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

Luke D Liu, Deborah L Duricka, Luke D Liu, Deborah L Duricka

Abstract

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.

Keywords: Cerebral blood flow; Dysautonomia; Long COVID/PASC; Myalgic encephalitis/chronic fatigue syndrome (ME/CFS); Postural orthopedic tachycardia syndrome (POTS); Stellate ganglion block.

Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.

Figures

Fig. 1
Fig. 1
Intensity of Long COVID symptoms over time. Data was collected retrospectively for Pre-COVID timepoint. NOTE: Y axis set to −1 to visualize a score of zero.
Fig. 2
Fig. 2
Intensity of Long COVID symptoms over time. Data was collected retrospectively for Pre-COVID timepoint. NOTE: Y axis set to −1 to visualize a score of zero.

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