Pain Management in the Post-COVID Era—An Update: A Narrative Review

El-Tallawy, Salah N.; Perglozzi, Joseph V; Ahmed, R; Kaki, Abdullah M.; Nagiub, Mohamed S; LeQuang, Jo Ann; Hadarah, Mamdouh M

doi:10.1007/s40122-023-00486-1

Cited by 16 publications

(48 citation statements)

References 119 publications

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“…Headache is one of the most disabling symptoms of long COVID. It may occur alone or in combination with other symptoms of long COVID, such as muscle weakness, dizziness, and vertigo, as well as insomnia or other sleep impairments [14,15]. It has also been shown that approximately 14% of the patients examined had long-COVID headaches in a case-control analysis nested in a prospective cohort study [9], in which the patients with long-COVID headaches were younger and female predominant and had higher frequencies of anosmia and myalgia.…”

Section: Discussionmentioning

confidence: 99%

“…A persistent headache for more than three months after an infection is considered a diagnosis of "chronic headache attributed to systemic viral infection" [11][12][13]. Since headache is one of the most common symptoms during infection and in long COVID patients [14,15], it is highly possible that headache-related symptoms can cause physical and mental problems in patients with long COVID.…”

Section: Introductionmentioning

confidence: 99%

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Manifestation of Headache Affecting Quality of Life in Long COVID Patients

Fujita

Otsuka

Sunada

et al. 2023

JCM

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Objectives: The present study aimed to elucidate the characteristics of long COVID patients with headaches. Methods: A single-center retrospective observational study was performed for long COVID outpatients who visited our hospital from 12 February 2021 to 30 November 2022. Results: A total of 482 long COVID patients, after excluding 6, were divided into two groups: the Headache group of patients with complaints of headache (113 patients: 23.4%) and the remaining Headache-free group. Patients in the Headache group were younger (median age: 37 years) than patients in the Headache-free group (42 years), while the ratio of females (56%) in the Headache group was nearly the same as that in the Headache-free group (54%). The proportion of patients in the Headache group who were infected in the Omicron-dominant phase (61%) was larger than the proportions of patients infected in the Delta (24%) and preceding (15%) phases, and that trend was significantly different from the trend in the Headache-free group. The duration before the first visit for long COVID was shorter in the Headache group (71 days) than in the Headache-free group (84 days). The proportions of patients in the Headache group with comorbid symptoms, including general fatigue (76.1%), insomnia (36.3%), dizziness (16.8%), fever (9.7%), and chest pain (5.3%) were larger than the proportions of patients in the Headache-free group, whereas blood biochemical data were not significantly different between the two groups. Interestingly, patients in the Headache group had significant deteriorations of scores indicating depression and scores for quality of life and general fatigue. In multivariate analysis, headache, insomnia, dizziness, lethargy, and numbness were shown to be involved in the quality of life (QOL) of long COVID patients. Conclusions: The manifestation of headaches related to long COVID was found to have a significant impact on social and psychological activities. Alleviation of headaches should be a priority for the effective treatment of long COVID.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Manifestation of Headache Affecting Quality of Life in Long COVID Patients

Fujita

Otsuka

Sunada

et al. 2023

JCM

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“…These interventions focus on improving and restoring the functional ability and quality of life, which align with the multidimensional and complex nature of both LC and chronic pain. [74][75][76] Additionally, digital interventions are providing promising avenues to manage chronic pain, physical and mental health impacts of LC, facilitating patient self-management and aid their re-integration into daily life and work, indicating an important step forward in managing LC MSK pain. [76][77][78] There are several unique findings in our study which help us understand other related conditions.…”

