Khoja Omar, Silva-Passadouro Bárbara, Cristescu Elena, McEwan Katie, Doherty Derek, O'Connell Fiona, Ponchel Frederique, Mulvey Matthew, Astill Sarah, Tan Ai Lyn, Sivan Manoj
Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.
Leeds Teaching Hospitals NHS Trust, Chapel Allerton Hospital, Leeds, UK.
J Pain Res. 2024 Jul 31;17:2531-2550. doi: 10.2147/JPR.S466294. eCollection 2024.
New-onset chronic musculoskeletal (MSK) pain is one of the common persistent symptoms in Long COVID (LC). This study investigated its clinical characteristics, underlying mechanisms, and impact on function, psychological health, and quality of life.
Thirty adults (19 female, 11 male) with LC and new-onset chronic MSK pain underwent clinical examination, Quantitative Sensory Testing (QST), and blood tests for inflammatory markers and completed the following outcome measures: Timed Up and Go test (TUG), handgrip strength test, COVID-19 Yorkshire Rehabilitation Scale (C19-YRS), Brief Pain Inventory (BPI), Pain Self-Efficacy Questionnaire (PSEQ), Pain Catastrophizing Scale (PCS), International Physical Activity Questionnaire-short form (IPAQ-sf), Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9), and EuroQol Five Dimensions health-related quality of life (EQ-5D-5L).
New-onset chronic MSK pain was widespread and continuous in nature, and worse in the joints. When compared to normative values reported in the literature: a) QST revealed mechanical hyperalgesia, heightened temporal summation of pain, and hypoesthesia to vibration stimuli, which is strongly suggestive of central sensitization; b) Plasma cytokine assays indicated distinct pro-inflammatory profiles; c) TUG time indicated reduced balance and mobility; d) handgrip strength revealed general weakness; e) physical activity was lower; and f) there were moderate levels of depression and anxiety with lower self-efficacy scores and lower levels of pain catastrophizing. LC symptoms were of moderate severity (44.8/100), moderate functional disability (22.8/50) and severely compromised overall health (2.6/10) when compared to pre-COVID scores.
New-onset chronic MSK pain in LC tends to be widespread, constant, and associated with weakness, reduced function, depression, anxiety, and reduced quality of life. There is associated central sensitization and proinflammatory state in the condition. Further research is essential to explore the longitudinal progression and natural evolution of the new-onset chronic MSK pain in LC.
新发慢性肌肉骨骼（MSK）疼痛是长新冠（LC）常见的持续症状之一。本研究调查了其临床特征、潜在机制以及对功能、心理健康和生活质量的影响。
30名患有长新冠且新发慢性肌肉骨骼疼痛的成年人（19名女性，11名男性）接受了临床检查、定量感觉测试（QST）以及炎症标志物血液检测，并完成了以下结局指标评估：计时起立行走测试（TUG）、握力测试、新冠-约克郡康复量表（C19-YRS）、简明疼痛量表（BPI）、疼痛自我效能问卷（PSEQ）、疼痛灾难化量表（PCS）、国际体力活动问卷简表（IPAQ-sf）、广泛性焦虑障碍量表（GAD-7）、患者健康问卷（PHQ-9）以及欧洲五维健康相关生活质量量表（EQ-5D-5L）。
新发慢性肌肉骨骼疼痛具有广泛性和持续性，在关节处更为严重。与文献报道的标准值相比：a）定量感觉测试显示存在机械性痛觉过敏、疼痛时间总和增加以及对振动刺激感觉减退，强烈提示中枢敏化；b）血浆细胞因子检测显示出不同的促炎特征；c）计时起立行走测试时间表明平衡和活动能力下降；d）握力显示普遍虚弱；e）体力活动水平较低；f）存在中度抑郁和焦虑，自我效能得分较低，疼痛灾难化程度较低。与新冠前得分相比，长新冠症状的严重程度为中度（44.8/100），功能残疾为中度（22.8/50），总体健康严重受损（2.6/10）。
长新冠中的新发慢性肌肉骨骼疼痛往往具有广泛性、持续性，且与虚弱、功能减退、抑郁、焦虑以及生活质量下降相关。该病症存在相关的中枢敏化和促炎状态。进一步研究对于探索长新冠中新发慢性肌肉骨骼疼痛的纵向进展和自然演变至关重要。
