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<bold>Background:</bold> Several strategies have been employed to manage COVID-19-related cytokine storms, but non-pharmacological approaches remain underexplored. Studies in mice and humans have shown that non-invasive trans-cranial Vagus Nerve Stimulation (VNS) is effective and safe in resolving inflammatory conditions, including sepsis. This review aims to assess the impact of VNS as an adjuvant treatment for COVID-19 patients. <bold>Methods:</bold> A systematic search was conducted in PubMed, WOS, Scopus, and Cochrane databases until Feb 2025 for interventional trials evaluating efficacy and safety of VNS compared to standard care (SOC) in COVID-19 patients. Keywords included “vagus nerve stimulation” AND “COVID-19.” PICO framework comprised COVID-19 patients (P), VNS with standard care (I), standard care alone (C), and clinical/paraclinical outcomes (O). Review articles, case reports, studies on healthy volunteers, or non-COVID-19 VNS indications were excluded. <bold>Results:</bold> Of 297 articles, 6 met the inclusion criteria. Four randomized trials showed significant reductions in inflammatory markers, particularly CRP and IL-6, with VNS plus SOC compared to SOC alone. Five studies reported on clinical outcomes: symptoms, hospital stay duration, and need for mechanical ventilation. One study showed a decrease in depression, while another reported better memory and attention. No studies showed improvement in respiratory symptoms. Two studies suggested a trend towards reduced need for NIV and mortality, though both were small. No serious adverse events were reported. <bold>Conclusion:</bold> VNS may be a safe and effective adjuvant treatment for COVID-19, but more research is needed to confirm the beneficial effect.