RT Journal Article T1 Efficacy and safety of HD-tDCS and respiratory rehabilitation for critically ill patients with COVID-19 The HD-RECOVERY randomized clinical trial. A1 Andrade, Suellen Marinho A1 Cecilia de Araujo Silvestre, Maria A1 Tenorio de França, Eduardo Eriko A1 Bezerra Sales Queiroz, Maria Heloisa A1 de Jesus Santana, Kelly A1 Lima Holmes Madruga, Marcela Lais A1 Torres Teixeira Mendes, Cristina Katya A1 Araujo de Oliveira, Eliane A1 Bezerra, Joao Felipe A1 Barreto, Renata Gomes A1 Alves Fernandes da Silva, Silmara Maria A1 Alves de Sousa, Thais A1 Medeiros de Sousa, Wendy Chrystyan A1 Patrícia da Silva, Mariana A1 Cintra Ribeiro, Vanessa Meira A1 Lucena, Paulo A1 Beltrammi, Daniel A1 Catharino, Rodrigo Ramos A1 Caparelli-Dáquer, Egas A1 Hampstead, Benjamin M A1 Datta, Abhishek A1 Teixeira, Antonio Lucio A1 Fernandez-Calvo, Bernardino A1 Sato, Joao Ricardo A1 Bikson, Marom K1 Acute respiratory distress syndrome K1 Coronavirus disease K1 High-definition transcranial direct current stimulation K1 Noninvasive brain stimulation K1 Respiratory rehabilitation AB Acute Respiratory Distress Syndrome (ADRS) due to coronavirus disease 2019 (COVID-19) has been associated with muscle fatigue, corticospinal pathways dysfunction, and mortality. High-Definition transcranial Direct Current Stimulation (HD-tDCS) may be used to attenuate clinical impairment in these patients. The HD-RECOVERY randomized clinical trial was conducted to evaluate the efficacy and safety of HD-tDCS with respiratory rehabilitation in patients with moderate to severe ARDS due to COVID-19. Fifty-six critically ill patients were randomized 1:1 to active (n = 28) or sham (n = 28) HD-tDCS (twice a day, 30-min, 3-mA) plus respiratory rehabilitation for up to 10 days or until intensive care unit discharge. The primary outcome was ventilator-free days during the first 28 days, defined as the number of days free from mechanical ventilation. Furthermore, secondary outcomes such as delirium, organ failure, hospital length of stay and adverse effects were investigated. Active HD-tDCS induced more ventilator-free days compared to sham HD-tDCS. Patients in the active group vs in the sham group experienced lower organ dysfunction, delirium, and length of stay rates over time. In addition, positive clinical response was higher in the active vs sham group. There was no significant difference in the prespecified secondary outcomes at 5 days. Adverse events were similar between groups. Among patients with COVID-19 and moderate to severe ARDS, use of active HD-tDCS compared with sham HD-tDCS plus respiratory rehabilitation resulted in a statistically significant increase in the number of ventilator-free days over 28 days. HD-tDCS combined with concurrent rehabilitation therapy is a safe, feasible, potentially add-on intervention, and further trials should examine HD-tDCS efficacy in a larger sample of patients with COVID-19 and severe hypoxemia. YR 2022 FD 2022-05-05 LK http://hdl.handle.net/10668/22066 UL http://hdl.handle.net/10668/22066 LA en NO Andrade SM, Cecília de Araújo Silvestre M, Tenório de França EÉ, Bezerra Sales Queiroz MH, de Jesus Santana K, Lima Holmes Madruga ML, et al. Efficacy and safety of HD-tDCS and respiratory rehabilitation for critically ill patients with COVID-19 The HD-RECOVERY randomized clinical trial. Brain Stimul. 2022 May-Jun;15(3):780-788 DS RISalud RD Apr 12, 2025