新型冠状病毒感染的急性后遗症与神经性疼痛:文献综述及未来方向

Post-acute sequelae SARS-CoV-2 infection and neuropathic pain: a narrative review of the literature and future directions.

作者信息

Vu Peter D, Abdi Salahadin

机构信息

The Department of Physical Medicine & Rehabilitation, TIRR Memorial Hermann., McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA.

The Department of Pain Medicine, Division of Anesthesiology, Critical Care & Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

出版信息

Pain Manag. 2025 Jun;15(6):333-343. doi: 10.1080/17581869.2025.2501521. Epub 2025 May 14.

Abstract

PURPOSE OF REVIEW

Neuropathic pain is a recognized and debilitating symptom of SARS-CoV-2 infection across acute, post-acute, and long-COVID phases. Initially emerging as acute or subacute symptoms, these neuropathic manifestations can evolve into chronic conditions, with approximately 10% of all SARS-CoV-2 cases (estimated 65 million individuals globally) developing post-acute SARS-CoV-2 (PASC) neuropathic sequalae. Given the limited literature specifically addressing neuropathic pain related to PASC, a deeper understanding is needed to improve management and reduce patient burden.

RECENT FINDINGS

PASC symptoms are associated with disease severity, elevated body mass indexes, preexisting psychological conditions, and addiction history. Sex differences appear to influence prevalence, and the multisystem nature of PASC complicates symptom presentation, with mood disorders, fatigue, and cognitive dysfunction contributing to altered pain perception. Proposed mechanisms include immune dysregulation, persistent viral protein effects, and neuroanatomical changes. Management typically involves a multimodal approach.

SUMMARY

This review examines SARS-CoV-2 neuropathic pain across the illness trajectory, examining its pathophysiology, prevalence, and treatment. It highlights the potential for subacute neuropathic symptoms to become chronic and calls for future research to refine long-term management strategies and assess broader healthcare implications.

摘要

综述目的

神经性疼痛是新冠病毒感染在急性期、急性后期和长期新冠阶段公认的使人衰弱的症状。这些神经性表现最初以急性或亚急性症状出现,可发展为慢性疾病,在所有新冠病毒病例中约10%(全球估计有6500万人)会出现急性后期新冠病毒感染(PASC)的神经性后遗症。鉴于专门针对与PASC相关的神经性疼痛的文献有限,需要更深入的了解以改善管理并减轻患者负担。

最新发现

PASC症状与疾病严重程度、体重指数升高、既往心理状况和成瘾史有关。性别差异似乎会影响患病率,且PASC的多系统性质使症状表现复杂化,情绪障碍、疲劳和认知功能障碍会导致疼痛感知改变。提出的机制包括免疫失调、持续的病毒蛋白作用和神经解剖学变化。管理通常采用多模式方法。

总结

本综述研究了新冠病毒感染病程中的神经性疼痛,探讨了其病理生理学、患病率和治疗方法。它强调了亚急性神经性症状发展为慢性的可能性,并呼吁未来开展研究以完善长期管理策略并评估更广泛的医疗影响。

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