Clinical Characteristics and Mechanisms of Musculoskeletal Pain in Long COVID

Khoja, O.; Passadouro, Bárbara Silva; Mulvey, Matthew R; Delis, Ioannis; Astill, Sarah; Tan, Ai Lyn; Sivan, Manoj

doi:10.2147/jpr.s365026

Cited by 44 publications

(31 citation statements)

References 98 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Post-COVID articular pain can be treated with non-steroidal anti-inflammatory drugs (NSAIDs) and local steroids with good results [ 31 ], suggesting that these localized, post-COVID arthritic pain symptoms exhibit nociceptive features. Nevertheless, it is important to consider that a large proportion of subjects with post-COVID joint or muscle pain exhibit generalized/widespread symptoms [ 32 ]. This generalized pain pattern may be related to the hypothesis that local connective tissue damage caused by SARS-CoV-2 in patients with joint hypermobility can lead to widespread symptomatology [ 33 ].…”

Section: Phenotyping Post-covid Painmentioning

confidence: 99%

Phenotyping Post-COVID Pain as a Nociceptive, Neuropathic, or Nociplastic Pain Condition

Fernández‐de‐las‐Peñas

Nijs

Neblett

et al. 2022

Biomedicines

View full text Add to dashboard Cite

Pain after an acute Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19) condition (post-COVID pain) is becoming a new healthcare emergency. Precision medicine refers to an evidence-based method of grouping patients based on their diagnostic/symptom presentation and then tailoring specific treatments accordingly. Evidence suggests that post-COVID pain can be categorized as nociceptive (i.e., pain attributable to the activation of the peripheral receptive terminals of primary afferent neurons in response to noxious chemical, mechanical, or thermal stimuli), neuropathic (i.e., pain associated with a lesion or disease of the somatosensory nervous system and limited to a “neuroanatomically plausible” distribution of the system), nociplastic (i.e., pain arising from altered nociception despite no clear evidence of actual or threatened tissue damage causing the activation of peripheral nociceptors or evidence for disease or lesion of the somatosensory system causing the pain), or mixed type (when two pain phenotypes co-exist). Each of these pain phenotypes may require a different treatment approach to maximize treatment effectiveness. Accordingly, the ability to classify post-COVID pain patients into one of these phenotypes would likely be critical for producing successful treatment outcomes. The 2021 International Association for the Study of Pain (IASP) clinical criteria and grading system provide a framework for classifying pain within a precision pain medicine approach. Here we present data supporting the possibility of grouping patients with post-COVID pain into pain phenotypes, using the 2021 IASP classification criteria, with a specific focus on nociplastic pain, which is probably the primary mechanism involved in post-COVID pain. Nociplastic pain, which is usually associated with comorbid symptomology (e.g., poor sleep quality, fatigue, cognitive–emotional disturbances, etc.) and is considered to be more difficult to treat than other pain types, may require a more nuanced multimodal treatment approach to achieve better treatment outcomes.

show abstract

Section: Phenotyping Post-covid Painmentioning

confidence: 99%

Phenotyping Post-COVID Pain as a Nociceptive, Neuropathic, or Nociplastic Pain Condition

Fernández‐de‐las‐Peñas

Nijs

Neblett

et al. 2022

Biomedicines

View full text Add to dashboard Cite

show abstract

“…Potential underlying mechanisms proposed for explaining the development of post-COVID pain include systemic immune cell hyperactivation due to prolonged inflammation, viral toxicity, microvascular injury due to hypercoagulability, as well as psychological factors [ 33 ]. Several of the proinflammatory signaling molecules elevated in COVID-19 due to the cytokine storm impact the skeletal muscle nociception.…”

Section: Discussionmentioning

confidence: 99%

Post-COVID Pain Is Not Associated with Inflammatory Polymorphisms in People Who Had Been Hospitalized by COVID-19

Fernández‐de‐las‐Peñas

Giordano

Dı́az-Gil

et al. 2022

JCM

View full text Add to dashboard Cite

Our aim was to assess the association between four inflammatory polymorphisms with the development of post-COVID pain and to associate these polymorphisms with the clinical pain phenotype in individuals who had been hospitalized by COVID-19. Three potential genotypes of IL-6 (rs1800796), IL-10 (rs1800896), TNF-α (rs1800629), and IFITM3 (rs12252) single nucleotide polymorphisms (SNPs) were obtained from no-stimulated saliva samples from 293 (49.5% female, mean age: 55.6 ± 12.9 years) previously hospitalized COVID-19 survivors by polymerase chain reactions. Pain phenotyping consisted of the evaluation of pain features, sensitization-associated symptoms, anxiety levels, depressive levels, sleep quality, catastrophizing, and kinesiophobia levels in patients with post-COVID pain. Analyses were conducted to associate clinical features with genotypes. One hundred and seventeen (39.9%) patients experienced post-COVID pain 17.8 ± 5.2 months after hospital discharge. No significant differences in the distribution of the genotype variants of any SNPs were identified between COVID-19 survivors with and without post-COVID pain (all, p > 0.47). Similarly, the clinical pain phenotype was not significantly different between patients with and without post-COVID pain since no differences in any variable were observed for any SNPs. In conclusion, four SNPs associated with inflammatory and immune responses did not appear to be associated with post-COVID pain in previously hospitalized COVID-19 survivors. Further, neither of the SNPs were involved in the phenotyping features of post-COVID pain.

