New Hope for Long-Covid Sufferers

– The stellate ganglion block is a procedure that has been utilized since the 1930s for treating sympathetically mediated pain states of the head, neck, and upper extremities. It has been used in treating Reflex Sympathetic Dystrophies, Complex Regional Pain Syndromes, Post-Herpetic Neuralgia symptoms and even peripheral arterial disease states. The idea is to reduce sympathetic overstimulation or innervation to the head, neck and upper extremities. This has shown to have improvement in pain, function, and circulation to the affected areas.

During the pandemic, which impacted roughly 40% of Americans, various syndromes were described in individuals after recovery from acute covid illness. Long Covid syndromes affect nearly 19% of individuals testing positive for Covid. Covid Anosmia and dysgeusia is described as a loss or altered sense of smell and taste after acute symptoms of covid have resolved.
There have been few studies examining the effects of stellate ganglion block in patient populations experiencing long covid like symptoms.

A case report of a 48-year-old female patient with self-described anosmia and dysgeusia 4 months after recovering from her initial Covid infection symptoms:

Patient had a relatively mild case of Covid symptoms, however after resolution of the acute Covid viral illness, she had persistent loss of taste as well as smell. A stellate block was performed on her right stellate ganglion using 4cc 0.25% Marcaine followed by left side 72 hours later. The patient reported significant improvement in her previous anosmia as well as dysgeusia symptoms.

A patient with similar symptoms presented to our clinic. A 34-year-old female who had initially tested positive for Covid in September of 2020, recovered from her acute covid viral illness and developed similar persistent anosmia as well as dysgeusia and parosmia symptoms 3 months after her initial viral illness and her symptoms persisted for the past 21 months. A stellate block was performed on the right side, followed by the left side 2 weeks afterwards. She reported
significant improvement in her previous parosmia, dysgeusia, and parosmia symptoms after both sides were completed.
These represent a small but very encouraging segment of the population that could stand to benefit from this relatively low risk procedure. This also represents a data point in the evolving case use for the stellate ganglion block, possibly indicating that dysautonomia plays a role in the development of these symptoms.

Similarly, PTSD patients have seen remarkable benefit and even remission of symptoms with stellate ganglion block.

Providing the stellate ganglion block as a service to patients suffering from various dysautonomic states including Reflex Sympathetic Dystrophy, Complex Regional Pain Syndrome, Post Herpetic Neuralgias as well as Post-Traumatic-Stress-Disorder and now Long Covid syndrome has led to the remission of some of these chronic disease states. This represents an encouraging outlook, and hope for a possible cure, for those suffering from these chronic diseases.

Nikhil Shetty, MD

Reference sources:

Chauhan G, Upadhyay A, Khanduja S, et al. (August 08, 2022) Stellate Ganglion Block for Anosmia and Dysgeusia Due to Long COVID. Cureus 14(8): e27779. doi:10.7759/cureus.27779,patient%20after%20she%20underwent%20SGB

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

Liu LD, Duricka DL., J Neuroimmunol. 2022 Jan 15;362:577784. doi: 10.1016/j.jneuroim.2021.577784. Epub 2021 Dec 8., PMID: 34922127

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