School of Medicine, Center for Neuroplasticity and Pain, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark -
School of Medicine, Center for Neuroplasticity and Pain, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
Minerva Anestesiol. 2023 Dec;89(12):1134-1142. doi: 10.23736/S0375-9393.23.17471-2.
The Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) has provoked billions of infections worldwide. Several meta-analyses have observed that up to 50% of individuals who had survived to a SARS-CoV-2 acute infection suffer from post-COVID symptoms lasting for weeks or months and up to one year after infection. The prevalence of post-COVID pain ranges between 10% to 20% when assessed with other overall post-COVID symptoms and can reach up to 50% to 60% when investigated specifically. The most common musculoskeletal manifestations of post-COVID-19 condition include fatigue, myalgia, arthralgia or back pain. Despite pain of musculoskeletal origin is one of the most prevalent post-COVID pain symptoms, the exact pathophysiological mechanisms of musculoskeletal post-COVID pain are not completely understood. Studies have reported the complexity of post-COVID pain including immune, biological, and psychological factors, and more recently, they have suggested that genetic and epigenetic factors may also play a potential role, highlighting the need for further investigation into these mechanisms. Its management is still controversial, as no specific guideline for treating musculoskeletal post-COVID pain has been proposed with only general consideration about the relevance of multidisciplinary and multimodal treatment approaches. In this paper we will highlight the clinical features, the mechanism, and the management possibilities of musculoskeletal post-COVID pain.
由严重急性呼吸系统综合症冠状病毒 2 型（SARS-CoV-2）引起的 2019 年冠状病毒病（COVID-19）在全球范围内引发了数十亿例感染。几项荟萃分析观察到，多达 50%的在 SARS-CoV-2 急性感染中幸存下来的个体患有持续数周或数月且感染后长达一年的 COVID 后症状。当与其他整体 COVID 后症状一起评估时，COVID 后疼痛的患病率在 10%至 20%之间，当专门调查时，可达到 50%至 60%。COVID-19 后状况的最常见肌肉骨骼表现包括疲劳、肌痛、关节痛或背痛。尽管肌肉骨骼源性疼痛是最常见的 COVID 后疼痛症状之一，但肌肉骨骼 COVID 后疼痛的确切病理生理机制尚不完全清楚。研究报告了 COVID 后疼痛的复杂性，包括免疫、生物和心理因素，最近，他们还提出遗传和表观遗传因素也可能发挥潜在作用，突出了需要进一步研究这些机制。其管理仍存在争议，因为没有提出针对肌肉骨骼 COVID 后疼痛的具体治疗指南，仅一般性地考虑了多学科和多模式治疗方法的相关性。在本文中，我们将重点介绍肌肉骨骼 COVID 后疼痛的临床特征、机制和治疗可能性。