show abstract

“…). The incidence rates were different depending on the category of pain, location of pain (sore throat, myalgia, arthralgia, headache, chest pain, and abdominal pain), the severity of infection, long-standing disease, patients-related memory bias, demographic characteristics, and the stages of COVID-19 pandemic development such as emerging of new variants [6][7][8]. For example, Şahin et al [13] found that the prevalence of pain symptoms rose to 82.5% after the diagnosis of COVID-19 infection compare to 40.7% just before the infection.…”

Section: Factors Associated With Neurological and Musculoskeletal Pai...mentioning

confidence: 99%

“…Since the emergence of the SARS-CoV-2 pandemic at the end of 2019, much evidence has increasingly confirmed various painful symptoms during and after COVID-19 infection. The Covid-19 -related neurological, muscular, and skeletal symptoms were among the interests of researchers worldwide intending to reduce the risk of illness [5][6][7][8][9][10][11][12][13][14][15][16][17][18]. The most common experienced muscle pain is skeletal muscle or musculoskeletal pain when the level of "serum creatinine kinase" exceeds 200 U/L [14].…”

Section: Introductionmentioning

confidence: 99%

COVID-19-Related Neurological and Musculoskeletal Pain Symptoms- A Cross-Sectional Study

2022

pnr

View full text Add to dashboard Cite

Background: The neurological and musculoskeletal pain symptoms should be taken seriously when dealing with the acute phase of COVID-19 patients. This study aims to explore the neurological and musculoskeletal pain symptoms among confirmed COVID-19 patients.Methods: A cross-sectional study was conducted from 1st July to 30th August at the Baquba teaching hospital, Diyala province, Iraq. Medical records of one hundred and twenty-three hospitalized COVID-19 patients have been investigated for neurological and musculoskeletal pain symptoms. Descriptive, bivariate, and multiple logistic regression were performed to predict the prevalence of pain symptoms. SPSS version 16 was recruited to analyze the data, and the statistically significant was considered at less than 0.05.Results: The mean age of respondents was 46.38 (+ 12.37). Most of the patients were males (60.2%), with mild severity of COVID-19 (59.3%), had not been vaccinated yet (78.0%), tobacco smokers (38.2%), and had a history of DM (43.3%) and HT (25.4%), respectively. More than half of patients (66, 53.7%) developed at least one pain symptom after confirming the diagnosis of COVID-19 infection. The highest Prevalence of pain symptoms was headache (43.9%), neuropathic pain (34.8%), generalized myalgia (31.8%), polyarthralgia (25.7%), and low back pain (22.7%). In multiple logistic regression, the patients aged 50 years and above (odds ratio (OR) = 10.577, 95% CI: 2.867 to 9.029, P <0.001), males (OR = 3.769, 95% CI: 2.826 to 8.593, P=0.027), presence of comorbidities (OR = 6.407, 95% CI: 1.820 to 3.557, P = 0.004), the severity of COVID-19 (moderate to severe) (OR = 10.229, 95% CI: 2.450 to 6.714, P=0.001), and tobacco smoking (OR = 4.225, 95% CI: 1.160 to 5.390, P=0.029), were significantly associated with the presence of neurological and musculoskeletal pain symptoms (p < 0.001).Conclusion: Much evidence suggests the emergence of neuropathic and musculoskeletal pain symptoms in the acute phase of COVID-19 infection. Therefore, priority should be given to such symptoms when clinicians tried to diagnose COVID-19 patients.

show abstract

Clinical Characteristics and Mechanisms of Musculoskeletal Pain in Long COVID

Cited by 44 publications

References 98 publications

Phenotyping Post-COVID Pain as a Nociceptive, Neuropathic, or Nociplastic Pain Condition

Phenotyping Post-COVID Pain as a Nociceptive, Neuropathic, or Nociplastic Pain Condition

Post-COVID Pain Is Not Associated with Inflammatory Polymorphisms in People Who Had Been Hospitalized by COVID-19

COVID-19-Related Neurological and Musculoskeletal Pain Symptoms- A Cross-Sectional Study

Contact Info

Product

Resources

About