Nerve Block for Long COVID

(DSBLongCOVID Trial)

Overseen By Megan Nicklay, BS

Age: 18+

Sex: Any

Trial Phase: Phase 1

Sponsor: Megan Nicklay

Must not be taking: Anticoagulants

Disqualifiers: Under 18, Pregnancy, Glaucoma, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 4

Duration: 1 month

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether a nerve-blocking treatment can help individuals with long COVID symptoms related to the autonomic nervous system. The treatment uses a simple outpatient procedure with a local anesthetic (Stellate Ganglion Block with 0.5% Bupivacaine) to block specific nerves in the neck. Individuals experiencing long COVID symptoms such as dizziness, sweating, or stomach issues four or more weeks after infection may be suitable candidates for this trial. As a Phase 1 trial, the research focuses on understanding how the treatment works in people, offering participants the opportunity to be among the first to receive this innovative treatment.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but you cannot participate if you are currently using anticoagulants (blood thinners).

What prior data suggests that this nerve block is safe for long COVID patients?

Research has shown that stellate ganglion blocks have been safely used for other conditions, and similar methods are being tested for long COVID. Studies have found that this treatment can help reduce symptoms for many patients; for example, 86% of patients reported feeling better after the treatment.

The procedure involves injecting a local numbing medicine called bupivacaine to block certain nerves in the neck. Light sedation accompanies this minimally invasive procedure. Although this is an early-stage study, using a common anesthetic suggests it is reasonably safe. As with any medical procedure, some risks exist, but major side effects have not been frequently reported in research. ^{1 2 3 4 5}

Why do researchers think this study treatment might be promising for long COVID?

Most treatments for Long COVID focus on managing symptoms, such as fatigue and brain fog, with medications or lifestyle changes. Unlike these standard approaches, the Stellate Ganglion Block targets the nervous system directly. It involves a minimally invasive procedure where a local anesthetic, bupivacaine, is injected near specific nerve clusters in the neck. This treatment aims to reset the autonomic nervous system, potentially offering relief from Long COVID symptoms much faster than traditional methods. Researchers are excited because it could provide a novel solution for those who haven't found success with conventional treatments.

What evidence suggests that the stellate ganglion block is effective for long COVID?

Research has shown that a treatment called stellate ganglion block (SGB) using bupivacaine may help reduce symptoms of long COVID. In this trial, participants will receive active treatment with SGB. Studies have found that after receiving this treatment, patients often feel less tired and experience fewer symptoms after physical or mental activities. This suggests that SGB might help by calming the part of the nervous system that can be overactive in people with long COVID. Additionally, a series of cases in 2021 provided evidence that SGB can potentially ease long COVID symptoms, offering hope to those affected. ^{1 2 3 6 7}

Who Is on the Research Team?

Jonathann Kuo, MD

Principal Investigator

Medical Director

Are You a Good Fit for This Trial?

This trial is for adults who've had COVID-19 and are now suffering from long-term symptoms like low blood pressure, digestive issues, or pain. They must have confirmed past COVID-19 with a test and ongoing symptoms for at least four weeks. People can't join if they're on blood thinners, have glaucoma, previous similar treatments, local anesthetic allergies, are pregnant, or have infections/masses where the injection would go.

Inclusion Criteria

You have reported specific symptoms related to your body's automatic functions on the COMPASS-31 screening test.

You have had a confirmed diagnosis of COVID-19 using a standard test.

Your pain levels, as reported by you, are measured using a specific test called PROMIS-29.

Exclusion Criteria

You are currently taking blood-thinning medication.

You have had glaucoma in the past.

You have undergone prior stereotactic body radiation therapy (SGB).

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

1 visit (in-person)

Treatment

Participants receive Dual Sympathetic Blocks of the stellate ganglion, performed at 0 and 1 weeks

1 month

2 visits (in-person)

Follow-up

Participants are monitored for changes in autonomic symptoms and patient-reported outcomes using PROMIS-29 and COMPASS-31 surveys

4 weeks

1 visit (virtual)

What Are the Treatments Tested in This Trial?

Interventions

• Stellate Ganglion Block with 0.5% Bupivacaine

Trial Overview The study is testing whether injecting a numbing medication called bupivacaine into nerves in the neck (stellate ganglion block) helps relieve chronic symptoms that some people experience after COVID-19.

How Is the Trial Designed?

Group I: Active Experimental Treatment 1 Intervention

This is a non-randomized, non-blinded study. Participants eligible for this study will receive active treatment. Dual Sympathetic Blocks of the stellate ganglion are minimally- invasive outpatient procedures performed under monitored care anesthesia (light sedation). Under ultrasound visualization, a small needle is guided into the neck region that contains the stellate ganglion nerve cluster at C6-C7. Once the needle position is confirmed, a local anesthetic (7 cc of 0.5% bupivacaine/Marcaine) is injected around the stellate ganglion by the Principal Investigator. This procedure is repeated at the C3-C4 level to block the superior cervical ganglion nerve cluster (3 cc of 0.5% bupivacaine/Marcaine).

Who Is Running the Clinical Trial?

Megan Nicklay

Lead Sponsor

Trials

1

Recruited

20+

Jonathann Kuo, MD

Lead Sponsor

Trials

1

Recruited

20+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12374758/

Stellate Ganglion Block for the Management of Long ... The efficacy of stellate ganglion block (SGB) for managing post-acute sequelae of SARS-CoV-2 (PASC) remains an area of active exploration. In ...

2. sciencedirect.com sciencedirect.com/science/article/pii/S1566070224000493

Reduction of long COVID symptoms after stellate ganglion ... After one month or more following treatment, patients reported striking reductions in Fatigue, Worsening of Symptoms following Mental and Physical Activity, ...

3. clinicaltrials.gov clinicaltrials.gov/study/NCT05638620?term=AREA%5BConditionSearch%5D(Covid-19%20AND%20%22Recurrence%22)%20AND%20AREA%5BStudyType%5D(INTERVENTIONAL)&rank=8

Dual Sympathetic Blocks for Patients Experiencing ... A cases series conducted in 2021 showed promising results supporting Stellate ganglion blocks to reduce symptoms of Long COVID, or PASC. The case series ...

4. tandfonline.com tandfonline.com/doi/full/10.1080/21641846.2025.2455876

Stellate Ganglion Block reduces symptoms of SARS-CoV-2 ... Our previous work has shown that modulating the autonomic nervous system can alleviate symptoms of Long COVID, which shares striking similarities with ME/CFS.

5. cureus.com cureus.com/articles/343014-effectiveness-of-dual-sympathetic-blocks-for-sympathetically-mediated-symptoms-in-post-acute-sequelae-of-sars-cov-2-pasc-an-open-label-non-randomized-pilot-study

Effectiveness of Dual Sympathetic Blocks for ... A 2021 case series provided preliminary evidence supporting stellate ganglion blocks (SGBs) as a potential intervention for alleviating Long ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10498998/

Stellate Ganglion Block Relieves Long COVID-19 Symptoms ... Results indicated that a substantial proportion of patients (86%) experienced a reduction of their symptoms following SGB treatment.

7. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/37711269/

Stellate Ganglion Block Relieves Long COVID-19 ... Stellate Ganglion Block Relieves Long COVID-19 Symptoms in 86% of Patients: A Retrospective Cohort Study ... Cureus. 2023 Sep 13;15(9):e45161. doi ...