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

J Neuroimmunol. 2022 Jan 15:362:577784. doi: 10.1016/j.jneuroim.2021.577784. Epub 2021 Dec 8.


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.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Autonomic Nerve Block / methods*
  • COVID-19 / complications*
  • COVID-19 / surgery
  • Female
  • Humans
  • Post-Acute COVID-19 Syndrome
  • SARS-CoV-2
  • Stellate Ganglion / surgery*