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Ebbesen BD, Giordano R, Hedegaard JN, Calero JAV, Fernández-de-Las-Peñas C, Rasmussen BS, Nielsen H, Schiøttz-Christensen B, Petersen PL, Castaldo M, Arendt-Nielsen L. Prevalence and Risk Factors of Multitype Post-COVID Pain in a Cohort of Previously Hospitalized COVID-19 Survivors: A Danish Cross-Sectional Survey. THE JOURNAL OF PAIN 2024; 25:104579. [PMID: 38796126 DOI: 10.1016/j.jpain.2024.104579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 05/06/2024] [Accepted: 05/18/2024] [Indexed: 05/28/2024]
Abstract
This population-based study investigated the prevalence of de novo, multitype, post-coronavirus disease (COVID) pain and its associated risk factors in previously hospitalized coronavirus disease 2019 (COVID-19) survivors. The nationwide, cross-sectional study included a cohort of Danish residents previously hospitalized due to severe acute respiratory syndrome coronavirus-2 infection between March 2020 and December 2021. Demographic data, preexisting medical comorbidities, previous pain-related symptoms, medication use for pain management, pain intensity (4-point scale), and development of de novo, multitype, post-COVID pain were collected by a self-reported survey distributed via e-Boks (a secured national digital mail system used in Denmark to provide public information to residents). The sample comprised 4,712 previously hospitalized COVID-19 survivors (48.6% women, mean age: 60.1 ± 15.6 years). At the time of the study (21 ± 6 months after hospitalization), 18.0% (847) reported the presence of de novo, multitype, post-COVID pain, and 38.6% of any pain. A multivariate analysis revealed that female sex (Odds Ratio (OR) 1.711, 95% Confidence Interval (CI) 1.444-2.023), higher body mass index (OR 1.032, 95% CI 1.019-1.045), intensive care unit admission (OR 1.597, 95% CI 1.324-1.926), previous history of whiplash (OR 2.471, 95% CI 1.004-6.081), anxiety (OR 3.626, 95% CI 1.335-9.708), and younger age (OR .982, 95% CI .976-.987) were factors associated with development of de novo, multitype, post-COVID pain. High income (OR .635, 95% CI .494-.817) and high educational level (OR .774, 95% CI .609-.984) were protective factors. In conclusion, multitype pain as a de novo post-COVID symptom was present in 18.0% of previously hospitalized COVID-19 survivors more than 1 year after hospital discharge and as such can be considered as adding to the global burden of chronic pain. PERSPECTIVE: The study investigates the prevalence of de novo, multitype, post-COVID pain in previously hospitalized COVID-19 survivors. This article presents potential risk factors associated with developing new pain symptoms. The results will contribute to understanding the possibility of predicting postinfectious pain from COVID-19 for future analysis.
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Affiliation(s)
- Brian Duborg Ebbesen
- Center for Neuroplasticity and Pain, Department of Health Science and Technology, School of Medicine, Aalborg University, North Denmark Region, Aalborg, Denmark; Department of Gastroenterology & Hepatology, Mech-Sense, Clinical Institute, Aalborg University Hospital, North Denmark Region, Aalborg, Denmark
| | - Rocco Giordano
- Center for Neuroplasticity and Pain, Department of Health Science and Technology, School of Medicine, Aalborg University, North Denmark Region, Aalborg, Denmark; Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, North Denmark Region, Aalborg, Denmark
| | - Jakob Nebeling Hedegaard
- Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, North Denmark Region, Aalborg, Denmark
| | - Juan Antonio Valera Calero
- Center for Neuroplasticity and Pain, Department of Health Science and Technology, School of Medicine, Aalborg University, North Denmark Region, Aalborg, Denmark; Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Complutense University of Madrid, Madrid, Spain
| | - César Fernández-de-Las-Peñas
- Center for Neuroplasticity and Pain, Department of Health Science and Technology, School of Medicine, Aalborg University, North Denmark Region, Aalborg, Denmark; Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - Bodil Steen Rasmussen
- Department of Anaesthesia and Intensive Care Medicine, Aalborg University Hospital, North Denmark Region, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, North Denmark Region, Aalborg, Denmark
| | - Henrik Nielsen
- Department of Clinical Medicine, Aalborg University, North Denmark Region, Aalborg, Denmark; Department of Infectious Diseases, Aalborg University Hospital, North Denmark Region, Aalborg, Denmark
| | - Berit Schiøttz-Christensen
- Department of Regional Health Research, University of Southern Denmark, Region of Southern Denmark, Odense, Denmark; Department of Infectious Diseases, Aarhus University Hospital, Central Denmark Region, Aarhus, Denmark
| | - Pernille Lykke Petersen
- Department of Anaesthesia and Intensive Care, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Capital Region of Denmark, Copenhagen, Denmark
| | - Matteo Castaldo
- Center for Neuroplasticity and Pain, Department of Health Science and Technology, School of Medicine, Aalborg University, North Denmark Region, Aalborg, Denmark
| | - Lars Arendt-Nielsen
- Center for Neuroplasticity and Pain, Department of Health Science and Technology, School of Medicine, Aalborg University, North Denmark Region, Aalborg, Denmark; Department of Gastroenterology & Hepatology, Mech-Sense, Clinical Institute, Aalborg University Hospital, North Denmark Region, Aalborg, Denmark; Steno Diabetes Center North Denmark, Clinical Institute, Aalborg University Hospital, North Denmark Region, Aalborg, Denmark.
