Stellate ganglion block reduces symptoms of Long COVID: A case series.
Liu, Luke D, Duricka, Deborah L · Journal of neuroimmunology · 2022 · DOI
Quick Summary
This small study looked at a procedure called a stellate ganglion block, which uses local anesthetic to temporarily quiet the nerve signals in the neck that control your 'fight or flight' response. Two Long COVID patients received this procedure, and their symptoms—including fatigue, brain fog, and dizziness upon standing—improved. The authors suggest that an imbalance in the autonomic nervous system (the system that controls automatic body functions) may be contributing to Long COVID symptoms.
Why It Matters
This study offers a potential explanation for why some ME/CFS and Long COVID patients experience unexplained fatigue, cognitive dysfunction, and orthostatic intolerance by implicating dysautonomia. If autonomic dysfunction is confirmed as a mechanism in larger, controlled studies, it could open new therapeutic avenues for patients whose conditions have been difficult to treat. The hypothesis connecting inflammatory cytokine responses to autonomic imbalance aligns with ongoing ME/CFS research into neuroimmune dysfunction.
Observed Findings
Two Long COVID patients received stellate ganglion block procedures
Symptom improvement was reported in fatigue, brain fog, and orthostatic intolerance following the procedure
The authors noted improvement in additional symptoms including anosmia and taste disturbances
The case series linked symptom profiles to 'sickness behavior' associated with pro-inflammatory cytokine responses
Inferred Conclusions
Dysautonomia (autonomic nervous system imbalance) may contribute to Long COVID symptomatology
Blockade of cervical sympathetic chain activity may allow the autonomic nervous system to 'reboot' and restore balance
Long COVID symptoms resemble classic sickness behavior triggered by inflammatory cytokine signaling
Remaining Questions
Does stellate ganglion block produce sustained symptom improvement, or are benefits temporary?
How many Long COVID patients would show similar improvement, and what patient characteristics predict response?
What are the mechanisms linking pro-inflammatory cytokines to the specific dysautonomic pattern observed in Long COVID?
What This Study Does Not Prove
This case series does not establish that stellate ganglion block is an effective or safe treatment for Long COVID; two cases cannot demonstrate efficacy. It does not prove that dysautonomia is the primary cause of Long COVID—only that autonomic dysfunction may play a role. Symptom improvement in two patients could reflect placebo effect, natural recovery, or other unmeasured factors, and lacks objective biomarkers or long-term outcome data.