Soares Felipe Henriques Carvalho, Kubota Gabriel Taricani, Fernandes Ana Mércia, Hojo Bruno, Couras Catarina, Costa Bárbara Venturoti, Lapa Jorge Dornellys da Silva, Braga Luíza Mansur, Almeida Matheus Merula de, Cunha Pedro Henrique Martins da, Pereira Vítor Hugo Honorato, Morais Adriano Donizeth Silva de, Teixeira Manoel Jacobsen, Ciampi de Andrade Daniel
Pain Center, Department of Neurology, University of São Paulo, São Paulo, Brazil.
Pain Center, Instituto do Câncer do Estado de São Paulo Octavio Frias de Oliveira, University of São Paulo, São Paulo, Brazil.
Eur J Pain. 2021 Jul;25(6):1342-1354. doi: 10.1002/ejp.1755. Epub 2021 Apr 8.
We assessed whether COVID-19 is associated with de novo pain and de novo chronic pain (CP).
This controlled cross-sectional study was based on phone interviews of patients discharged from hospital after COVID-19 compared to the control group composed of individuals hospitalized during the same period due to non-COVID-19 causes. Patients were classified as having previous CP based on the ICD-11/IASP criteria, de novo pain (i.e. any new type of pain, irrespective of the pain status before hospital stay), and de novo CP (i.e. persistent or recurring de novo pain, lasting more than 3 months) after COVID-19. We assessed pain prevalence and its characteristics, including headache profile, pain location, intensity, interference, and its relationship with fatigue, and persistent anosmia. Forty-six COVID-19 and 73 control patients were included. Both groups had similar sociodemographic characteristics and past medical history.
Length of in-hospital-stay and ICU admission rates were significantly higher amongst COVID-19 survivours, while mechanical ventilation requirement was similar between groups. Pre-hospitalisation pain was lower in COVID-19 compared to control group (10.9% vs. 42.5%; p = 0.001). However, the COVID-19 group had a significantly higher prevalence of de novo pain (65.2% vs. 11.0%, p = 0.001), as well as more de novo headache (39.1%) compared to controls (2.7%, p = 0.001). New-onset CP was 19.6% in COVID-19 patients and 1.4% (p = 0.002) in controls. These differences remained significant (p = 0.001) even after analysing exclusively (COVID: n = 40; controls: n = 34) patients who did not report previous pain before the hospital stay. No statistically significant differences were found for mean new-onset pain intensity and interference with daily activities between both groups. COVID-19 pain was more frequently located in the head/neck and lower limbs (p < 0.05). New-onset fatigue was more common in COVID-19 survivours necessitating inpatient hospital care (66.8%) compared to controls (2.5%, p = 0.001). COVID-19 patients who reported anosmia had more new-onset pain (83.3%) compared to those who did not (48.0%, p = 0.024).
COVID-19 was associated with a significantly higher prevalence of de novo CP, chronic daily headache, and new-onset pain in general, which was associated with persistent anosmia.
There exists de novo pain in a substantial number of COVID-19 survivours, and some develop chronic pain. New-onset pain after the infection was more common in patients who reported anosmia after hospital discharge.
我们评估了新型冠状病毒肺炎（COVID-19）是否与新发疼痛和新发慢性疼痛（CP）相关。
这项对照横断面研究基于对COVID-19出院患者的电话访谈，并与同期因非COVID-19原因住院的个体组成的对照组进行比较。根据国际疾病分类第11版/国际疼痛研究协会（ICD-11/IASP）标准，将患者分为既往有CP、COVID-19后新发疼痛（即任何新型疼痛，无论住院前的疼痛状况如何）和新发CP（即持续或反复出现的新发疼痛，持续超过3个月）。我们评估了疼痛患病率及其特征，包括头痛类型、疼痛部位、强度、干扰情况，以及其与疲劳和持续性嗅觉丧失的关系。纳入了46例COVID-19患者和73例对照患者。两组在社会人口统计学特征和既往病史方面相似。
COVID-19幸存者的住院时间和重症监护病房（ICU）入住率显著更高，而两组之间的机械通气需求相似。与对照组相比，COVID-19患者住院前疼痛发生率更低（10.9%对42.5%；p = 0.001）。然而，COVID-19组新发疼痛的患病率显著更高（65.2%对11.0%，p = 0.001），与对照组相比，新发头痛也更多（39.1%对2.7%，p = 0.001）。COVID-19患者新发CP为19.6%，对照组为1.4%（p = 0.002）。即使仅分析住院前未报告疼痛的患者（COVID组：n = 40；对照组：n = 34），这些差异仍然显著（p = 0.001）。两组之间新发疼痛的平均强度和对日常活动的干扰在统计学上无显著差异。COVID-19相关疼痛更常见于头颈部和下肢（p < 0.05）。与对照组（2.5%，p = 0.001）相比，需要住院治疗的COVID-19幸存者中新发疲劳更常见（66.8%）。报告嗅觉丧失的COVID-19患者比未报告的患者有更多新发疼痛（83.3%对48.0%，p = 0.024）。
COVID-19与新发CP、慢性每日头痛和总体新发疼痛的患病率显著升高相关，且与持续性嗅觉丧失有关。
大量COVID-19幸存者存在新发疼痛，部分患者发展为慢性疼痛。感染后新发疼痛在出院后报告嗅觉丧失的患者中更常见。
