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expert reaction to conference abstract looking at long COVID and the vagus nerve

A conference abstract presented at the European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) Annual Meeting looks at vagus  nerve dysfunction in long COVID.


Dr David Strain, Chair of BMA Board of Science and Clinical senior lecturer and honorary consultant, University of Exeter Medical School, said:

“This is a conference abstract. The full paper is not available and therefore it is not possible to properly critique the data. It has also not undergone peer-review.

“The study appears to add to a growing collection of data suggesting at least some of the symptoms of long COVID is mediated through a direct impact on the nervous system. There is a well-established knowledge base that associates the vagus nerve with some of the cardinal features of long COVID such as palpitations, night sweats and gastrointestinal disturbances. Establishing vagal nerve damage is useful information, as there are recognised, albeit not perfect, treatments for other causes of vagal nerve dysfunction that may be extrapolated to be beneficial for people with this type of Long COVID.

“It is important to caveat that not all symptoms of long Covid may be associated with the direct impact of vagal dysfunction and there are many other presentations that will need further investigation. Further, we must remember that association is not necessarily causation. The Vagus nerve (so named because of its vagrant nature as it wanders through the body) is one of the longest nerves in the body and the longest and most complex of the cranial nerves. It is entirely possible that people susceptibility to nerve damage are at the greatest risk of developing long Covid; in this case this observation tells us little more than  nerve damage is an result of COVID, this is greater in those with Long Covid, and the damage is easy to detect in a long, complex nerve. Indeed, it is unlikely that vagal nerve damage could account for many other symptoms such as brain fog or muscle aches and pains. 

“Treatment with agents that have been demonstrated to be efficacious against vagal nerve dysfunction may provide relief for patients, however are unlikely to treat the underlying diagnosis, and thus patients would be at risk of rebound symptoms once treatment stops. Randomised Controlled trials into a Long Covid treatments will soon be commencing considering treatments for both underlying causes and symptomatic control I’m sure we will be able to evaluate these agents will only know when we respectively start with the symptoms whether reversal of this damage.”



Conference abstract: ‘Vagus nerve dysfunction in post-COVID-19 condition’ by G. Lladós et al was presented at the European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) Annual Meeting to be held in Lisbon from 23-26 April.

The full study is not available and this research has not undergone peer-review.



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