Preliminary outcomes of the COVID-19 pandemic: a new chronic pain profile
- Authors: Shen N.P.1,2, Logvinenko V.V.1,3, Tsiryatieva S.B.1,2, Osin V.I.1,2, Masserov A.A.1,2
-
Affiliations:
- Tyumen State Medical University
- Regional Clinical Hospital No. 1, Tyumen
- Hospital for War Veterans, Tyumen
- Issue: Vol 16, No 3 (2022)
- Pages: 171-183
- Section: Reviews
- URL: https://journals.rcsi.science/1993-6508/article/view/232467
- DOI: https://doi.org/10.17816/RA109668
- ID: 232467
Cite item
Abstract
In summing up the preliminary results of the COVID-19 pandemic that has not yet ended, modern research pays much attention to the so-called “post-COVID” syndrome, which includes the long-term consequences of the disease. In English, symptoms are reported as “long COVID”, “post-acute COVID”, or “chronic post-COVID syndrome” and are described as symptoms of fatigue, respiratory disorders, memory, and sleep problems. Symptoms such as muscle pain and decreased endurance when performing habitual physical exertion are mentioned much less often. Meanwhile, among the complaints of those who have been ill, this symptom is present quite often, reducing the quality of life and tolerability of normal physical exertion. This review aimed to provide an in-depth study of a new type of the chronic myofascial pain syndrome after COVID-19, i.e., the frequency of occurrence, causes of the development, and pathophysiology of chronic pain syndrome associated with COVID-19 and manifested as fibromyalgia of various localizations. To answer the questions posed, the authors searched for information in four electronic databases. The key search terms used were “COVID-19”, “long COVID,” and “signs and symptoms of pain syndrome”. A review of current literature data has shown that close study and dynamic monitoring of patients who had COVID-19 can contribute to further deciphering the pathophysiological mechanisms of the development of its long-term consequences and provide answers to questions on the prevention and treatment of chronic pain syndrome in this patient cohort.
Keywords
Full Text
##article.viewOnOriginalSite##About the authors
Natalia P. Shen
Tyumen State Medical University; Regional Clinical Hospital No. 1, Tyumen
Author for correspondence.
Email: nataliashen@rambler.ru
ORCID iD: 0000-0002-3256-0374
SPIN-code: 2963-7338
MD, Dr. Sci. (Med.), professorRussian Federation, Tyumen; Tyumen
Vladimir V. Logvinenko
Tyumen State Medical University; Hospital for War Veterans, Tyumen
Email: log-vi@yandex.ru
ORCID iD: 0000-0002-1230-7355
SPIN-code: 9369-0383
MD, Cand. Sci. (Med.)
Russian Federation, Tyumen; TyumenSvetlana B. Tsiryatieva
Tyumen State Medical University; Regional Clinical Hospital No. 1, Tyumen
Email: s_b_c@mail.ru
ORCID iD: 0000-0002-3881-2851
SPIN-code: 2424-2070
MD, Dr. Sci. (Med.)Russian Federation, Tyumen; Tyumen
Valentin I. Osin
Tyumen State Medical University; Regional Clinical Hospital No. 1, Tyumen
Email: osinvalentin9610@gmail.com
ORCID iD: 0000-0003-4383-0816
anesthesiologist-resuscitator
Tyumen; TyumenAleksander A. Masserov
Tyumen State Medical University; Regional Clinical Hospital No. 1, Tyumen
Email: amassyorov@yandex.ru
ORCID iD: 0000-0002-6042-2606
SPIN-code: 6148-2797
anesthesiologist-resuscitator
Russian Federation, Tyumen; TyumenReferences
- Komaroff AL, Lipkin WI. Insights from myalgic encephalomyelitis/chronic fatigue syndrome may help unravel the pathogenesis of postacute COVID-19 syndrome. Trends Mol Med. 2021;27(9):895–906. doi: 10.1016/j.molmed.2021.06.002
- Wadehra S. COVID Long Haulers and the New Chronic Pain Profile. 2022;22(1). Accessed: November 4, 2022. Available from: https://www.practicalpainmanagement.com/pain/other/covid-long-haulers-new-chronic-pain-profile.
