Matei Daniela, Traistaru Rodica, Amzolini Anca Maria, Ianosi Laura Simona, Neagoe Carmen Daniela, Mitrea Adina, Clenciu Diana, Avramescu Taina Elena
Department of Medical Rehabilitation, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania.
Department Medical Semiology, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania.
Life (Basel). 2024 Jul 27;14(8):942. doi: 10.3390/life14080942.
Significant gaps remain in the understanding of the etiology and pathogenesis of fibromyalgia (FM), and the COVID-19 pandemic has introduced even more unknowns. Social factors specific to that period, the viral infection itself, and/or vaccination are additional elements that can complicate the progression of the disease or the response to treatment. Aim: The primary hypothesis to be evaluated in this study is that an acute COVID-19 infection, even when considered recovered, may induce changes in the response to non-pharmacological treatment in FM patients, particularly concerning pain. Results: We included 128 patients diagnosed with FM before the pandemic began. The patients were divided based on their history of acute SARS-CoV-2 infection and COVID-19 vaccination status. All patients followed the same rehabilitation program (cognitive therapy, kinesitherapy). Perceived pain: The non-COVID-19 patient groups showed a statistically significant reduction in pain at the final evaluation compared to patients with a history of acute SARS-CoV-2 infection ( < 0.001). Algometric evaluation: Patients without COVID-19 infection and that were vaccinated exhibited the best improvement in pain threshold, both across evaluation times ( < 0.001) and compared to any of the other three groups studied ( < 0.001). Using the WHYMPI questionnaire, the same group of patients (those not having experienced acute COVID-19 and who were vaccinated) was the only group with a statistically significant improvement in pain severity ( = 0.009). In conclusion, to control and improve FM pain symptoms, in addition to appropriate medication, we propose paying additional attention to the history of acute SARS-CoV-2 infection and the COVID-19 vaccination status.
在纤维肌痛(FM)的病因和发病机制的理解方面仍存在重大差距,而新冠疫情又带来了更多未知因素。该时期特有的社会因素、病毒感染本身和/或疫苗接种是可能使疾病进展或治疗反应复杂化的额外因素。目的:本研究中要评估的主要假设是,即使被认为已康复,急性新冠病毒感染也可能导致FM患者对非药物治疗的反应发生变化,尤其是在疼痛方面。结果:我们纳入了128名在疫情开始前被诊断为FM的患者。这些患者根据其急性SARS-CoV-2感染史和新冠疫苗接种状况进行分组。所有患者都遵循相同的康复计划(认知疗法、运动疗法)。疼痛感知:与有急性SARS-CoV-2感染史的患者相比,非新冠患者组在最终评估时疼痛有统计学显著降低(<0.001)。压痛计评估:未感染新冠且接种疫苗的患者在疼痛阈值方面表现出最佳改善,在各个评估时间均如此(<0.001),并且与其他三组研究对象相比也是如此(<0.001)。使用WHYMPI问卷,同一组患者(未经历过急性新冠且接种疫苗的患者)是唯一在疼痛严重程度上有统计学显著改善的组(=0.009)。总之,为了控制和改善FM疼痛症状,除了适当用药外,我们建议额外关注急性SARS-CoV-2感染史和新冠疫苗接种状况。