Tag: musculoskeletal pain

Prevalence of musculoskeletal pain as a long-covid symptom after hospitalisation in covid-19 survivors

Abstract:

Background and aims: Up to 60% of COVID-19 survivors develop long-COVID symptomatology with 90 different manifestations. The aim of this large cohort study was to study the prevalence of persistent musculoskeletal pain as a long-COVID symptom in COVID-19 survivors.
Methods: This cross-sectional exploratory study was based on responses to pain-related questionnaires from a national survey including data from 1) 4.833 previously hospitalised patients with a confirmed SARS-CoV-2 infection and from 2) a population of 132.427 non-hospitalised SARS-CoV-2 infected persons. Time from confirmed infection to response was 8-30 months. The questionnaire was designed to focus specifically on the type of post-COVID persistent pain, pain intensities, and quality of life.
Results: Data from 1.000 randomly selected previously hospitalised (51.2% males; 60.4±15.2 years; 85.6±18.5 kg) and 1.000 randomly selected non-hospitalised COVID-19 survivors (43.5% males; 50.4±15.9 years; 79.2±16.6 kg) were included. Long-COVID pain symptoms were more prevalent within the hospital group (38.8% vs. 12.7%, p<0.001). When analysing specifically for de novo musculoskeletal pain, the prevalence was likewise highest in the hospital group (20% vs. 4.2%, p<0.001). A higher proportion (p<0.001) of previously hospitalised survivors (20%) reported presence of widespread pain when compared with non-hospitalised patients (4.2%). Long-COVID pain intensities were not different between groups (p<0.329).
Conclusions: This study showed that long-COVID musculoskeletal pain was more prevalent in the hospital group compared to a non-hospitalised group. The high prevalence of long-COVID musculoskeletal and widespread pain symptoms following SARS-CoV-2 infection highlights the need of attention to this new group of pain patients.
Source: Ebbesen, B. D., Giordano, R., Varol, U., Fernández-de-Las-Peñas, C., Rasmussen, B. S., Nielsen, H., Schiøttz-Christensen, B., Lykke Petersen, P., Castaldo, M., & Arendt-Nielsen, L. (2023). Prevalence of musculoskeletal pain as a long-covid symptom after hospitalisation in covid-19 survivors. Abstract from 13th Congress of the European Pain Federation EFIC, Budapest, Hungary. https://vbn.aau.dk/en/publications/prevalence-of-musculoskeletal-pain-as-a-long-covid-symptom-after-

Musculoskeletal involvement: COVID-19 and post COVID 19

Abstract:

The worldwide pandemic of coronavirus disease 2019 (COVID-19) was known to predominantly affect the lungs, but it was realized that COVID-19 had a large variety of clinical involvement. Cardiovascular, gastrointestinal, neurological, and musculoskeletal systems are involved by direct or indirect mechanisms with various manifestations.

The musculoskeletal involvement can manifest during COVID-19 infection, due to medications used for the treatment of COVID-19, and in the post/long COVID-19 syndrome. The major symptoms are fatigue, myalgia/arthralgia, back pain, low back pain, and chest pain. During the last two years, musculoskeletal involvement increased, but no clear consensus was obtained about the pathogenesis. However, there is valuable data that supports the hypothesis of angiotensinconverting enzyme 2, inflammation, hypoxia, and muscle catabolism. Additionally, medications that were used for treatment also have musculoskeletal adverse effects, such as corticosteroid-induced myopathy and osteoporosis. Therefore, while deciding the drugs, priorities and benefits should be taken into consideration.

Symptoms that begin three months from the onset of the COVID-19 infection, continue for at least two months, and cannot be explained by another diagnosis is accepted as post/long COVID-19 syndrome. Prior symptoms may persist and fluctuate, or new symptoms may manifest. In addition, there must be at least one symptom of infection. Most common musculoskeletal symptoms are myalgia, arthralgia, fatigue, back pain, muscle weakness, sarcopenia, impaired exercise capacity, and physical performance. In addition, the female sex, obesity, elderly patients, hospitalization, prolonged immobility, having mechanical ventilation, not having vaccination, and comorbid disorders can be accepted as clinical predictors for post/long COVID-19 syndrome.

Musculoskeletal pain is also a major problem and tends to be in chronic form. There is no consensus on the mechanism, but inflammation and angiotensin-converting enzyme 2 seem to play an important role. Localized and generalized pain may occur after COVID-19, and general pain is at least as common as localized pain. An accurate diagnosis allows physicians to initiate pain management and proper rehabilitation programs.

Source: Evcik D. Musculoskeletal involvement: COVID-19 and post COVID 19. Turk J Phys Med Rehabil. 2023 Feb 28;69(1):1-7. doi: 10.5606/tftrd.2023.12521. PMID: 37201006; PMCID: PMC10186015.

Clinical Characteristics and Mechanisms of Musculoskeletal Pain in Long COVID

Abstract:

Objective: Musculoskeletal (MSK) pain is being increasingly reported by patients as one of the most common persistent symptoms in post-COVID-19 syndrome or Long COVID. However, there is a lack of understanding of its prevalence, characteristics, and underlying pathophysiological mechanisms. The objective of this review is to identify and describe the features and characteristics of MSK pain in Long COVID patients.

Methods: The narrative review involved a literature search of the following online databases: MEDLINE (OVID), EMBASE (OVID), CINAHL, PsyclNFO, and Web of Science (December 2019 to February 2022). We included observational studies that investigated the prevalence, characteristics, risk factors and mechanisms of MSK pain in Long COVID. After screening and reviewing the initial literature search results, a total of 35 studies were included in this review.

Results: The overall reported prevalence of MSK pain in Long COVID ranged widely from 0.3% to 65.2%. The pain has been reported to be localized to a particular region or generalized and widespread. No consistent pattern of progression of MSK pain symptoms over time was identified. Female gender and higher BMI could be potential risk factors for Long COVID MSK pain, but no clear association has been found with age and ethnicity. Different pathophysiological mechanisms have been hypothesized to contribute to MSK pain in Long COVID including increased production of proinflammatory cytokines, immune cell hyperactivation, direct viral entry of neurological and MSK system cells, and psychological factors.

Conclusion: MSK pain is one of the most common symptoms in Long COVID. Most of the current literature on Long COVID focuses on reporting the prevalence of persistent MSK pain. Studies describing the pain characteristics are scarce. The precise mechanism of MSK pain in Long COVID is yet to be investigated. Future research must explore the characteristics, risk factors, natural progression, and underlying mechanisms of MSK pain in Long COVID.

Source: Khoja O, Silva Passadouro B, Mulvey M, Delis I, Astill S, Tan AL, Sivan M. Clinical Characteristics and Mechanisms of Musculoskeletal Pain in Long COVID. J Pain Res. 2022 Jun 17;15:1729-1748. doi: 10.2147/JPR.S365026. PMID: 35747600; PMCID: PMC9212788. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9212788/ (Full text)