Prevalence and characteristics of new-onset pain in COVID-19 survivours, a controlled study

Felipe Henriques Carvalho Soares, Gabriel Taricani Kubota, Ana Mércia Fernandes, Bruno Hojo, Catarina Couras, Bárbara Venturoti Costa, Jorge Dornellys da Silva Lapa, Luíza Mansur Braga, Matheus Merula de Almeida, Pedro Henrique Martins da Cunha, Vítor Hugo Honorato Pereira, Adriano Donizeth Silva de Morais, Manoel Jacobsen Teixeira, Daniel Ciampi de Andrade, “Pain in the Pandemic Initiative Collaborators”

Research output: Contribution to journalJournal articleResearchpeer-review

69 Citations (Scopus)

Abstract

BACKGROUND: We assessed whether COVID-19 is associated with de novo pain and de novo chronic pain (CP).

METHODS: This controlled cross-sectional study was based on phone interviews of patients discharged from hospital after COVID-19 compared to the control group composed of individuals hospitalized during the same period due to non-COVID-19 causes. Patients were classified as having previous CP based on the ICD-11/IASP criteria, de novo pain (i.e. any new type of pain, irrespective of the pain status before hospital stay), and de novo CP (i.e. persistent or recurring de novo pain, lasting more than 3 months) after COVID-19. We assessed pain prevalence and its characteristics, including headache profile, pain location, intensity, interference, and its relationship with fatigue, and persistent anosmia. Forty-six COVID-19 and 73 control patients were included. Both groups had similar sociodemographic characteristics and past medical history.

RESULTS: Length of in-hospital-stay and ICU admission rates were significantly higher amongst COVID-19 survivours, while mechanical ventilation requirement was similar between groups. Pre-hospitalisation pain was lower in COVID-19 compared to control group (10.9% vs. 42.5%; p = 0.001). However, the COVID-19 group had a significantly higher prevalence of de novo pain (65.2% vs. 11.0%, p = 0.001), as well as more de novo headache (39.1%) compared to controls (2.7%, p = 0.001). New-onset CP was 19.6% in COVID-19 patients and 1.4% (p = 0.002) in controls. These differences remained significant (p = 0.001) even after analysing exclusively (COVID: n = 40; controls: n = 34) patients who did not report previous pain before the hospital stay. No statistically significant differences were found for mean new-onset pain intensity and interference with daily activities between both groups. COVID-19 pain was more frequently located in the head/neck and lower limbs (p < 0.05). New-onset fatigue was more common in COVID-19 survivours necessitating inpatient hospital care (66.8%) compared to controls (2.5%, p = 0.001). COVID-19 patients who reported anosmia had more new-onset pain (83.3%) compared to those who did not (48.0%, p = 0.024).

CONCLUSION: COVID-19 was associated with a significantly higher prevalence of de novo CP, chronic daily headache, and new-onset pain in general, which was associated with persistent anosmia.

SIGNIFICANCE: There exists de novo pain in a substantial number of COVID-19 survivours, and some develop chronic pain. New-onset pain after the infection was more common in patients who reported anosmia after hospital discharge.

Original languageEnglish
JournalEuropean Journal of Pain
Volume25
Issue number6
Pages (from-to)1342-1354
Number of pages13
ISSN1090-3801
DOIs
Publication statusPublished - Jul 2021
Externally publishedYes

Bibliographical note

© 2021 European Pain Federation - EFIC®.

Keywords

  • Anosmia/epidemiology
  • COVID-19/complications
  • Chronic Pain/epidemiology
  • Cross-Sectional Studies
  • Headache/epidemiology
  • Humans
  • Pain/epidemiology
  • Prevalence
  • Survivors

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