De novo post-COVID-19 chronic pain: a piece of information about risk factor and clinical features

OBJECTIVE: SARS-CoV-2 infection has been linked with chronic pain, leading to disability and affecting quality of life. Single nucleotide polymorphisms in the Mu-opioid receptor gene, which influence pain intensity, perception, and analgesic response, may contribute to chronic pain development. We compared patients with de novo post-COVID-19 pain with individuals with chronic pain due to knee osteoarthritis (OA) and investigated whether opioid receptor Mu 1 (OPRM1) polymorphisms (rs1799971; rs1799972) were associated with de novo pain.

METHODS: Seventy-one post-COVID-19 pain patients, 113 patients with knee OA, and 157 controls without chronic pain were evaluated using physical examinations, pain assessments, and standardized questionnaires addressing quality of life, cognitive function, emotional status, and sociodemographic data. Opioid receptor Mu 1 polymorphisms were genotyped using the TaqMan Real-Time qPCR. Pain characteristics were compared using the Χ 2 test, while Fisher exact test and logistic regression were applied to assess risk factors and calculated odds ratios.

RESULTS: Although chronic pain intensity was similar between the 2 cohorts, de novo post-COVID-19 pain patients reported higher opioid intake, increased pain sensitivity, and more catastrophic thinking. By contrast, patients with knee OA provided clearer descriptions of their pain and exhibited higher levels of depression and cognitive impairment. Musculoskeletal disorders and lower pain pressure threshold were significantly associated with post-COVID-19 pain development. Although the frequencies of OPRM1-mutated alleles varied between cases and controls, no significant associations were observed.

CONCLUSION: De novo post-COVID-19 pain exhibits different clinical features compared with chronic pain conditions, underscoring the need for tailored management and treatment strategies in this postpandemic scenario.