Post COVID-19 Syndrome Treatment With Variable Pulse Transcranial Magnetic Stimulation

Prior treatment

• Implanted electronic devices, including pacemakers, defibrillators, implant medication pumps, or vagus nerve stimulators (VNS)
• Active alcohol abuse: \>14 drinks a week or formal diagnosis, illicit drug use or drug abuse
• Intracranial implant within 30 cm of magnet (e.g., aneurysm clips, endovascular coil, cerebral shunts, brain stimulators, cochlear implants, stents, or electrodes) or any other metal object within or near the head, excluding the mouth, which cannot be safely removed
• Previous stroke with residual deficits

Other illness

• Any seizure history within the past 10 years
• Based on PI's or local physician's assessment that subject unable to tolerate the trial procedure due to medical condition
• Any condition which in the judgment of the investigator would prevent the subject from completion of the study

Lab values

• Clinical abnormality or clinically unstable medical condition, as indicated by medical history, physical examination, or clinical laboratory testing, that in the Investigator's judgment might pose a potential safety risk to the subject or limit interpretation of the trial results

Other

• Enrolled or plans to enroll in an interventional trial during this study
• Subjects unable to comprehend or follow verbal commands
• Subjects unable to comprehend and sign the informed consent
• Pregnant or trying to become pregnant; negative urine pregnancy test at screening will be required for females of childbearing potential

• Patients who have had a recent episode of COVID-19 and who present to the Post COVID-19 Clinic at Mayo Clinic Rochester with at least one of the PCC symptoms of interest - anosmia, tinnitus, fatigue. Symptoms consistent with PCC lasting at least 1 month after the positive test date. Subjects must have ongoing symptoms for \> 4 weeks following the start of an acute covid infection. This is consistent with the CDC definition for post covid conditions. Start date is determined by date of first positive COVID test. There is no limitation of maximum time from acute infection start.
• At least one of the PCC symptoms of interest:
  • Anosmia: Olfactory Threshold Test scores corresponding to Anosmia or Hyposmia
  • Tinnitus: \>0 score on Tinnitus Handicap Inventory (not present prior to SARS-COVID 2 infection)
  • Fatigue: Total Modified Fatigue Impact Scale (MFIS) Score of 40 or above