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德国及全球范围内新冠疫情期间及之后的疼痛:当前知识的叙述性综述

Pain during and after COVID-19 in Germany and worldwide: a narrative review of current knowledge.

作者信息

Meyer-Frießem Christine H, Gierthmühlen Janne, Baron Ralf, Sommer Claudia, Üçeyler Nurcan, Enax-Krumova Elena K

机构信息

Department of Anaesthesiology, Intensive Care and Pain Medicine, BG University Hospital, Bergmannsheil gGmbH, Bochum, Germany.

Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital of Schleswig-Holstein, Campus Kiel, Germany.

出版信息

Pain Rep. 2021 Jan 20;6(1):e893. doi: 10.1097/PR9.0000000000000893. eCollection 2021 Jan-Feb.

Abstract

Pain is a common symptom accompanying the coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Nonspecific discomfort such as sore throat and body ache are frequent. Parainfectious pain such as headache, myalgia, or neuropathic pain has also been reported. The latter seems to be associated with an autoimmune response or an affection of the peripheral neuromuscular system or the central nervous system because of the viral infection. Furthermore, chronic pain can be a complication of intensive care unit treatment due to COVID-19 itself (such as intensive care-acquired weakness) or of secondary diseases associated with the SARS-CoV-2 infection, including Guillain-Barré syndrome, polyneuritis, critical illness polyneuropathy, or central pain following cerebrovascular events. Data on long-lasting painful symptoms after clinically manifest COVID-19 and their consequences are lacking. In addition, preexisting chronic pain may be exacerbated by limited and disrupted health care and the psychological burden of the COVID-19 pandemic. Medical providers should be vigilant on pain during and after COVID-19.

摘要

疼痛是由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的2019冠状病毒病(COVID-19)伴随的常见症状。喉咙痛和身体疼痛等非特异性不适很常见。也有关于感染后疼痛的报道,如头痛、肌痛或神经性疼痛。后者似乎与自身免疫反应或病毒感染导致的外周神经肌肉系统或中枢神经系统受累有关。此外,慢性疼痛可能是COVID-19本身重症监护病房治疗的并发症(如重症监护获得性肌无力),或是与SARS-CoV-2感染相关的继发性疾病的并发症,包括吉兰-巴雷综合征、多发性神经炎、重症疾病性多发性神经病或脑血管事件后的中枢性疼痛。目前缺乏关于COVID-19临床症状出现后长期疼痛症状及其后果的数据。此外,现有的慢性疼痛可能因医疗保健受限和中断以及COVID-19大流行带来的心理负担而加重。医疗服务提供者应在COVID-19期间及之后对疼痛保持警惕。

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