Stellate Ganglion Block for Long COVID- a Potential Game changer for a Chronic Debilitating Condition
Long COVID, also known as post-acute sequelae of COVID-19 (PASC), is a condition characterized by persistent or lingering symptoms following an acute COVID-19 infection. While most people recover from COVID-19 within a few weeks, some individuals continue to experience symptoms for months or even longer after the initial infection has resolved.
Key Features of Long COVID:
1. Duration of Symptoms- Symptoms can persist for weeks or months after the initial COVID-19 infection. There is no strict timeline for the onset or resolution of symptoms; some people may start experiencing long COVID symptoms soon after their acute illness, while others may develop them later.
2. Variety of Symptoms- Long COVID can present with a wide range of symptoms that can vary in severity and frequency. Common symptoms include:
- Fatigue
- Shortness of breath
- Cognitive difficulties (often referred to as "brain fog")
- Joint and muscle pain
- Chest pain or tightness
- Persistent loss of taste or smell (also known as ageusia and anosmia, respectively)
- Heart palpitations
- Sleep disturbances
- Anxiety and depression
3. Autonomic Dysfunction- Some individuals may experience issues with their autonomic nervous system, leading to symptoms such as orthostatic intolerance (difficulty standing up without feeling faint), irregular heart rate, and issues with body temperature regulation.
4. Impact on Quality of Life- Long COVID can have a significant impact on an individual's quality of life, affecting their ability to work, engage in physical activities, and maintain social relationships.
5. Risk Factors- Long COVID can affect individuals of all ages and backgrounds, but certain factors may increase the risk, such as the severity of the initial COVID-19 infection, underlying health conditions, and possibly even age.
6. Lack of Consensus on Mechanism- The exact mechanisms behind long COVID are not yet fully understood. It may involve ongoing inflammation, immune system dysregulation, or other factors. There is a strong case Long COVID to be sympathetically mediated.
Management of Long COVID:
- Multidisciplinary Approach- Management of long COVID often involves a team of healthcare providers, including primary care physicians, pulmonologists, cardiologists, neurologists, and mental health professionals, among others.
- Symptom Management- Treatment focuses on managing individual symptoms, such as physical therapy for fatigue or breathing exercises for shortness of breath.
- Monitoring and Follow-up- Regular follow-up with healthcare providers is important to monitor symptoms and adjust treatment plans as needed.
- NAD infusions
- Stellate Ganglion Block
An exciting new potential therapeutic approach being investigated is the use of the stellate ganglion block (SGB) for long COVID. Here's an overview of the use of SGB for this condition:
What Is Stellate Ganglion Block (SGB)?
Stellate ganglion block involves injecting local anesthetics directed at the stellate ganglion, a cluster of nerves located in the neck. This nerve cluster is part of the sympathetic nervous system and is involved in regulating various bodily functions, including heart rate, blood pressure, and other autonomic responses. The purpose of this is by blocking the sympathetic nervous system, SGB can help modulate autonomic function and potentially alleviate symptoms related to autonomic dysfunction.
Potential Benefits of SGB for Long COVID:
- Autonomic Dysfunction- Long COVID is known to cause autonomic dysfunction in some patients, leading to symptoms such as orthostatic intolerance, irregular heart rate, and temperature regulation issues. SGB may help regulate autonomic responses and provide relief from these symptoms.
- Reduction of Inflammation- There is evidence to suggest that SGB may reduce inflammation, which could be beneficial for patients experiencing ongoing inflammatory symptoms associated with long COVID.
- Mood and Anxiety- SGB has been used in the past to treat conditions like PTSD and chronic pain, which often involve mood disturbances and anxiety. By modulating the nervous system, SGB may help improve mood and anxiety symptoms in long COVID patients.
Research and Considerations:
- Research- The use of SGB for long COVID is still an emerging area of research, with initial reports suggesting potential benefits. However, more studies are needed to fully understand its efficacy and safety in this population.
- Risks and Side Effects- As with any medical procedure, there are potential risks and side effects associated with SGB, such as temporary hoarseness, difficulty swallowing, and rare complications such as nerve injury or vascular injury. Horner’s Syndrome (ptosis, miosis, anhidrosis) will also be seen temporarily and is necessary to be present ensuring successful blockade.
- Individualized Approach- Long COVID symptoms can vary widely between patients, so an individualized approach is crucial. Healthcare providers should carefully assess each patient's symptoms and medical history before considering SGB as a treatment option.
Conclusion:
While stellate ganglion block shows promise as a potential treatment for certain symptoms of long COVID, particularly autonomic dysfunction and mood disturbances, further research is needed to establish its safety and efficacy. At StrIVeMD Wellness and Ketamine, patients considering SGB for long COVID have a lengthy consult with an board-certified pain medicine/anesthesiologist experienced in treating the condition to discuss the potential benefits and risks, as well as a holistic/functional medicine approach to sleep hygiene, diet, and exercise.