- Fiala K, Martens J, Abd-Elsayed A. Post-COVID Pain Syndromes. Curr Pain Headache Rep. 2022;26(5):379–383. doi: 10.1007/s11916-022-01038-6
- Soares F, Kubota GT, Fernandes AM, et.al. Prevalence and characteristics of new-onset pain in COVID-19 survivours, a controlled study. Eur J Pain. 2021;25(6):1342–1354. doi: 10.1002/ejp.1755
- Fernández-de-Las-Peñas C, de-la-Llave-Rincón AI, Ortega-Santiago R, et al. Prevalence and risk factors of musculoskeletal pain symptoms as long-term post-COVID sequelae in hospitalized COVID-19 survivors: a multicenter study. Pain. 2022;163(9):e989–e996. doi: 10.1097/j.pain.0000000000002564
- Murat S, Dogruoz Karatekin B, Icagasioglu A, et al. Clinical presentations of pain in patients with COVID-19 infection. Ir J Med Sci. 2021;190(3):913–917. doi: 10.1007/s11845-020-02433-x
- Magdy R, Hussein M, Ragaie C, et al. Characteristics of headache attributed to COVID-19 infection and predictors of its frequency and intensity: A cross sectional study. Cephalalgia. 2020;40(13):1422–1431. doi: 10.1177/0333102420965140
- Uygun Ö, Ertaş M, Ekizoğlu E, et al. Headache characteristics in COVID-19 pandemic-a survey study. J Headache Pain. 2020;21(1):121. doi: 10.1186/s10194-020-01188-1
- Abdullahi A, Candan SA, Abba MA, et al. Neurological and Musculoskeletal Features of COVID-19: A Systematic Review and Meta-Analysis. Front Neurol. 2020;11:687. doi: 10.3389/fneur.2020.00687
- Shigemura J, Ursano RJ, Morganstein JC, et al. Public responses to the novel 2019 coronavirus (2019-nCoV) in Japan: Mental health consequences and target populations. Psychiatry Clin Neurosci. 2020;74(4):281–282. doi: 10.1111/pcn.12988
- Karayanni H, Dror AA, Oren D, et al. Exacerbation of chronic myofascial pain during COVID-19. Advances in Oral and Maxillofacial Surgery. 2021;1:100019. doi: 10.1016/j.adoms.2021.100019
- Lopez-Leon S, Wegman-Ostrosky T, Perelman C, et al. More than 50 Long-term effects of COVID-19: a systematic review and meta-analysis. medRxiv [Preprint]. 2021:2021.01.27.21250617. doi: 10.1101/2021.01.27.21250617. Update in: Sci Rep. 2021;11(1):16144.
- Oguz-Akarsu E, Gullu G, Kilic E, et al. Pandemic Study Team. Insight into pain syndromes in acute phase of mild-to-moderate COVID-19: Frequency, clinical characteristics, and associated factors. Eur J Pain. 2022;26(2):492–504. doi: 10.1002/ejp.1876
- Funk AL, Kuppermann N, Florin TA, et al. Post-COVID-19 Conditions Among Children 90 Days After SARS-CoV-2 Infection. JAMA Netw Open. 2022;5(7):e2223253. doi: 10.1001/jamanetworkopen.2022.23253
- Schieszer J. Pain Syndromes Common in Patients With Long COVID [Internet]. Clinical Pain Advisor [cited 04 November 2022]. Available from: https://www.clinicalpainadvisor.com/chronic-pain/long-term-effects-of-covid-19-including-pain-syndromes/.
- Li L.Q, Huang T, Wang YQ, et al. COVID-19 patients’ clinical characteristics, discharge rate, and fatality rate of meta-analysis. J Med Virol. 2020;92(6):577–583. doi: 10.1002/jmv.25757
- Morjaria JB, Omar F, Polosa R, et al. Bilateral lower limb weakness: a cerebrovascular consequence of covid-19 or a complication associated with it? Intern Emerg Med. 2020;15(5):901–905. doi: 10.1007/s11739-020-02418-9
- Bakılan F, Gökmen İG, Ortanca B, et al. Musculoskeletal symptoms and related factors in postacute COVID-19 patients. Int J Clin Pract. 2021;75(11):e14734. doi: 10.1111/ijcp.14734
- Herrero-Montes M, Fernández-de-Las-Peñas C, Ferrer-Pargada D, et al. Prevalence of Neuropathic Component in Post-COVID Pain Symptoms in Previously Hospitalized COVID-19 Survivors. Int J Clin Pract. 2022;2022:3532917. doi: 10.1155/2022/3532917
- Fernández-de-Las-Peñas C, Navarro-Santana M, Plaza-Manzano G, et al. Time course prevalence of post-COVID pain symptoms of musculoskeletal origin in patients who had survived severe acute respiratory syndrome coronavirus 2 infection: a systematic review and meta-analysis. Pain. 2022;163(7):1220–1231. doi: 10.1097/j.pain.0000000000002496
- Attal N, Martinez V, Bouhassira D. Potential for increased prevalence of neuropathic pain after the COVID-19 pandemic. Pain Rep. 2021;6(1):e884. doi: 10.1097/PR9.0000000000000884
- Shraim MA, Massé-Alarie H, Hodges PW. Methods to discriminate between mechanism-based categories of pain experienced in the musculoskeletal system: a systematic review. Pain. 2021;162(4):1007–1037. doi: 10.1097/j.pain.0000000000002113
- Vaz A, Costa A, Pinto A, et al. Complex regional pain syndrome after severe COVID-19 — A case report. Heliyon. 2021;7(11):e08462. doi: 10.1016/j.heliyon.2021.e08462
- McWilliam M, Samuel M, Alkufri FH. Neuropathic pain post-COVID-19: a case report. BMJ Case Rep. 2021;14(7):e243459. doi: 10.1136/bcr-2021-243459
- Attal N, Bouhassira D, Baron R. Diagnosis and assessment of neuropathic pain through questionnaires. Lancet Neurol. 2018;17(5):456–466. doi: 10.1016/S1474-4422(18)30071-1
- Rowbotham MC. Is fibromyalgia a neuropathic pain syndrome? J Rheumatol Suppl. 2005;75:38–40.
