Hospital admission is associated with disability and late musculoskeletal pain in individuals with long COVID

Abstract

BackgroundThe acute clinical repercussions of SARS-CoV-2 infection have been widely studied. However, the possible late repercussions of long COVID have not yet been well defined in the literature.ObjectivesTo identify the presence of pain and musculoskeletal disability in patients with Long COVID and also to identify predictive factors for pain intensity in this population.MethodsIn this cross-sectional and retrospective observational study individuals with Long COVID symptoms were included. It was collected musculoskeletal disability measures, data from patient-related outcome measures and variables from a COVID-19 outpatient service database. Associations and sub-group analyses were performed considering the variables pain, disability and hospitalization. Linear regression was performed to identify predictive factors for pain intensity in Long COVID patients.ResultsWe evaluated 195 patients and most of them (57%) presented musculoskeletal pain in one area of the body. Pain sub-group presented worse disability indices and worse clinical course during hospitalization. Hospitalized patients presented worse disability indices comparing to non-hospitalized. Significant correlations were found between pain and days of non-invasive oxygen support (r = 0.21; p = 0.003); days in intensive care unit (r = 0.22; p = 0.002) and days in invasive mechanical ventilation (r = 0.35; p = 0.001). Hospitalized individuals showed a higher chance of presenting late musculoskeletal pain (OR = 1.42: 95%CI 1.09–2.04). Days in intensive care unit (β = 0,234: P = 0,001) and days in invasive mechanical ventilation (β = 0.764: P = 0.001) were predictors of pain intensity [F(2,192) = 18.559; R2 = 0.231; p = 0.001].ConclusionIndividuals with Long COVID presented musculoskeletal pain and disability. Hospitalized patients showed a greater chance of having musculoskeletal pain. Days in intensive care unit and days in invasive mechanical ventilation were predictors of late musculoskeletal pain intensity.

Clinical characterization of new-onset chronic musculoskeletal pain in Long COVID: a cross-sectional study

“…No to low risk (0-4), n (%) 3 (12) Mild (5)(6)(7)(8)(9), n (%) 8 (32) Moderate (10)(11)(12)(13)(14), n (%) 10 ( 40)…”

“…Existing literature predominantly focuses on documenting the prevalence and location of pain, with only limited attempts to phenotype it and explore its features. [13][14][15][16][17] A healthy control-matched study revealed that individuals with LC experience heightened pain intensity and interference, severe insomnia, fear of movement, catastrophizing, fear-avoidance beliefs, depression, and anxiety. 15 In a review aimed to phenotype the post-COVID pain using the 2021 IASP classification criteria, the authors suggested the possibility of nociplastic pain to be the primary mechanism involved in post-COVID pain.…”

Clinical Characterization of New-Onset Chronic Musculoskeletal Pain in Long COVID: A Cross-Sectional Study

“…Existing literature predominantly focuses on documenting the prevalence and location of pain, with only limited attempts to phenotype it and explore its features. 13–18 A healthy control-matched study revealed that individuals with LC experience heightened pain intensity and interference, severe insomnia, fear of movement, catastrophizing, fear-avoidance beliefs, depression, and anxiety. 15 An early review of MSK pain following COVID-19 infection revealed multifaceted effects on MSK pain, with patients reporting widespread pain patterns resembling those of MSK origin.…”