Stellate ganglion block reduces symptoms of Long COVID: A case series

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., 2008Dantzer R. O’Connor J.C. Freund G.G. Johnson R.W. Kelley K.W. From inflammation to sickness and depression: when the immune system subjugates the brain.Nat. Rev. Neurosci. 2008 Jan; 9 (PMID: 18073775; PMCID: PMC2919277): 46-56https://doi.org/10.1038/nrn2297Crossref PubMed Scopus (4395) Google Scholar). 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.