- Cruccu G, Truini A. Tools for assessing neuropathic pain. PLoS Med. 2009;6(4):e1000045. doi: 10.1371/journal.pmed.1000045
- Clear J, Uebbing E, Hartman K. Emerging Neuropathic Pain Treatments. 2022;(22)33. Accessed: November 4, 2022. Available from: https://www.practicalpainmanagement.com/issue202203/emerging-neuropathic-pain-treatments.
- Zha M, Chaffee K, Alsarraj J. Trigger point injections and dry needling can be effective in treating long COVID syndrome-related myalgia: a case report. J Med Case Rep. 2022;16(1):31. doi: 10.1186/s13256-021-03239-w
- Tokumasu K, Honda H, Sunada N, et al. Clinical Characteristics of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Diagnosed in Patients with Long COVID. Medicina (Kaunas). 2022;58(7):850. doi: 10.3390/medicina58070850
- Fricton JR, Kroening R, Haley D, Siegert R. Myofascial pain syndrome of the head and neck: a review of clinical characteristics of 164 patients. Oral Surg Oral Med Oral Pathol. 1985;60(6):615–623. doi: 10.1016/0030-4220(85)90364-0
- Tantanatip A, Chang KV. Myofascial Pain Syndrome. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022.
- Simons DG, Travell JG, Simons LS. Myofascial Pain and Dysfunction: the Trigger Point Manual. Frost EAM, editor. Philadelphia: Lippincott Williams & Wilkins; 1991.
- Tough EA, White AR, Richards S, Campbell J. Variability of criteria used to diagnose myofascial trigger point pain syndrome — evidence from a review of the literature. Clin J Pain. 2007;23(3):278–286. doi: 10.1097/AJP.0b013e31802fda7c
- Couppé C, Midttun A, Hilden J, et al. Spontaneous Needle Electromyographic Activity in Myofascial Trigger Points in the Infraspinatus Muscle: A Blinded Assessment. Journal of Musculoskeletal Pain. 2001;9:16–17. doi: 10.1300/j094v09n03_02
- Giamberardino MA, Affaitati G, Fabrizio A, Costantini R. Myofascial pain syndromes and their evaluation. Best Pract Res Clin Rheumatol. 2011;25(2):185–198. doi: 10.1016/j.berh.2011.01.002
- Li YC, Bai WZ, Hashikawa T. The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19 patients. J Med Virol. 2020;92(6):552–555. doi: 10.1002/jmv.25728
- Hamming I, Timens W, Bulthuis M., et al. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol. 2004;203(2):631–637. doi: 10.1002/path.1570
- Ziegler CGK, Allon SJ, Nyquist SK, et al. SARS-CoV-2 Receptor ACE2 Is an Interferon-Stimulated Gene in Human Airway Epithelial Cells and Is Detected in Specific Cell Subsets across Tissues. Cell. 2020;181(5):1016–1035.e19. doi: 10.1016/j.cell.2020.04.035
- Saud A, Naveen R, Aggarwal R, Gupta L. COVID-19 and Myositis: What We Know So Far. Curr Rheumatol Rep. 2021;23(8):63. doi: 10.1007/s11926-021-01023-9
- Hannah JR, Ali SS, Nagra D, et al. Skeletal muscles and Covid-19: a systematic review of rhabdomyolysis and myositis in SARS-CoV-2 infection. Clin Exp Rheumatol. 2022;40(2):329–338. doi: 10.55563/clinexprheumatol/mkfmxt
- Netland J, Meyerholz DK, Moore S, et al. Severe acute respiratory syndrome coronavirus infection causes neuronal death in the absence of encephalitis in mice transgenic for human ACE2. J Virol. 2008;82(15):7264–7275. doi: 10.1128/JVI.00737-08
- Chen R, Wang K, Yu J, et al. The Spatial and Cell-Type Distribution of SARS-CoV-2 Receptor ACE2 in the Human and Mouse Brains. Front Neurol. 2021;11:573095. doi: 10.3389/fneur.2020.573095
