Short Communication: Stellate Ganglion Blockade for Persistent Olfactory and Gustatory Symptoms Post-COVID-19

Vaughna Galvin, Dennis J Cheek, Yan Zhang, Gregory Collins, David Gaskin, Vaughna Galvin, Dennis J Cheek, Yan Zhang, Gregory Collins, David Gaskin

Abstract

One hundred ninety-five patients presenting with post-COVID symptomology, including parosmia and dysgeusia, underwent reversible stellate ganglion blockade. Stellate ganglion blockade was performed at an outpatient facility, and patients were evaluated via survey at seven days post-injection. Of the 195 participants, ages ranged from 18-69 years of age with the breakdown of sexes being females n = 157 and males n = 38. The most significant finding was a reported improvement in olfaction post-injection in 87.4% of subjects. The effectiveness of this novel treatment for post-COVID is promising and warrants further investigation.

Keywords: COVID; cervical sympathetic block; dysautonomia; dysgeusia; parosmia.

Conflict of interest statement

The authors report no conflicts of interest in this work.

© 2023 Galvin et al.

Figures

Figure 1
Figure 1
Data Collected on Google Survey Form.

References

    1. Bagheri S, Asghari A, Farhadi M, et al. Coincidence of COVID-19 epidemic and olfactory dysfunction outbreak in Iran. Med J Islam Repub Iran. 2020;34:62. doi:10.34171/mjiri.34.62
    1. Giacomelli A, Pezzati L, Conti F, et al. Self-reported olfactory and taste disorders in patients with severe acute respiratory coronavirus 2 infection: a cross-sectional study. Clin Infect Dis. 2020;71:889–890. doi:10.1093/cid/ciaa330
    1. Gorzkowski V, Bevilacqua S, Charmillon A, et al. Evolution of Olfactory Disorders in COVID-19 Patients. Laryngoscope. 2020;130:2667–2673. doi:10.1002/lary.28957
    1. Meng X, Deng Y, Dai Z, Meng Z. COVID-19 and anosmia: a review based on up-to-date knowledge. Am J Otolaryngol. 2020;41:102581. doi:10.1016/j.amjoto.2020.102581
    1. Spinato G, Fabbris C, Polesel J, et al. Alterations in smell or taste in mildly symptomatic outpatients with SARS-CoV-2 infection. JAMA. 2020;323:2089–2090. doi:10.1001/jama.2020.6771
    1. Lerner D, Garvey K, Arrighi-Allisan A, et al. Clinical Features of Parosmia Associated With COVID-19 Infection. Laryngoscope. 2022;132(3):633–639. doi:10.1002/lary.29982
    1. Eliezer M, Hautefort C, Hamel A, et al. Sudden and complete olfactory loss of function as a possible symptom of COVID-19. JAMA Otolaryngol Head Neck Surg. 2020;146:674–675. doi:10.1001/jamaoto.2020.0832
    1. Moein S, Hashemian S, Mansourafshar B, Khorram-Tousi A, Tabarsi P, Doty R. Smell dysfunction: a biomarker for COVID-19. Int Forum Allergy Rhinol. 2020;10:944–950. doi:10.1002/alr.22587
    1. Pierron D, Pereda-Loth V, Mantel M, et al. Smell and taste changes are early indicators of the COVID-19 pandemic and political decision effectiveness. Nat Commun. 2020;11:5152. doi:10.1038/s41467-020-18963-y
    1. Tong J, Wong A, Zhu D, Fastenberg J, Tham T. The prevalence of olfactory and gustatory dysfunction in COVID-19 patients: a systematic review and meta-analysis. Otolaryngol Head Neck Surg. 2020;163:3–11. doi:10.1177/0194599820926473
    1. Vaira L, Salzano G, Deiana G, De Riu G. Anosmia and ageusia: common findings in COVID-19 patients. Laryngoscope. 2020;130:1787. doi:10.1002/lary.28692
    1. Whitcroft K, Hummel T. Olfactory dysfunction in COVID-19: diagnosis and management. JAMA. 2020;323:2512–2514. doi:10.1001/jama.2020.8391
    1. Ercoli T, Masala C, Pinna I, et al. Qualitative smell/taste disorders as sequelae of acute COVID-19. Neurol Sci. 2021;42(12):4921–4926. doi:10.1007/s10072-021-05611-6
    1. Parma V, Ohla K, Veldhuizen MG, et al. More than smell—COVID-19 is associated with severe impairment of smell, taste, and chemesthesis. Chem Senses. 2020;45:609–622. doi:10.1093/chemse/bjaa041
