While COVID-19 cases have decreased in recent months, there are still potentially millions of people suffering from long COVID—the prolonged symptoms which can persist for months or even years after a COVID-19 infection. These symptoms can include fatigue, shortness of breath, sleep disorders, fever, gastrointestinal issues, anxiety, depression, and “brain fog”, as per the National Institutes of Health. Another common symptom is COVID smell loss. Fortunately, recent research and clinical practices in the U.S. have identified a potential solution to this debilitating condition.
According to the Cleveland Clinic, stellate ganglion block (SGB) is an injection of medication into the stellate ganglion, a part of the sympathetic nervous system that is located in the neck on either side of the voice box. A SGB into these nerves can help reduce pain in the neck, head, upper chest, and upper arms, and can also enhance circulation and blood supply to the arm. SGB is already used to treat several conditions, but now researchers and medical professionals are looking at whether the injection can possibly treat COVID-related loss of smell as well.
A recent Newsweek article, for example, highlighted the work of David Gaskin, MHS, CRNA, a nurse anesthetist in nonsurgical pain management in Bryan, Texas, who has performed SGB on about 200 long-COVID patients and says the procedure has had an 85% to 90% success rate. In December 2021, a case series published in the Journal of Neuroimmunology found that SGB can help to reduce a range of symptoms of long COVID, including fatigue, cognitive difficulties, and a loss of distortion of smell. In the case study, two long COVID patients were treated with SGB, with one reporting “durable restoration of taste and smell” two weeks after the procedure, and the other reporting “drastic improvement” in her sense of smell just minutes after. Researchers suggested that the SGB may have helped to rebalance the interaction between the nervous and immune systems, but noted that further study is required.
In SGB, a specialist will inject a local anesthetic to the area using a thin needle, and with the aid of an X-ray or ultrasound will use a second needle to inject an anesthetic medication. The procedure can last up to 30 minutes and is estimated to cost around $2,000. While the procedure is low risk, there is a possibility of some side effects, including bruising or soreness at the injection site, drooping eyelids, bloodshot eyes, tearing, hoarse voice, or difficulty swallowing, although these will generally clear up within a few hours. In addition, it’s not guaranteed to work; in the Newsweek article, one patient experienced an improvement in smell and taste for just a couple hours before reverting back to her previous state.
Research has found that during a COVID-19 infection, people are 27 times more likely to experience a loss of smell compared to people who have not been infected with the virus. It’s unclear how common loss of smell is in those who’ve contracted the virus; however, according to U.K. government research based on 351,850 responses to a survey, 37% of people with self-reported long COVID experienced smell loss.
“Long COVID has a serious impact on people’s ability to go back to work or have a social life. It affects their mental health and may have significant economic consequences for them, their families, and for society,” the World Health Organization declared in a brief last year. In February 2021, U.S. Congress dedicated $1.15 billion to fund research on long COVID. Around the world, other countries have also funded similar avenues of research, with the U.K. government pledging £18.5 million to look deeper into the causes, symptoms, and potential treatment pathways of long COVID. While the use of SGB to treat long COVID-related loss of smell is still in its novel treatment stage, it could offer some optimism for people struggling with the enduring mental and physical effects of COVID-19.