- Montalvan V, Lee J, Bueso T, et al. Neurological manifestations of COVID-19 and other coronavirus infections: A systematic review. Clin Neurol Neurosurg. 2020;194:105921. doi: 10.1016/j.clineuro.2020.105921
- Li K, Wohlford-Lenane C, Perlman S, et al. Middle East Respiratory Syndrome Coronavirus Causes Multiple Organ Damage and Lethal Disease in Mice Transgenic for Human Dipeptidyl Peptidase 4. J Infect Dis. 2016;213(5):712–722. doi: 10.1093/infdis/jiv499
- Cantuti-Castelvetri L, Ojha R, Pedro LD, et al. Neuropilin-1 facilitates SARS-CoV-2 cell entry and infectivity. Science. 2020;370(6518):856–860. doi: 10.1126/science.abd2985
- Lochhead JJ, Thorne RG. Intranasal delivery of biologics to the central nervous system. Adv Drug Deliv Rev. 2012;64(7):614–628. doi: 10.1016/j.addr.2011.11.002
- Lochhead JJ, Kellohen KL, Ronaldson PT, Davis TP. Distribution of insulin in trigeminal nerve and brain after intranasal administration. Sci Rep. 2019;9(1):2621. doi: 10.1038/s41598-019-39191-5
- Baig AM, Khaleeq A, Ali U, Syeda H. Evidence of the COVID-19 Virus Targeting the CNS: Tissue Distribution, Host-Virus Interaction, and Proposed Neurotropic Mechanisms. ACS Chem Neurosci. 2020;11(7):995–998. doi: 10.1021/acschemneuro.0c00122
- Li Z, Liu T, Yang N, et al. Neurological manifestations of patients with COVID-19: potential routes of SARS-CoV-2 neuroinvasion from the periphery to the brain. Front Med. 2020;14(5):533–541. doi: 10.1007/s11684-020-0786-5
- Hickey WF, Hsu BL, Kimura H. T-lymphocyte entry into the central nervous system. J Neurosci Res. 1991;28(2):254–260. doi: 10.1002/jnr.490280213
- Schwartz M, Deczkowska A. Neurological Disease as a Failure of Brain-Immune Crosstalk: The Multiple Faces of Neuroinflammation. Trends Immunol. 2016;37(10):668–679. doi: 10.1016/j.it.2016.08.001
- Ely EW, Shintani A, Truman B, et al. Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. JAMA. 2004;291(14):1753–1762. doi: 10.1001/jama.291.14.1753
- Iwashyna TJ, Ely EW, Smith DM, Langa KM. Long-term cognitive impairment and functional disability among survivors of severe sepsis. JAMA. 2010;304(16):1787–1794. doi: 10.1001/jama.2010.1553
- Verkhratsky A, Zorec R, Parpura V. Stratification of astrocytes in healthy and diseased brain. Brain Pathol. 2017;27(5):629–644. doi: 10.1111/bpa.12537
- Sierra A, Beccari S, Diaz-Aparicio I, et al. Surveillance, phagocytosis, and inflammation: how never-resting microglia influence adult hippocampal neurogenesis. Neural Plast. 2014;2014:610343. doi: 10.1155/2014/610343
- Goodall S, Twomey R, Amann M. Acute and chronic hypoxia: implications for cerebral function and exercise tolerance. Fatigue. 2014;2(2):73–92. doi: 10.1080/21641846.2014.909963
- Zhao M, Zhu P, Fujino M, et al. Oxidative Stress in Hypoxic-Ischemic Encephalopathy: Molecular Mechanisms and Therapeutic Strategies. Int J Mol Sci. 2016;17(12):2078. doi: 10.3390/ijms17122078
- Taylor CT, Doherty G, Fallon PG, Cummins EP. Hypoxia-dependent regulation of inflammatory pathways in immune cells. J Clin Invest. 2016;126(10):3716–3724. doi: 10.1172/JCI84433
- Beyrouti R, Adams ME, Benjamin L, et al. Characteristics of ischaemic stroke associated with COVID-19. J Neurol Neurosurg Psychiatry. 2020;91(8):889–891. doi: 10.1136/jnnp-2020-323586
