long COVID

by Dr. Kristian Flores, MD, ND

Why do some patients have virtually no COVID symptoms, why do some have significant symptoms, and why do some people get the complex version of COVID known as “Long COVID”? The answer is likely due to a variety of factors, but one thing is certain, the COVID-19 virus (SARSCoV-2) wreaks havoc on the Sympathetic Nervous System (SNS). Fortunately, we have a treatment option at Oregon Regenerative Medicine to address the neurological symptoms of Long COVID. Through a procedure called a Stellate Ganglion Block, we are able to reverse the Sympathetic Nervous System imbalance causing “Long COVID”.

We know that the virus can have a disastrous effect on all aspects of the nervous system, including the central and peripheral nervous systems. These individuals often have a complex constellation of symptoms including fatigue, standing intolerance (due to drops in blood pressure), elevated resting heart rates, brain fog, sleep disturbances, anxiety, depression, loss of taste and smell, and the list goes on. Newer research is starting to explain some reasons as to why this may be the case. 

The Sympathetic Nervous System’s role in Long COVID

The interaction between the sympathetic nervous system and the immune system gets disrupted in Long COVID. The Sympathetic Nervous System, or “fight-or-flight” system, plays a complex role in regulating cellular functions which need to occur automatically and without need for conscious decision making. This includes body temperature regulation, vascular flow, immunity, organ functions, digestion, all the processes that allow the body to maintain homeostasis. 

This “fight-or-flight” system is intimately involved in surveilling the body to make sure that there are no active threats or areas that need to be repaired. As it turns out, many of the same molecules that the immune system cells secrete to call attention to body invaders are also secreted by the Sympathetic Nervous System cells. These molecules let the body know that there is a threat to our bodies, ultimately resulting in an inflammatory ”fight-or-flight” response. This creates a “positive feedback loop”, meaning that the response is amplified as the two systems (nervous and immune) react to each other. Under Long COVID, the result can be a perpetual/chronic inflammatory cycle in which the nervous system stimulates immune system inflammation, and the immune system stimulates the nervous system inflammation. This process is thought to be one of the main driving factors of “Long COVID”.

Long COVID
Long COVID patients endure a complex constellation of symptoms including fatigue, standing intolerance (due to drops in blood pressure), elevated resting heart rates, brain fog, sleep disturbances, anxiety, depression, loss of taste and smell, and the list goes on.

As one might imagine, the treatment for this type of scenario can be complicated. The best approach is an individualized treatment plan with an emphasis on rebalancing the immune system, physical rehab, and rebalancing the nervous system. Fortunately, we have a treatment option at Oregon Regenerative Medicine that restores balance to the autonomic nervous system, the Stellate Ganglion Block. 

The stellate ganglion is a collection of sympathetic neurons that plays an essential role in the positive feedback system we described earlier. By expertly injecting (under ultrasound guidance) a benign anesthetic (procaine) we can hit a hard “reset” to these neurons and break the inflammatory cycle. 

Recently, in the Journal of Immunology some researchers published a case series of Long COVID patients who had dramatic and long-lasting responses to the Stellate Ganglion Block. Symptoms that responded included fatigue, memory/concentration issues, sleep problems, rapid heart rate, loss of taste and smell, dizziness, as well as depression and fight-or-flight anxiety. 

 If you would like to discuss your Long COVID symptoms or to learn more about the specialized treatments we offer at Oregon Regenerative Medicine, please call to schedule consultation and treatment.


Sources

  1. Liu LD, Duricka DL. Stellate ganglion block reduces symptoms of Long COVID: A case series. J Neuroimmunol. 2022;362:577784. doi:10.1016/j.jneuroim.2021.577784
  2. Lorenz Fischer, Hans Barop, Sabina Maria Ludin, Hans-Georg Schaible,
    Regulation of acute reflectory hyperinflammation in viral and other diseases by means of stellate ganglion block. A conceptual view with a focus on Covid-19,
    Autonomic Neuroscience, Volume 237, 2022, 102903, ISSN 1566-0702, https://doi.org/10.1016/j.autneu.2021.102903