Section: Discussionmentioning

confidence: 99%

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

Khoja,

Silva-Passadouro,

Cristescu

et al. 2024

Preprint

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Purpose: New-onset chronic musculoskeletal (MSK) pain is one of the common persistent symptoms in Long COVID (LC). This study investigated its clinical characteristics, underlying mechanisms, and impact on function, psychological health, and quality of life. Patients and methods: 30 adults (19 female, 11 male) with LC and new-onset chronic MSK pain underwent clinical examination, Quantitative Sensory Testing (QST), and blood tests for inflammatory markers, and completed the following outcome measures: Timed Up and Go test (TUG), handgrip strength test, COVID-19 Yorkshire Rehabilitation Scale (C19-YRS), Brief Pain Inventory (BPI), Pain Self-Efficacy Questionnaire (PSEQ), Pain Catastrophizing Scale (PCS), International Physical Activity Questionnaire - short form (IPAQ-sf), Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9), and EuroQol Five Dimensions health-related quality of life (EQ-5D-5L). Results: New-onset chronic MSK pain was widespread and continuous in nature, and worse in the joints. When compared to normative values reported in the literature: a) QST revealed mechanical hyperalgesia, heightened temporal summation of pain, and hypoesthesia to vibration stimuli, which is strongly suggestive of central sensitization; b) Plasma cytokine assays indicated distinct pro- inflammatory profiles; c) TUG time indicated reduced balance and mobility; d) handgrip strength revealed general weakness; e) physical activity was lower ; and f) there were moderate levels of depression and anxiety with lower self-efficacy scores and lower levels of pain catastrophizing. LC symptoms were of moderate severity (44.8/100), moderate functional disability (22.8/50) and severely compromised overall health (2.6/10) when compared to pre-COVID scores. Conclusion: New-onset chronic MSK pain in LC tends to be widespread, constant, and associated with weakness, reduced function, depression, anxiety, and reduced quality of life. There is associated central sensitization and proinflammatory state in the condition. Further research is essential to explore the longitudinal progression and natural evolution of the new-onset chronic MSK pain in LC.

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“…Jiang [ 128 ] developed a wearable telehealth system to monitor the patients and elderly [ 6 ]. Telehealth systems are also gaining importance, especially with the COVID-19 pandemic [ 129 ]. Remote health care offers many advantages.…”

Section: Incorporation Of Artificial Intelligence For Objective Pain ...mentioning

confidence: 99%

Incorporation of “Artificial Intelligence” for Objective Pain Assessment: A Comprehensive Review

El-Tallawy,

Pergolizzi,

Vasiliu-Feltes

et al. 2024

Pain Ther

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Pain is a significant health issue, and pain assessment is essential for proper diagnosis, follow-up, and effective management of pain. The conventional methods of pain assessment often suffer from subjectivity and variability. The main issue is to understand better how people experience pain. In recent years, artificial intelligence (AI) has been playing a growing role in improving clinical diagnosis and decision-making. The application of AI offers promising opportunities to improve the accuracy and efficiency of pain assessment. This review article provides an overview of the current state of AI in pain assessment and explores its potential for improving accuracy, efficiency, and personalized care. By examining the existing literature, research gaps, and future directions, this article aims to guide further advancements in the field of pain management. An online database search was conducted via multiple websites to identify the relevant articles. The inclusion criteria were English articles published between January 2014 and January 2024). Articles that were available as full text clinical trials, observational studies, review articles, systemic reviews, and meta-analyses were included in this review. The exclusion criteria were articles that were not in the English language, not available as free full text, those involving pediatric patients, case reports, and editorials. A total of (47) articles were included in this review. In conclusion, the application of AI in pain management could present promising solutions for pain assessment. AI can potentially increase the accuracy, precision, and efficiency of objective pain assessment.

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Pain Management in the Post-COVID Era—An Update: A Narrative Review

Cited by 16 publications

References 119 publications

Manifestation of Headache Affecting Quality of Life in Long COVID Patients

Manifestation of Headache Affecting Quality of Life in Long COVID Patients

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

Incorporation of “Artificial Intelligence” for Objective Pain Assessment: A Comprehensive Review

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