CureusAug 1, 2026

Stellate Ganglion Block for Long COVID Symptoms with PTSD, Anxiety, and Chronic Pain: A Case Report

Updated Aug 3, 2026

Abstract

A 58-year-old man with persistent post-COVID symptoms showed marked improvement in cognitive function, anxiety, and pain following sequential stellate ganglion blocks.

Post-acute sequelae of SARS-CoV-2 infection can include fatigue, cognitive dysfunction, pain, and neuropsychiatric issues.
The patient had a complex history of psychiatric disorders and chronic pain, leading to significant impairment in daily functioning.
Sequential stellate ganglion blocks were performed to alleviate symptoms of cognitive dysfunction, fatigue, pain, and anxiety.
Follow-up revealed improvement in anxiety, frustration tolerance, and cognition lasting approximately six months after the first treatments.
Repeat procedures for symptom recurrence were again associated with symptomatic improvement.
Emerging literature indicates potential benefits of stellate ganglion blocks for selected patients with post-acute sequelae of SARS-CoV-2, but further controlled studies are needed.

Simplified

Post-acute sequelae of SARS-CoV-2 infection (PASC), commonly referred to as long COVID, is characterized by persistent symptoms, including fatigue, cognitive dysfunction, pain, and neuropsychiatric complaints, that can impair daily functioning. Proposed mechanisms are heterogeneous and may include autonomic dysregulation in a subset of patients. Stellate ganglion block (SGB) is a cervical sympathetic block used to treat symptoms of post-traumatic stress disorder (PTSD), anxiety, and, more recently, PASC. A 58-year-old man with a history of attention-deficit/hyperactivity disorder, generalized anxiety disorder, obsessive-compulsive disorder, autism spectrum disorder, PTSD, and chronic musculoskeletal pain developed persistent post-COVID symptoms following infection in March 2020, including brain fog, slowed information processing, word-finding difficulty, worsening anxiety, impaired balance, and reduced hand-eye coordination that significantly impaired occupational functioning as a chef. In January 2023, sequential left- and right-sided SGBs one week apart were performed to address cognitive dysfunction, fatigue, pain, and anxiety. Follow-up documentation described marked improvement in anxiety, frustration tolerance, and cognition lasting approximately six months. Repeat right-sided SGBs were performed in December 2024 and September 2025 for recurrence of symptoms and were again associated with symptomatic improvement. This is the first case demonstrating both longitudinal and reproducible functional improvement in cognitive symptoms, anxiety, and pain following serial SGBs in a patient with PASC complicated by psychiatric comorbidity and chronic pain. Although emerging observational literature suggests potential benefit of SGB in selected patients with PASC, prospective controlled studies are required to determine efficacy, mechanisms, and long-term outcomes.

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Competing interests

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

PubMed

Stellate Ganglion Block for Long COVID Symptoms with PTSD, Anxiety, and Chronic Pain: A Case Report

Abstract

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