, and Up-to-Date. Manesh Patel receives grant support from Medtronic, Bayer, Janssen, and Heartflow, and consults for Bayer, Janssen, and Heartflow. All other authors report no relevant conflicts of interest.

Figures

Graphical Abstract
Graphical Abstract
.
Figure 1
Figure 1
Connection between the vagus nerve and immune system. ACh, acetylcholine; nAChR, nicotinic acetylcholine receptor; RAAS, renin angiotensin aldosterone system; ACE2, angiotensin-converting enzyme 2; SARS-CoV2, severe acute respiratory syndrome–coronavirus
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Clerkin, K. J., Fried, J. A., Raikhelkar, J., et al. (2020). Coronavirus disease 2019 (COVID-19) and cardiovascular disease. Circulation. - PubMed
    1. Zhou, F., Yu, T., Du, R., et al. (2020). Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. - PMC - PubMed
    1. Ruan, Q., Yang, K., Wang, W., Jiang, L., & Song, J. (2020). Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. - PMC - PubMed
    1. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506. doi: 10.1016/S0140-6736(20)30183-5. - DOI - PMC - PubMed
    1. Liao, M., Liu, Y., Yuan, J. et al. (2020). The landscape of lung bronchoalveolar immune cells in COVID-19 revealed by single-cell RNA sequencing. medRxiv.

Publication types

MeSH terms