The Effectiveness and Safety of Stellate Ganglion Block in the Treatment of Symptoms from Long COVID-19: A Pilot Study

Alexa O Levey; Grant H Chen; Alexandra Ngyuen; Luis Ostrosky-Zeichner; Jamal Hasoon; Sepideh Saroukhani; Matthew Lin

The Effectiveness and Safety of Stellate Ganglion Block in the Treatment of Symptoms from Long COVID-19: A Pilot Study

Psychopharmacol Bull. 2024 Aug 19;54(4):8-17.

Authors

Alexa O Levey¹, Grant H Chen², Alexandra Ngyuen³, Luis Ostrosky-Zeichner⁴, Jamal Hasoon⁵, Sepideh Saroukhani⁶, Matthew Lin⁷

Affiliations

¹ Levey, MD, Radiology Partners-Houston, Houston, TX, USA.
² Chen, MD, MBA, University of Texas Health Sciences Center at Houston, McGovern Medical School, Department of Anesthesiology, Critical Care, and Pain Medicine, Houston, TX, USA.
³ Ngyuen, MD, University of Texas Health Sciences Center at Houston, McGovern Medical School, Department of Anesthesiology, Critical Care, and Pain Medicine, Houston, TX, USA.
⁴ Ostrosky-Zeichner, MD, University of Texas Health Sciences Center at Houston, McGovern Medical School, Department of Internal Medicine, Division of Infectious Diseases, Houston, TX, USA.
⁵ Hasoon, MD, University of Texas Health Sciences Center at Houston, McGovern Medical School, Department of Anesthesiology, Critical Care, and Pain Medicine, Houston, TX, USA.
⁶ Saroukhani, MD, PhD, University of Texas Health Sciences Center at Houston, McGovern Medical School, Department of Internal Medicine, Division of Clinical and Translational Sciences, Houston, TX, USA.
⁷ Lin, MD, University of Texas Health Sciences Center at Houston, McGovern Medical School, Department of Physical Medicine and Rehabilitation, Houston, TX, USA.

PMID: 39263197
PMCID: PMC11385263 (available on 2025-08-19)

Abstract

Purpose: Pilot study to evaluate the safety and effectiveness of stellate ganglion blocks in the treatment of symptoms related to long COVID infection.

Materials and methods: A total of 17 patients who underwent stellate ganglion block for the treatment of their long COVID symptoms were included. COMPASS-31, GAD-7, PCL-5, and Fatigue Severity Score (FSS) pre and post intervention surveys and data on baseline heartrate and post- block heart rate recorded in the EMR.

Results: A total of 94% of patients reported moderate-to-severe autonomic dysfunction pre-procedure as measured by COMPASS-31. All patients reported some degree of symptomatic improvement from the block. Specifically, patients had significantly lower FSS scores (P = 0.002) and heart rate post-procedure (P = 0.008). Although the decrease in PCL-5 scores after the procedure was clinically meaningful, this change was not statistically significant (P = 0.159). No significant difference was found in pre and post procedure GAD-7 scores (P = 0.101).

Conclusions: Stellate ganglion block is a safe, low-risk, minimally invasive, and effective procedure in the treatment of symptoms for long COVID. It should be evaluated as an adjunctive treatment of select patients in this population.

Keywords: block; long COVID; stellate ganglion.

MeSH terms

Adult
Aged
Autonomic Nerve Block* / methods
COVID-19*
Female
Heart Rate / physiology
Humans
Male
Middle Aged
Pilot Projects
Post-Acute COVID-19 Syndrome
Stellate Ganglion* / drug effects
Treatment Outcome