Stellate ganglion block reduces symptoms of Long COVID: A case series.
Summary: This study evaluated stellate ganglion block (injection of local anesthetic into the front of the neck) in patients with long COVID (when people continue to have symptoms of COVID-19 for weeks or months after the initial illness).
Conclusion: Cervical sympathetic chain (paired bundle of nerve fibers that run from the base of the skull to the coccyx) activity can be blocked with local anesthetic (injection of medicine that numbs a small area of the body), allowing the regional autonomic nervous system (responsible for control of the bodily functions not consciously directed, such as breathing, the heartbeat, and digestive processes) to reboot. The patients were successfully treated using stellate ganglion block (injection of local anesthetic into the front of the neck).
After recovering from COVID-19, a significant proportion of symptomatic and asymptomatic individuals develop Long COVID. Fatigue, orthostatic intolerance, brain fog, anosmia, and ageusia/dysgeusia in Long COVID resemble "sickness behavior," the autonomic nervous system response to pro-inflammatory cytokines (Dantzer et al., 2008). Aberrant network adaptation to sympathetic/parasympathetic imbalance is expected to produce long-standing dysautonomia. Cervical sympathetic chain activity can be blocked with local anesthetic, allowing the regional autonomic nervous system to "reboot." In this case series, we successfully treated two Long COVID patients using stellate ganglion block, implicating dysautonomia in the pathophysiology of Long COVID and suggesting a novel treatment.