Persistent pain and associated risk factors in previously hospitalized COVID-19 survivors: data from an Italian cross-sectional study

BACKGROUND: The aim of this study was to investigate the prevalence and the characterization of post-COVID pain in an Italian cohort of previously hospitalized COVID-19 survivors. Furthermore, the study investigated risk factors for the presence of post-COVID pain at one year after the hospitalization.

METHODS: Subjects who agreed to participate received a telephonic interview, and if meeting the inclusion criteria, they were scheduled for a clinical assessment for post-COVID pain characteristics. They also fulfilled several questionnaires: the Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index, Central Sensitization Inventory (CSI), pain detect, Tampa Scale of Kinesiophobia, and Pain Catastrophizing Scale.

RESULTS: A sample of 246 subjects was included (36.6% women, age: 60.7± 14.5 years). Post-COVID pain prevalence was 26.2% (65 subjects), with musculoskeletal pain being the most common type (40 subjects, 16.2%). The multivariate analysis revealed that the number of post-COVID symptoms (WL=0.82, P<0.001), previous musculoskeletal pain (WL=0.82, P<0.001), HADS-D (WL=0.87, P<0.001), CSI (WL=0.84, P<0.001), obesity (WL=0.83, P=0.02), and previous neuropathic pain (WL=0.82, P=0.02) were risk factors associated with the presence of post-COVID pain. The model was able to correctly classify the 75.6% of post-COVID pain subjects and explained that 23% of the developing of post-COVID pain depends on the determined risk factors.

CONCLUSIONS: The results of this study confirmed that post-COVID pain may still be present 18 months one year after the hospitalization, and several risk factors may be identified. These results underline that post-COVID pain may still be affecting COVID-19 survivors after 18 months, representing a major social health problem.