Gümüş Atalay Sevgi, Borman Pınar, Yaman Ayşegül, Yaşar Evren
Department of Physical Medicine and Rehabilitation, University of Health Sciences, Ankara City Hospital, Ankara, Türkiye.
Department of Physical Medicine and Rehabilitation, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Türkiye.
Arch Rheumatol. 2024 Aug 26;39(3):436-446. doi: 10.46497/ArchRheumatol.2024.9990. eCollection 2024 Sep.
This study aimed to evaluate the neuropathic component of chronic musculoskeletal pain in post-coronavirus disease 2019 (COVID-19) and examine the relationship between neuropathic pain and clinical and demographic characteristics.
This cross-sectional study included 163 adult patients (85 females, 78 males; mean age: 41.7±4.3 years; range, 22 to 50 years) with post-COVID-19 musculoskeletal pain between February 1, 2021, and April 30, 2021. Demographic and clinical characteristics, including age, sex, affected site, duration, and severity of post-COVID-19 musculoskeletal pain using the Visual Analog Scale (VAS), as well as a neuropathic component of pain using the Leeds assessment of neuropathic symptoms and signs (LANSS), were collected. The most common post-COVID-19 symptoms, presence of hospitalization, and length of hospital stay during active COVID-19 infection were recorded from the patient records.
The mean duration and severity of pain were 7.85±1.53 months and 5.09±1.95, respectively. Half of the patients were hospitalized, and the mean length of hospital stay was 12.15±18.06 days. The most common pain sites were upper and lower back pain, followed by leg and arm pain. A total of 92 (56.4%) patients had previously received pharmacological or nonpharmacological treatment for post-COVID-19 musculoskeletal pain. Based on the LANSS (scores >12), 31 (19%) patients had neuropathic pain. There was a significant correlation between the presence of neuropathic pain and pulmonary involvement/symptoms. The presence and length of hospital stay were correlated with LANNS scores (p<0.05). The frequency, LANSS scores, and VAS-pain scores of the patients with and without neuropathic pain were similar between male and female patients (p>0.05).
The neuropathic component of chronic musculoskeletal pain may be common, as one-fifth of our patients had neuropathic pain as assessed by the LANNS. Therefore, the awareness of post-COVID-19 chronic neuropathic musculoskeletal pain should be increased. We believe that focusing on the identification of pain phenotypes would provide adequate and tailored chronic neuropathic musculoskeletal pain management in the post-COVID-19 period.
本研究旨在评估2019冠状病毒病（COVID-19）后慢性肌肉骨骼疼痛的神经病理性成分，并研究神经病理性疼痛与临床及人口统计学特征之间的关系。
这项横断面研究纳入了2021年2月1日至2021年4月30日期间患有COVID-19后肌肉骨骼疼痛的163例成年患者（85例女性，78例男性；平均年龄：41.7±4.3岁；范围22至50岁）。收集了人口统计学和临床特征，包括年龄、性别、受累部位、COVID-19后肌肉骨骼疼痛的持续时间和严重程度（使用视觉模拟量表[VAS]），以及使用利兹神经病理性症状和体征评估（LANSS）评估的疼痛的神经病理性成分。从患者记录中记录了最常见的COVID-19后症状、是否住院以及COVID-19活跃感染期间的住院时间。
疼痛的平均持续时间和严重程度分别为7.85±1.53个月和5.09±1.95。一半的患者曾住院，平均住院时间为12.15±18.06天。最常见的疼痛部位是上背部和下背部疼痛，其次是腿部和手臂疼痛。共有92例（56.4%）患者曾接受过针对COVID-19后肌肉骨骼疼痛的药物或非药物治疗。根据LANSS（评分>12），31例（19%）患者有神经病理性疼痛。神经病理性疼痛的存在与肺部受累/症状之间存在显著相关性。住院与否及住院时间与LANNS评分相关（p<0.05）。有神经病理性疼痛和无神经病理性疼痛患者的频率、LANSS评分和VAS疼痛评分在男性和女性患者之间相似（p>0.05）。
慢性肌肉骨骼疼痛的神经病理性成分可能很常见，因为根据LANNS评估，我们五分之一的患者有神经病理性疼痛。因此，应提高对COVID-19后慢性神经病理性肌肉骨骼疼痛的认识。我们认为，关注疼痛表型的识别将为COVID-19后时期提供充分且个性化的慢性神经病理性肌肉骨骼疼痛管理。
