Stellate Ganglion Block in the Treatment of Long COVID: A Systematic Review

Clinical Snapshot

Key Findings

• P Value: Not applicable - no statistical testing performed

• Effect Size: Response rates 55.8% to 100% across studies

• Primary Outcome: Symptomatic improvement in long COVID patients

• Nnt Or Sensitivity: Best response rates (>80%) for cough, dyspnea, headache, joint pain, pain interference, pins/needles, and subjective relief

• Confidence Interval: Not reported

Clinical Application

Requires specialist pain medicine or anaesthesia expertise; procedure availability may be limited in some centres Not currently listed on PBS; would require private payment or hospital-based delivery. TGA approval not required for established procedure. Consider RACGP guidelines on long COVID management Long COVID patients with autonomic dysfunction symptoms, particularly those with refractory symptoms

Abstract

OBJECTIVES: This review evaluates stellate ganglion block as a treatment for long COVID, seeking to evaluate the treatment's efficacy by various symptoms and the limitations of the current literature. STUDY DESIGN: Systematic Review. SETTING: Ambulatory or Outpatient Setting. METHODS, SUBJECTS: A systematic review of the current literature regarding use of stellate ganglion block in patients with long COVID was conducted. 2 databases were searched on August 28th, 2025. Search terms were "long COVID" and "stellate ganglion block", yielding 45 results. Studies examining patient outcomes after stellate ganglion block were included. Case reports, case series, basic science studies and previous reviews were excluded. Seven studies met inclusion criteria. RESULTS: Patients received a single stellate ganglion block in some studies and multiple stellate ganglion blocks in others. All studies reported symptomatic improvement without control groups. Response rates ranged from 55.8% to 100%. The most robust improvements (> 80% patients reporting relief) were seen in cough, dyspnea, headache, joint pain, pain interference/intensity, pins/needles, subjective relief. CONCLUSION: Stellate ganglion block is a promising treatment that appears to generate substantive benefit for many of the symptoms seen in long COVID. However, the current literature has small, uncontrolled studies with heterogenous study designs and follow-up periods. Standardized research with larger sample sizes, control groups, and longer-term follow up is necessary to elucidate the degree of benefit. IRB approval and clinical trial registration not required.

References

1. 1.Peddireddy, S., VanWingerden, N., Patel, P., Howard, G., & Berger, J. (2026). Stellate ganglion block in the treatment of long COVID: A systematic review. Current Pain and Headache Reports. https://doi.org/10.3947/ic.2024.0024