- Oxley TJ, Mocco J, Majidi S, et al. Large-Vessel Stroke as a Presenting Feature of Covid-19 in the Young. N Engl J Med. 2020;382(20):e60. doi: 10.1056/NEJMc2009787
- Middeldorp S, Coppens M, van Haaps TF, et al. Incidence of venous thromboembolism in hospitalized patients with COVID-19. J Thromb Haemost. 2020;18(8):1995–2002. doi: 10.1111/jth.14888
- Poissy J, Goutay J, Caplan M, et al. Pulmonary Embolism in Patients With COVID-19: Awareness of an Increased Prevalence. Circulation. 2020;142(2):184–186. doi: 10.1161/CIRCULATIONAHA.120.047430
- Marques-Deak A, Cizza G, Sternberg E. Brain-immune interactions and disease susceptibility. Mol Psychiatry. 2005;10(3):239–250. doi: 10.1038/sj.mp.4001643
- Guo Q, Zheng Y, Shi J, et al. Immediate psychological distress in quarantined patients with COVID-19 and its association with peripheral inflammation: A mixed-method study. Brain Behav Immun. 2020;88:17–27. doi: 10.1016/j.bbi.2020.05.038
- Kempuraj D, Selvakumar GP, Ahmed ME, et al. COVID-19, Mast Cells, Cytokine Storm, Psychological Stress, and Neuroinflammation. Neuroscientist. 2020;26(5–6):402–414. doi: 10.1177/1073858420941476
- Ownby RL, Crocco E, Acevedo A, et al. Depression and risk for Alzheimer disease: systematic review, meta-analysis, and metaregression analysis. Arch Gen Psychiatry. 2006;63(5):530–538. doi: 10.1001/archpsyc.63.5.530
- Zaim S, Chong JH, Sankaranarayanan V, Harky A. COVID-19 and Multiorgan Response. Curr Probl Cardiol. 2020;45(8):100618. doi: 10.1016/j.cpcardiol.2020.100618
- Mao L, Jin H, Wang M, et al. Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China. JAMA Neurol. 2020;77(6):683–690. doi: 10.1001/jamaneurol.2020.1127
- Chen LYC, Quach TTT. COVID-19 cytokine storm syndrome: a threshold concept. Lancet Microbe. 2021;2(2):e49–e50. doi: 10.1016/S2666-5247(20)30223-8
- Chen R, Lan Z, Ye J, et al. Cytokine Storm: The Primary Determinant for the Pathophysiological Evolution of COVID-19 Deterioration. Front Immunol. 2021;12:589095. doi: 10.3389/fimmu.2021.589095
- Que Y, Hu C, Wan K, et al. Cytokine release syndrome in COVID-19: a major mechanism of morbidity and mortality. Int Rev Immunol. 2022;41(2):217–230. doi: 10.1080/08830185.2021.1884248
- McGonagle D, Ramanan AV, Bridgewood C. Immune cartography of macrophage activation syndrome in the COVID-19 era. Nat Rev Rheumatol. 2021;17(3):145–157. doi: 10.1038/s41584-020-00571-1
- Rodriguez-Smith JJ, Verweyen EL, Clay GM, et al. Inflammatory biomarkers in COVID-19-associated multisystem inflammatory syndrome in children, Kawasaki disease, and macrophage activation syndrome: a cohort study. Lancet Rheumatol. 2021;3(8):e574–e584. doi: 10.1016/S2665-9913(21)00139-9
- Pergolizzi JV Jr, Raffa RB, Varrassi G, et al; NEMA Research Group. Potential neurological manifestations of COVID-19: a narrative review. Postgrad Med. 2022;134(4):395–405. doi: 10.1080/00325481.2020.1837503
- Jha NK, Ojha S, Jha SK, et al. Evidence of Coronavirus (CoV) Pathogenesis and Emerging Pathogen SARS-CoV-2 in the Nervous System: A Review on Neurological Impairments and Manifestations. J Mol Neurosci. 2021;71(11):2192–2209. doi: 10.1007/s12031-020-01767-6
- Rokni M, Ghasemi V, Tavakoli Z. Immune responses and pathogenesis of SARS-CoV-2 during an outbreak in Iran: Comparison with SARS and MERS. Rev Med Virol. 2020;30(3):e2107. doi: 10.1002/rmv.2107
![](/img/style/loading.gif)