Long COVID – Sonora WellCare LLC

Dolphin Neurostim for Treating Long-Haul Symptoms of COVID-19
The Dolphin vagal nerve stimulator (i.e., the Dolphin Neurostim) is the first medical device authorized by Health Canada to provide symptoms relief to people with post–COVID-19 condition.1,2 Post–COVID-19 condition, also known as long COVID (or long COVID syndrome due to its various symptoms), refers to ongoing physical or psychological symptoms that persist in some people for more than 3 months after acute COVID-19.3 The true prevalence of post–COVID-19 condition is uncertain and is reported to vary based on multiple factors and criteria used to assess the condition.4 For example, self-reported estimates indicate the prevalence may be between 4% and 10% and may vary based on the variant of infection.5 However, in up to 30% or 40% of people who acquire COVID-19, some common symptoms, such as fatigue and shortness of breath, can persist after the acute illness.3,6

There is substantial uncertainty and limited knowledge about the pathophysiology, characterization, and clinical effectiveness of treatments for post–COVID-19 condition. However, vagal nerve stimulation may be a potential adjunct therapeutic option for some people.7

Basharat S, Mahood Q; Authors. Vagus Nerve Stimulation for the Treatment of Post–COVID-19 Condition: Health Technology Update [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2022 Sep. Available from: https://www.ncbi.nlm.nih.gov/books/NBK603323/

How It Works
The vagus nerve is part of the body’s autonomic nervous system and carries neurological signals from multiple organ systems to the brain, and vice versa.8 It has different functions in helping to regulate the digestive, cardiovascular, muscular, and respiratory processes of the body, and may relay certain sensory activation inputs from environmental signals, pro-inflammatory markers, or other signals to the brain and other organs.8,9 The nerve is also considered to play a role between the nervous and immune systems, modulating responses to inflammation.8 Due to its modulating role for many organ systems, the vagus nerve has been an active area of clinical research for more than 20 years.9

Electrical stimulation of the vagus nerve has been studied for a variety of health conditions, most notably for epilepsy, depression, pain, and stroke rehabilitation.10 The nerve can be stimulated by electrical pulse delivered through a surgically implanted device or by a noninvasive device over a specified duration.11 Noninvasive stimulation may be delivered through electrodes placed on the skin surface in the neck or ear (targeting the auricular branch).12 The Dolphin Neurostim is a battery-operated noninvasive device that delivers electrical signals to the vagus nerve through its auricular branch by connecting a wire clip to a person’s ear.1 People may use the device to self-administer stimulations multiple times a day, per their health care provider’s guidance.1 Early evidence from similar devices suggests that noninvasive neurostimulation could help alleviate some symptoms related to the long-term effects of COVID-19.13,14

Who Might Benefit?
The Dolphin Neurostim device is specifically intended for people experiencing long-term symptoms of COVID-19 and/or asthma-related shortness of breath.2 It is also intended for people for whom approved drug therapies are not tolerated or provide insufficient symptom relief, as assessed by their health care provider.2