Loewenstein Rehabilitation Medical Center, Ra'anana, Israel.
Israel Defense Forces Medical Corps, Ramat Gan, Israel.
Pain Pract. 2024 Jan;24(1):120-159. doi: 10.1111/papr.13277. Epub 2023 Jul 21.
Individuals recovering from acute COVID-19 episodes may continue to suffer from various ongoing symptoms, collectively referred to as Long-COVID. Long-term pain symptoms are amongst the most common and clinically significant symptoms to be reported for this post-COVID-19 syndrome.
This systematic review and meta-analysis aimed to evaluate the proportions of persisting pain symptoms experienced by individuals past the acute phase of COVID-19 and to identify their associated functional consequences and inflammatory correlates.
Two online databases were systematically searched from their inception until 31 March 2022. We searched primary research articles in English, which evaluated individuals after laboratory-confirmed COVID-19 acute phase resolution and specifically reported on pain symptoms and their inflammatory and/or functional outcomes.
Of the 611 identified articles, 26 were included, used for data extraction, and assessed for their methodological quality and risk of bias by two independent reviewers. Pain symptoms were grouped under one of six major pain domains, serving as our primary co-outcomes. Proportional meta-analyses of pooled logit-transformed values of single proportions were performed using the random-effects-restricted maximum-likelihood model. An estimated 8%, 6%, 18%, 18%, 17%, and 12% of individuals continued to report the persistence of chest, gastrointestinal, musculoskeletal joint, musculoskeletal muscle, general body, and nervous system-related pain symptoms, respectively, for up to one year after acute phase resolution of COVID-19. Considerable levels of heterogeneity were demonstrated across all results. Functional and quality-of-life impairments and some inflammatory biomarker elevations were associated with the persistence of long-COVID pain symptoms.
This study's findings suggest that although not well characterized, long-COVID pain symptoms are being experienced by non-negligible proportions of those recovering from acute COVID-19 episodes, thus highlighting the importance of future research efforts to focus on this aspect.
从急性 COVID-19 发作中恢复的个体可能会继续遭受各种持续存在的症状，这些症状统称为“长新冠”。长期疼痛症状是这种新冠后综合征中最常见和临床上最重要的报告症状之一。
本系统评价和荟萃分析旨在评估急性 COVID-19 后个体持续存在疼痛症状的比例，并确定其相关的功能后果和炎症相关性。
从成立之初到 2022 年 3 月 31 日，我们系统地在两个在线数据库中进行了搜索。我们搜索了以英语发表的评估实验室确诊的 COVID-19 急性阶段缓解后个体的原始研究文章，并特别报告了疼痛症状及其炎症和/或功能结果。
在 611 篇确定的文章中，有 26 篇被纳入，用于数据提取，并由两名独立的审查员评估其方法学质量和偏倚风险。疼痛症状分为六大主要疼痛领域之一，作为我们的主要次要结果。使用随机效应限制最大似然模型对单个比例的对数转换值进行比例荟萃分析。在 COVID-19 急性阶段缓解后长达一年的时间里，估计有 8%、6%、18%、18%、17%和 12%的个体继续报告存在胸部、胃肠道、肌肉骨骼关节、肌肉骨骼肌肉、全身和神经系统相关的疼痛症状。所有结果均表现出相当大的异质性。功能和生活质量受损以及一些炎症生物标志物升高与长新冠疼痛症状的持续存在相关。
本研究的结果表明，尽管尚未得到很好的描述，但从急性 COVID-19 发作中恢复的个体中，相当比例的人正在经历长新冠疼痛症状，因此强调未来研究工作应重点关注这一方面。
