Epipharyngeal Abrasive Therapy (EAT) Improved Premature Ventricular Contractions (PVCs) and Brain Fog Associated With Long COVID: A Case Report

A 50-year-old man with premature ventricular contractions (PVCs) detected before coronavirus disease 2019 (COVID-19) infection developed persistent fatigue and brain fog following COVID-19, which caused difficulty in continuing his work. Epipharyngeal abrasive therapy (EAT) was started without pharmacological treatment. Serial Holter electrocardiography demonstrated a marked reduction in PVC burden after continued EAT. In contrast, improvement in brain fog and recovery of work motivation occurred at a later stage, eventually allowing him to return to work. PVCs are considered an autonomic-sensitive peripheral manifestation, whereas brain fog likely represents dysfunction of central autonomic networks. The temporal dissociation observed between early improvement in PVCs and delayed cognitive recovery indicates that EAT may exert time-dependent effects on peripheral and central autonomic regulation. This case suggests that EAT could serve as a non-pharmacological and minimally invasive therapeutic option for both peripheral and central symptoms associated with autonomic dysfunction in Long COVID.