Ketenci Ayşegül, Zure Mert, Akpınar Fatma Merih, Soluk Özdemir Yelda, Balbaloğlu Özlem, Akaltun Mazlum Serdar, Erden Ender, Çağlıyan Türk Ayla, Korkmaz Merve Damla, Metin Ökmen Burcu, Altındağ Özlem, Soyupek Feray, Yakşi Elif, Sindel Dilşad, Sezgin Nalan, Ustaömer Kübra, Kesiktaş Fatma Nur, Dere Didem, Güneş Şevket, Medin Ceylan Cansın, Sonel Tur Birkan, Evcik Deniz
Department of Physical Medicine and Rehabilitation, Koç University Hospital, Istanbul, Türkiye.
Department of Physical Therapy and Rehabilitation, Istanbul Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Türkiye.
Turk J Phys Med Rehabil. 2024 Feb 1;70(1):30-38. doi: 10.5606/tftrd.2024.13828. eCollection 2024 Mar.
This study aims to accurately evaluate pain lasting longer than three months and falls under the category of chronic pain and to determine the risk factors to follow up and treat properly and to develop appropriate diagnostic and treatment algorithms.
Between March 2021 and December 2021, a total of 437 patients (162 males, 275 females; mean age: 44±14.6 years; range, 12 to 82 years) who were referred to the participating centers due to pain complaints and were diagnosed with post-COVID-19 condition according to the criteria defined by the World Health Organization (WHO) were included in the study. The patients were divided into three groups as nociceptive pain, neuropathic pain, and central sensitization, based on the physician's clinical evaluation and the Self-Report Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) and Central Sensitization Inventory scores.
The most common diagnosis was nociceptive pain followed by central sensitization. Patients with nociceptive pain had less pain. It was found that not exercising regularly, having a chronic disease and being a woman were risk factors for central sensitization, having thyroid disease before COVID-19, and defining the current pain as very severe were risk factors for neuropathic pain.
In the evaluation of post-COVID-19 pain, neuropathic pain and central sensitization should be also considered in addition to nociceptive pain and the severity of pain, systemic diseases and physical activity should be questioned.
本研究旨在准确评估持续超过三个月且属于慢性疼痛范畴的疼痛，并确定后续需妥善随访和治疗的风险因素，以及制定合适的诊断和治疗方案。
在2021年3月至2021年12月期间，共有437例患者（162例男性，275例女性；平均年龄：44±14.6岁；年龄范围12至82岁）因疼痛主诉被转诊至参与研究的中心，并根据世界卫生组织（WHO）定义的标准被诊断为新冠后状况，纳入本研究。根据医生的临床评估以及利兹神经病理性症状和体征自评量表（S-LANSS）和中枢敏化量表评分，将患者分为伤害性疼痛、神经病理性疼痛和中枢敏化三组。
最常见的诊断是伤害性疼痛，其次是中枢敏化。伤害性疼痛患者的疼痛程度较轻。发现不定期锻炼、患有慢性病和女性是中枢敏化的危险因素，新冠前患有甲状腺疾病以及将当前疼痛定义为非常严重是神经病理性疼痛的危险因素。
在评估新冠后疼痛时，除伤害性疼痛外，还应考虑神经病理性疼痛和中枢敏化，并且应询问疼痛的严重程度、全身性疾病和身体活动情况。
