343 posters, 5 videos, 2 audios, 18 topics, 33 sessions, 263 authors, 202 institutions

24th Annual Pain Medicine Meeting 2025

November 13-15, 2025| JW Marriott Austin, Austin, Texas

2227258

Stellate Ganglion Block in the Treatment of Long COVID: Preliminary Findings of a Systematic Review

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Poster Presenter

Sudeep Peddireddy

Authors

Sudeep Peddireddy

Affiliations

Temple University Health System

Part of Topic

Scientific Abstracts - Late Breaking > Regional Anesthesia

Stellate Ganglion Block in the Treatment of Long COVID: Preliminary Findings of a Systematic Review

Background

Post Acute Sequelae of SARS-CoV-2, also known as Long COVID, is a chronic condition that can occur after COVID-19 infection.
Stellate ganglion block (SGB) is a treatment traditionally used to manage autonomic dysfunction and pain, but has gained traction as a possible, off-label treatment for the varied constellation of symptoms seen in Long COVID.

Inclusion/Exclusion Criteria

To be included, studies must examine outcomes of patients diagnosed with long COVID after at least one SGB, be written in English, and have the full-text article available.
Of the 45 results, the following were excluded: 14 duplicate results, 12 case reports/series, 4 unpublished/ongoing clinical trials, 2 articles examining unrelated therapies (ketamine, OMT), and 6 reviews/clinical guidelines that were not specific to SGB in the setting of long COVID.

Results

Table 1. Symptoms examined in the various papers, efficacy reported by percentage of aggregated patients that reported benefit

Symptom	Papers	Gross Efficacy (patients reporting benefit / total patients)
Anxiety	4 of 7 papers	22/32 = 68.8% of patient reported improvement in anxiety Note: 1 paper noted no significant change in GAD-7 score
Autonomic Dysfunction	4 of 7 papers	23/30 = 76.7% of patients reported improvements in autonomic dysfunction symptoms Note: 1 study showed a statistically significant decrease in heart rate by 10 beat per minute
Brain Fog/Cognitive Dysfunction	3 of 7 papers	58/81 = 71.6% of patients reported improvement in brain fog symptoms
Chest Pain	2 of 7 papers	12/20 = 60% of patients reported improvement in chest pain
Cough	1 of 7 papers	8/10 = 80% of patients reported resolution of cough
Depression/ Mood changes	4 of 7 papers	36/52 = 69.2% of patients reported improvement in depression/mood symptoms
Dizziness	3 of 7 papers	28/40 = 70% of patients reported improvement of dizziness
Fatigue	6 of 7 papers	74/106 = 69.8% of patients reported improvement in fatigue Note: 1 study showed a significant decrease of 9 points in median Fatigue Severity Scale (FSS) scores
Headache	2 of 7 papers	26/32 = 81.3% of patients reported improvement in headache
Joint Pain	1 of 7 papers	15/16 = 93.8% patients reported resolution of joint pain
Pain	1 of 7 papers	13/16 = 81.3% patients reported improvement of pain interference and pain intensity via PROMIS-29 scores
Pins/Needles	1 of 7 papers	9/9 = 100% of patients reported resolution of numbness/tingling
Sleep	5 of 7 papers	39/54 = 72.2% of patients reported an improvement in sleep-related problems. Note: 1 study found no significant improvement in assessment of wakefulness after sleep onset, total sleep time, percent REM sleep, sleep fragmentation, and sleep apnea
Smell/Taste Changes	4 of 7 papers	38/68 = 55.8% of patients reported improvement in changes in taste/smell

Discussion

Seven studies met inclusion criteria. Patients received a single SGB in some studies and multiple SGBs in others.
More than half of the studies examined changes in taste/smell, anxiety, autonomic dysfunction, depression, sleep.
The least studied symptoms include headache, joint pain, parasthesias.
All studies shared some similar limitations: small sample sizes, heterogeneity of study design, outcome measure, and follow-up intervals. They also lacked control groups.

Conclusion

Though it is off-label, SGB is a promising treatment that appears to generate substantive benefit for many of the symptoms seen in Long COVID. The literature does have significant limitations however.