Decrease in pain perception during acute SARS-CoV-2 infection: a case series

Hentsch, Lisa; Stancu, Patrick; Allali, Gilles; Lövblad, Karl‐Olof; Lobrinus, Johannes Alexander; Cocetta, Sara; Pautex, Sophie; Uginet, Marjolaine; Serratrice, Jacques; Coen, Matteo

doi:10.1097/j.pain.0000000000002512

Cited by 3 publications

(3 citation statements)

References 26 publications

(39 reference statements)

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“…From a mechanical hypersensitivity perspective, this model aligns with the somatosensory trajectory, both acute and chronic, of many patients with COVID-19. For example, our findings align with other hypotheses and reports that acute SARS-CoV-2 infection may attenuate existing pain or reduce expected myalgic hypersensitivity due to viral infection ( 60 , 121 ) but may also result in prolonged pain symptoms ( 122 ). This SARS-CoV-2 model was also useful for further identifying core mechanisms across pain models while also potentially providing insights into the viral-mediated nociceptive states that are relevant for drug development.…”

Section: Discussionsupporting

confidence: 91%

SARS-CoV-2 airway infection results in the development of somatosensory abnormalities in a hamster model

et al. 2023

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Although largely confined to the airways, SARS-CoV-2 infection has been associated with sensory abnormalities that manifest in both acute and chronic phenotypes. To gain insight on the molecular basis of these sensory abnormalities, we used the golden hamster model to characterize and compare the effects of infection with SARS-CoV-2 and influenza A virus (IAV) on the sensory nervous system. We detected SARS-CoV-2 transcripts but no infectious material in the cervical and thoracic spinal cord and dorsal root ganglia (DRGs) within the first 24 hours of intranasal virus infection. SARS-CoV-2–infected hamsters exhibited mechanical hypersensitivity that was milder but prolonged compared with that observed in IAV-infected hamsters. RNA sequencing analysis of thoracic DRGs 1 to 4 days after infection suggested perturbations in predominantly neuronal signaling in SARS-CoV-2–infected animals as opposed to type I interferon signaling in IAV-infected animals. Later, 31 days after infection, a neuropathic transcriptome emerged in thoracic DRGs from SARS-CoV-2–infected animals, which coincided with SARS-CoV-2–specific mechanical hypersensitivity. These data revealed potential targets for pain management, including the RNA binding protein ILF3, which was validated in murine pain models. This work elucidates transcriptomic signatures in the DRGs triggered by SARS-CoV-2 that may underlie both short- and long-term sensory abnormalities.

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Section: Discussionsupporting

confidence: 91%

SARS-CoV-2 airway infection results in the development of somatosensory abnormalities in a hamster model

et al. 2023

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“…Indeed, breathlessness is defined as a subjective experience, with physiological and affective manifestations [ 33 ]. Distinct neuronal pathways have been demonstrated for these manifestations, with affective dimensions of breathlessness associated with the limbic system, whereby information from vagal afferents in the lungs projects to the amygdala, medial dorsal areas of the thalamus and the insula [ 63 ]. Importantly, the limbic system is also associated with PTSS [ 64 ], with evidence to suggest that interactions between breathlessness and PTSS may manifest in this emotional neural network.…”

Section: Discussionmentioning

confidence: 99%

The Interactive Effects of Post-Traumatic Stress Symptoms and Breathlessness on Fatigue Severity in Post-COVID-19 Syndrome

