Pain paths among post‐COVID‐19 condition subjects: A prospective cross‐sectional study with in‐person evaluation

Abstract

Background: New-onset chronic pain has been acknowledged as part of the post-COVID-19 condition. However, available fine-grained data about its clinical phenotype, trajectories and main associated characteristics remain scarce. We described the distinct temporal evolutions of post-COVID-19 pain and their epidemiological and phenotypical features. Methods: A prospective cross-sectional study enrolled post-COVID-19 condition patients (i.e. who had persisting COVID-19-related symptoms over 30 days since their first positive laboratory test), whose COVID-19 diagnosis had been supported by RT-PCR of oral/nasopharyngeal swab or serology. They underwent in-person evaluations with a structured interview, pain and quality-of-life-related questionnaires and thorough physical examination. Chronic pain (CP) and probable neuropathic pain (NP) were defined according to IASP criteria. Results:The present study included 226 individuals, 177 (78.3%) of whom presented over 3 months since their first COVID-19 symptom. New-onset pain occurred in 170 (75.2%) participants and was chronic in 116 (68.2%). A chronic course was associated with COVID-19-related hospitalization, new-onset fatigue, lower cognitive performance, motor and thermal sensory deficits, mood and sleep impairments and overall lower quality-of-life levels. Probable NP occurred in only 7.6% new-onset pain patients, and was associated with pain chronification, new-onset fatigue, motor and thermal sensory deficits, mechanical allodynia and lower rates of SARS-CoV-2 vaccination. Previous CP was reported by 86 (38.1%) individuals and had aggravated after the infection in 66 (76.7%) of them, which was associated with orthostatic hypotension. Conclusions: Post-COVID pain phenomena follow different paths, which are associated with specific clinical and epidemiological features, and possibly distinct underlying mechanisms, prognostic and therapeutic implications. Significance: COVID-19-related pain usually follows a chronic course and is non-neuropathic. Its possible courses and phenotypes are associated with distinct

Pain associated with COVID-19 vaccination is unrelated to skin biopsy abnormalities

“…Previous studies indicated that pain associated with long COVID syndrome affects lower limbs or has a widespread distribution in a considerable proportion of patients. 19,30 Three patients had a sars-cov-2 infection more than 3 months before vaccination. Although we cannot exclude that a previous infection may influence generalized sensory symptoms and pain associated with vaccine, these 3 patients had spared QST variables and did not differ from the other patients in clinical variables.…”

Pain in Parkinson disease: mechanistic substrates, main classification systems, and how to make sense out of them

“…68,71 This is also valid for systemic disease, which may affect motor and somatosensory systems in different proportions leading to different types of pain syndromes. 5,63,80,82,101,118 1.2. Pain as a nonmotor symptom of Parkinson disease Motor parkinsonism (also known as akinetic rigid syndrome) is defined by the presence of bradykinesia (ie, the slowness and decrement in amplitude or speed of movement) in combination with rigidity (ie, the increased muscle tonus on slow passive movement of major joints), rest tremor (ie, 4-6 Hz tremor in the fully resting limb, which is frequently suppressed during movement initiation), or both.…”

“…68,71 This is also valid for systemic disease, which may affect motor and somatosensory systems in different proportions leading to different types of pain syndromes. 5,63,80,82,101,118…”

Investigating the fluctuating nature of post-COVID pain symptoms in previously hospitalized COVID-19 survivors: the LONG-COVID-EXP multicenter study

“…8,15 In addition, it is notable to remark that studies investigating post-COVID pain but within an overall post-COVID-19 condition have reported lower prevalence rates (10%-20%) than those studies specifically investigating just post-COVID pain (40%-60%). 1,6,17,30,36 It should be also considered that most studies investigating post-COVID pain symptoms have used cross-sectional designs because they assessed the presence of pain just at one follow-up period. 1,6,8,15,17,30,36 Understanding the long-term evolution of post-COVID pain symptomatology may have implications for optimizing patient treatment care, public health outcomes, and for informing patients.…”

“…8,15 In addition, it is notable to remark that studies investigating post-COVID pain but within an overall post-COVID-19 condition have reported lower prevalence rates (10%-20%) than those studies specifically investigating just post-COVID pain (40%-60%). 1,6,17,30,36…”