Terapia electroconvulsiva en comparación con la Estimulación Magnética Transcraneal en episodios depresivos post COVID-19. Revisión sistemática

Abstract

Introduction: COVID-19 left numerous sequelae, significantly affecting people's quality of life. Among these consequences, depression is of particular concern, with uncertainty regarding its neurobiological impact. Therefore, therapies such as Electroconvulsive Therapy (ECT) and Transcranial Magnetic Stimulation (TMS) have emerged as potentially viable treatment options. General Objective: To evaluate the efficacy of Electroconvulsive Therapy and Transcranial Magnetic Stimulation in the treatment of post-COVID-19 depressive episodes. Methodology: A systematic review was conducted based on the criteria established by the PRISMA 2020 statement, including articles published in Spanish and English, with free access, and involving individuals aged ≥18 years. Reviews, meta-analyses, and gray literature that did not address ECT and/or TMS for post-COVID-19 depression were excluded. Searches were conducted in the PubMed, Taylor & Francis, and Scopus databases from November 2024 to March 2025, using the JBI tool. Results: Case reports and cross-sectional studies highlighted the efficacy of TMS, associated with high tolerability, in moderate cases, whereas ECT showed greater efficacy in severe cases. Good adherence to the procedures was identified, with minor adverse effects. Discussion: The results supported the use of these therapies on an individualized basis; however, limitations such as methodological heterogeneity and small sample sizes increased the risk of bias. Conclusions: TMS is recommended for moderate cases and ECT for severe cases; however, further controlled studies are needed to strengthen the evidence supporting this practice.