    1. Chauhan G, Upadhyay A, Khanduja S, Emerick T. Stellate ganglion block for anosmia and dysgeusia due to long COVID. Cureus. 2022;14(8):e27779. doi:10.7759/cureus.27779
    1. Liu L, Duricka D. Stellate ganglion block reduces symptoms of Long COVID: a case series. J Neuroimmunol. 2022;362:577784. doi:10.1016/j.jneuroim.2021.577784
    1. Moon H, Chon J, Lee S, Ju Y, Sung C. Long-term results of stellate ganglion block in patients with olfactory dysfunction. Korean J Pain. 2013;26(1):57–61. doi:10.3344/kjp.2013.26.1.57
    1. Iannilli E, Leopold D, Hornung D, Hummel T. Advances in understanding parosmia: an fMRI study. ORL J Otorhinolaryngol Relat Spec. 2019;81:185–192. doi:10.1159/000500558
    1. Hummel T, Whitcroft K, Andrews P, et al. Position paper on olfactory dysfunction. Rhinol Suppl. 2017;54(26):1–30. doi:10.4193/Rhino16.248
    1. Leopold D. Distortion of olfactory perception: diagnosis and treatment. Chem Senses. 2002;27:611–615. doi:10.1093/chemse/27.7.611
    1. Tan C, Tan B, Tan X, et al. Neuroradiological Basis of COVID‐19 Olfactory Dysfunction: a Systematic Review and Meta‐Analysis. Laryngoscope. 2022;132:1260–1274. doi:10.1002/lary.30078
    1. Parker J, Kelly C, Gane S. Molecular mechanism of parosmia. medRxiv. 2021. doi:10.1101/2021.02.21251085
    1. Fischer L, Barop H, Ludin S, Schaible H. Regulation of acute reflectory hyperinflammation in viral and other diseases by means of stellate ganglion block. A conceptual view with a focus on COVID-19. Auton Neurosci. 2022;237:102903. doi:10.1016/j.autneu.2021.102903
    1. Elenkov I, Wilder R, Chrousos G, Vizi E. The sympathetic nerve–an integrative interface between two supersystems: the brain and the immune system. Pharmacol Rev. 2000;52(4):595–638.
    1. Grebe K, Takeda K, Hickman H, et al. Cutting edge: sympathetic nervous system increases proinflammatory cytokines and exacerbates influenza a virus pathogenesis. J Immunol. 2010;184(2):540–544. doi:10.4049/jimmunol.0903395
    1. Janig W. Autonomic nervous system and inflammation. Auton Neurosci. 2014;182:1–3. doi:10.1016/j.autneu.2014.02.002
    1. Libby P, Luscher T. COVID-19 is, in the end, an endothelial disease. Eur Heart J. 2020;41(32):3038–3044. doi:10.1093/eurheartj/ehaa623
    1. Steenblock C, Todorov V, Kanczkowski W, et al. Severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) and the neuroendocrine stress axis. Mol Psychiatry. 2020:1–7. doi:10.1038/s41380-020-0758-9
    1. Tracey K. The inflammatory reflex. Nature. 2002;420(6917):853–859. doi:10.1038/nature01321
    1. Tracey K. Reflex control of immunity. Nat Rev Immunol. 2009;9(6):418–428. doi:10.1038/nri2566
    1. DeVere R. Disorders of taste and smell. Continuum. 2017;23:421–446. doi:10.1212/CON.0000000000000463
    1. Ellis H, Lawson H. Anatomy for Anaesthetists. 9 ed. Wiley Blackwell; 2014.
    1. Liu M, Tian J, Su Y, Wang T, Xiang Q, Wen L. Cervical sympathetic block regulates early systemic inflammatory response in severe trauma patients. Med Sci Monit. 2013;19:194–201. doi:10.12659/MSM.883833
    1. Xie A, Zhang X, Ju F, Li W, Zhou Y, Wu D. Effects of the ultrasound-guided stellate ganglion block on hemodynamics, stress response, and gastrointestinal function in postoperative patients with colorectal cancer. Comput Intell Neurosci. 2022;2056969. doi:10.1155/2022/2056969
    1. Westerhaus M. Loewy. Central representation of the sympathetic nervous system in the cerebral cortex. Brain Res. 2001;903(1–2):117–127. doi:10.1016/s0006-8993(01
    1. Cho S. Clinical diagnosis and treatment of olfactory dysfunction. Hanyang Med Rev. 2014;34:107. doi:10.7599/hmr.2014.34.3.107
    1. Kang P, Kloke J, Jain S. Olfactory dysfunction and parasympathetic dysautonomia in Parkinson’s disease. Clin Auton Res. 2012;22(4):161–166. doi:10.1007/s10286-012-0158-6

Source: PubMed

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