830 - Stellate Ganglion Blocks for Long COVID Management in a Pediatric Patient

The patient is a 12-year-old male who experienced persistent sore throat, daily fevers, fatigue, memory deficits, orthostatic tachycardia after acute viral illness in 09/2024. The patient had an extensive workup across multiple specialties and facilities over the next 7 months following his illness, including positive COVID IgG, transiently elevated TSH, negative echocardiogram and Holter monitor, pulmonary function testing within normal limits, flexible laryngoscopy and esophagogastroduodenoscopy with no acute abnormalities.  

The patient and his family were offered a stellate ganglion block (SGB) in 01/2025 which resolved nearly all of his symptoms. He underwent a repeat SGB in 04/2025 with all symptoms completely resolved. When he presented to Pediatric PM&R clinic in 07/2025, the patient still experienced complete resolution of his symptoms.  


Discussions: While there have been case reports and retrospective reviews of improvement in Long-COVID symptoms after SGB, to the best of our knowledge, this has not been reported in the pediatric population. In this particular case, the patient and his family sought evaluations from several specialties, hospital systems, and states across the US, highlighting the inefficiency and burden of current Long-COVID management in pediatrics. The exact mechanism of SGB’s role in treating Long-COVID symptoms is not understood, but it has been previously theorized that modulating sympathetic hyperactivity in the autonomic nervous system contributes to its utility. Further large-group studies are needed to better validate findings from published case reports, and additional studies are needed to create reproducible protocols for stellate ganglion blocks specifically for Long-COVID symptom management. 

Conclusions: Stellate ganglion blocks may be useful for treating Long-COVID symptoms in both children and adults.