Public Health, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom.
General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom.
Pain. 2023 Jan 1;164(1):84-90. doi: 10.1097/j.pain.0000000000002663. Epub 2022 Apr 22.
The risk of COVID-19 in those with chronic pain is unknown. We investigated whether self-reported chronic pain was associated with COVID-19 hospitalisation or mortality. UK Biobank recruited 502,624 participants aged 37 to 73 years between 2006 and 2010. Baseline exposure data, including chronic pain (>3 months, in at least 1 of 7 prespecified body sites) and chronic widespread pain (>3 months, all over body), were linked to COVID-19 hospitalisations or mortality. Univariable or multivariable Poisson regression analyses were performed on the association between chronic pain and COVID-19 hospitalisation and Cox regression analyses of the associations with COVID-19 mortality. Multivariable analyses adjusted incrementally for sociodemographic confounders, then lifestyle risk factors, and finally long-term condition count. Of 441,403 UK Biobank participants with complete data, 3180 (0.7%) were hospitalised for COVID-19 and 1040 (0.2%) died from COVID-19. Chronic pain was associated with hospital admission for COVID-19 even after adjustment for all covariates (incidence rate ratio 1.16; 95% confidence interval [CI] 1.08-1.24; P < 0.001), as was chronic widespread pain (incidence rate ratio 1.33; 95% CI 1.06-1.66; P = 0.012). There was clear evidence of a dose-response relationship with number of pain sites (fully adjusted global P -value < 0.001). After adjustment for all covariates, there was no association between chronic pain (HR 1.01; 95% CI 0.89-1.15; P = 0.834) but attenuated association with chronic widespread pain (HR 1.50, 95% CI 1.04-2.16, P -value = 0.032) and COVID-19 mortality. Chronic pain is associated with higher risk of hospitalisation for COVID-19, but the association with mortality is unclear. Future research is required to investigate these findings further and determine whether pain is associated with long COVID.
患有慢性疼痛的人感染 COVID-19 的风险尚不清楚。我们研究了自我报告的慢性疼痛是否与 COVID-19 住院或死亡有关。英国生物银行（UK Biobank）在 2006 年至 2010 年期间招募了 502624 名年龄在 37 至 73 岁之间的参与者。基线暴露数据，包括慢性疼痛（>3 个月，至少在 7 个预设身体部位中的 1 个部位）和慢性广泛疼痛（>3 个月，全身），与 COVID-19 住院或死亡相关。对慢性疼痛与 COVID-19 住院之间的关联进行单变量或多变量泊松回归分析，对与 COVID-19 死亡率相关的关联进行 Cox 回归分析。多变量分析逐步调整社会人口统计学混杂因素，然后是生活方式危险因素，最后是长期疾病计数。在有完整数据的 441403 名英国生物银行参与者中，有 3180 人（0.7%）因 COVID-19 住院，1040 人（0.2%）死于 COVID-19。即使在调整了所有协变量后，慢性疼痛也与 COVID-19 住院有关（发病率比 1.16；95%置信区间 [CI] 1.08-1.24；P <0.001），慢性广泛性疼痛也是如此（发病率比 1.33；95%CI 1.06-1.66；P = 0.012）。随着疼痛部位数量的增加，存在明显的剂量反应关系（完全调整后的全局 P 值<0.001）。在调整了所有协变量后，慢性疼痛与 COVID-19 死亡率之间没有关联（HR 1.01；95%CI 0.89-1.15；P = 0.834），但与慢性广泛性疼痛的关联减弱（HR 1.50，95%CI 1.04-2.16，P 值=0.032）。慢性疼痛与 COVID-19 住院风险增加有关，但与死亡率的关系尚不清楚。需要进一步研究这些发现，并确定疼痛是否与长期 COVID 有关。