Harenwall

Heywood-Everett

Henderson

et al. 2022

JCM

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Background: Post-traumatic stress symptoms (PTSS) and breathlessness have been well documented in the acute phase of COVID-19 as well as in Post-COVID-19 Syndrome (PCS), commonly known as Long-COVID. The present study aimed to explore whether PTSS and breathlessness interact to exacerbate fatigue among individuals recovering from PCS, similar to the effects evidenced in other health conditions that feature respiratory distress.. Methods: Outcome measures were collected from 154 participants reporting persistent fatigue following acute COVID-19 infection who were enrolled in a 7-week rehabilitation course provided by the Primary Care Wellbeing Service (PCWBS) in Bradford District Care NHS Foundation Trust (BDCFT). Results: Hierarchical multiple linear regression revealed that fatigue severity was associated with a significant interaction between PTSS and breathlessness, even when controlling for pre-COVID health related quality of life (HRQoL), age, symptom duration and hospital admittance during the acute phase. Furthermore, improvements in fatigue following rehabilitation were significantly associated with improvements in PTSS. Conclusions: PTSS may be an important therapeutic target in multidisciplinary rehabilitation for reducing fatigue in the recovery from PCS. It is therefore important that treatment for PCS takes a biopsychosocial approach to recovery, putting emphasis on direct and indirect psychological factors which may facilitate or disrupt physical recovery. This highlights the need for all PCS clinics to screen for PTSD and if present, target as a priority in treatment to maximise the potential for successful rehabilitation.

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“…Pain is a hallmark symptom reported in individuals with acute SARS‐CoV‐2 infection, as well as in long‐COVID (Augustin et al, 2021; Carfi et al, 2020). However, a growing number of case studies have reported reductions in chronic disease‐related pain during and following infection with SARS‐CoV‐2 (Hentsch et al, 2021). Further, some evidence exists to suggest an analgesic role for the SARS‐CoV‐2 spike protein via blocking of vascular endothelial growth factor‐A signaling (Moutal et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

Longitudinal observations of sympathetic neural activity and hemodynamics during 6 months recovery from SARS‐CoV ‐2 infection

Stute

Szeghy

Stickford

et al. 2022

Physiological Reports

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Cross‐sectional data indicate that acute SARS‐CoV‐2 infection increases resting muscle sympathetic nerve activity (MSNA) and alters hemodynamic responses to orthostasis in young adults. However, the longitudinal impact of contracting SARS‐CoV‐2 on autonomic function remains unclear. The aim of this study was to longitudinally track MSNA, sympathetic transduction to blood pressure (BP), and hemodynamics over 6 months following SARS‐CoV‐2 infection. Young adults positive with SARS‐CoV‐2 reported to the laboratory three times over 6 months (V1:41 ± 17, V2:108 ± 21, V3:173 ± 16 days post‐infection). MSNA, systolic (SBP) and diastolic (DBP) blood pressure, and heart rate (HR) were measured at rest, during a cold pressor test (CPT), and at 30° head‐up tilt (HUT). Basal SBP (p = 0.019) and DBP (p < 0.001) decreased throughout the 6 months, whereas basal MSNA and HR were not different. Basal sympathetic transduction to BP and estimates of baroreflex sensitivity did not change over time. SBP and DBP were lower during CPT (SBP: p = 0.016, DBP: p = 0.007) and HUT at V3 compared with V1 (SBP: p = 0.041, DBP: p = 0.017), with largely no changes in MSNA. There was a trend toward a visit‐by‐time interaction for burst incidence (p = 0.055) during HUT, wherein at baseline immediately prior to tilting, burst incidence was lower at V3 compared with V1 (p = 0.014), but there were no differences between visits in the 30 HUT position. These results support impairments to cardiovascular health, and potentially autonomic function, which may improve over time. However, the improvements in BP over 6 months recovery from mild SARS‐CoV‐2 infection are likely not a direct result of changes in sympathetic activity.

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Decrease in pain perception during acute SARS-CoV-2 infection: a case series

Abstract: Temporary chronic pain reduction related to acute COVID-19 has been observed, providing new knowledge on the possible mechanisms of pain modulation and potential therapeutic options.

Cited by 3 publications

References 26 publications

SARS-CoV-2 airway infection results in the development of somatosensory abnormalities in a hamster model

SARS-CoV-2 airway infection results in the development of somatosensory abnormalities in a hamster model

The Interactive Effects of Post-Traumatic Stress Symptoms and Breathlessness on Fatigue Severity in Post-COVID-19 Syndrome

Longitudinal observations of sympathetic neural activity and hemodynamics during 6 months recovery from SARS‐CoV ‐2 infection

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