We assessed whether COVID‐19 is associated with de novo pain and de novo chronic pain (CP). This controlled cross‐sectional study was based on phone interviews of patients discharged from hospital after COVID‐19 compared to control group composed of individuals hospitalized during the same period due to non‐COVID‐19 causes. Patients were classifyed 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 asssessed 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. Length of in‐hospital‐stay and ICU admission rates were significantly higher among COVID‐19 survivors, while mechanical ventilation requirement was similar between groups. Pre‐hospitalization pain was lower in COVID‐19 compared to control group (10.9% vs. 42.5%; P=0.001). However, 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 analyzing exclusively (COVID: n=40; controls: n=34) patients who did not report previous pain before 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 survivors 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). 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.

Supplemental Digital Content is Available in the Text. An original tool to distinguish Parkinson disease-related from non-Parkinson disease-related pain and to classify it into 3 mechanistic pain descriptors.

Supplemental Digital Content is Available in the Text.

Objective To compare the analgesic effects of stimulation of the anterior cingulate cortex (ACC) or the posterior superior insula (PSI) against sham deep (d) repetitive (r) transcranial magnetic stimulation (TMS) in patients with central neuropathic pain (CNP) after stroke or spinal cord injury in a randomized, double-blinded, sham-controlled, 3-arm parallel study. Methods Participants were randomly allocated into the active PSI-rTMS, ACC-rTMS, sham-PSI-rTMS, or sham-ACC-rTMS arms. Stimulations were performed for 12 weeks, and a comprehensive clinical and pain assessment, psychophysics, and cortical excitability measurements were performed at baseline and during treatment. The main outcome of the study was pain intensity (numeric rating scale [NRS]) after the last stimulation session. Results Ninety-eight patients (age 55.02 ± 12.13 years) completed the study. NRS score was not significantly different between groups at the end of the study. Active rTMS treatments had no significant effects on pain interference with daily activities, pain dimensions, neuropathic pain symptoms, mood, medication use, cortical excitability measurements, or quality of life. Heat pain threshold was significantly increased after treatment in the PSI-dTMS group from baseline (1.58, 95% confidence interval [CI] 0.09-3.06]) compared to sham-dTMS (−1.02, 95% CI −2.10 to 0.04, p = 0.014), and ACC-dTMS caused a significant decrease in anxiety scores (−2.96, 95% CI −4.1 to −1.7]) compared to sham-dTMS (−0.78, 95% CI −1.9 to 0.3; p = 0.018). Conclusions ACC-and PSI-dTMS were not different from sham-dTMS for pain relief in CNP despite a significant antinociceptive effect after insular stimulation and anxiolytic effects of ACC-dTMS. These results showed that the different dimensions of pain can be modulated in humans noninvasively by directly stimulating deeper SNC cortical structures without necessarily affecting clinical pain per se. ClinicalTrials.gov identifier: NCT01932905.