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Bhattacharya M, Chatterjee S, Saxena S, Nandi SS, Lee SS, Chakraborty C. Current landscape of long COVID clinical trials. Int Immunopharmacol 2024; 132:111930. [PMID: 38537538 DOI: 10.1016/j.intimp.2024.111930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/18/2024] [Accepted: 03/23/2024] [Indexed: 05/01/2024]
Abstract
Long COVID was reported as a multi-systemic condition after the infection of SARS-CoV-2, and more than 65 million people are suffering from this disease. It has been noted that around 10% of severe SARS-CoV-2 infected individuals are suffering from the enduring effects of long COVID. The symptoms of long COVID have also been noted in several mild or asymptomatic SARS-CoV-2 infected individuals. While limited reports on clinical trials investigating new therapeutics for long COVID exist, there is an abundance of scattered information available regarding these trials. This review explores the extensive literature search, and complete clinical trial database search to map the current status of long COVID clinical trials worldwide. The study listed about 110 long COVID clinical trials. In addition to conducting extensive long COVID clinical trials, we have comprehensively presented an overview of the condition, its symptoms, notable manifestations, associated clinical trials, the unique challenges it poses, and our recommendations for addressing long COVID.
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Affiliation(s)
- Manojit Bhattacharya
- Department of Zoology, Fakir Mohan University, Vyasa Vihar, Balasore 756020, Odisha, India
| | - Srijan Chatterjee
- Institute for Skeletal Aging & Orthopedic Surgery, Hallym University-Chuncheon Sacred Heart Hospital, Chuncheon, Gangwon-Do 24252, Republic of Korea
| | - Sanskriti Saxena
- Division of Biology, Indian Institute of Science Education and Research-Tirupati, Panguru, Tirupati 517619, Andhra Pradesh, India
| | - Shyam Sundar Nandi
- ICMR-National Institute of Virology, (Mumbai unit), Indian Council of Medical Research, Haffkine Institute Compound, A. D. Marg, Parel, Mumbai 400012, India
| | - Sang-Soo Lee
- Institute for Skeletal Aging & Orthopedic Surgery, Hallym University-Chuncheon Sacred Heart Hospital, Chuncheon, Gangwon-Do 24252, Republic of Korea.
| | - Chiranjib Chakraborty
- Department of Biotechnology, School of Life Science and Biotechnology, Adamas University, Kolkata, West Bengal 700126, India.
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Lam CM, Sanderson M, Vu DT, Sayed D, Latif U, Chadwick AL, Staats P, York A, Smith G, Velagapudi V, Khan TW. Musculoskeletal and Neuropathic Pain in COVID-19. Diagnostics (Basel) 2024; 14:332. [PMID: 38337848 PMCID: PMC10855145 DOI: 10.3390/diagnostics14030332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 02/12/2024] Open
Abstract
Chronic pain constitutes a significant disease burden globally and accounts for a substantial portion of healthcare spending. The COVID-19 pandemic contributed to an increase in this burden as patients presented with musculoskeletal or neuropathic pain after contracting COVID-19 or had their chronic pain symptoms exacerbated by the virus. This extensive literature review analyzes the epidemiology of pain pre-pandemic, the costs associated with the COVID-19 pandemic, the impact of the virus on the body, mechanisms of pain, management of chronic pain post-pandemic, and potential treatment options available for people living with chronic pain who have had or are currently infected with COVID-19.
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Affiliation(s)
- Christopher M. Lam
- Department of Anesthesiology, Pain, and Perioperative Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA; (C.M.L.); (M.S.); (D.T.V.); (D.S.); (U.L.); (A.L.C.); (A.Y.)
| | - Miles Sanderson
- Department of Anesthesiology, Pain, and Perioperative Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA; (C.M.L.); (M.S.); (D.T.V.); (D.S.); (U.L.); (A.L.C.); (A.Y.)
| | - Dan T. Vu
- Department of Anesthesiology, Pain, and Perioperative Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA; (C.M.L.); (M.S.); (D.T.V.); (D.S.); (U.L.); (A.L.C.); (A.Y.)
| | - Dawood Sayed
- Department of Anesthesiology, Pain, and Perioperative Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA; (C.M.L.); (M.S.); (D.T.V.); (D.S.); (U.L.); (A.L.C.); (A.Y.)
| | - Usman Latif
- Department of Anesthesiology, Pain, and Perioperative Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA; (C.M.L.); (M.S.); (D.T.V.); (D.S.); (U.L.); (A.L.C.); (A.Y.)
| | - Andrea L. Chadwick
- Department of Anesthesiology, Pain, and Perioperative Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA; (C.M.L.); (M.S.); (D.T.V.); (D.S.); (U.L.); (A.L.C.); (A.Y.)
| | - Peter Staats
- National Spine and Pain Centers, Frederick, MD 21702, USA;
| | - Abigail York
- Department of Anesthesiology, Pain, and Perioperative Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA; (C.M.L.); (M.S.); (D.T.V.); (D.S.); (U.L.); (A.L.C.); (A.Y.)
| | - Gabriella Smith
- School of Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA; (G.S.); (V.V.)
| | - Vivek Velagapudi
- School of Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA; (G.S.); (V.V.)
| | - Talal W. Khan
- Department of Anesthesiology, Pain, and Perioperative Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA; (C.M.L.); (M.S.); (D.T.V.); (D.S.); (U.L.); (A.L.C.); (A.Y.)
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Ebbesen BD, Giordano R, Valera-Calero JA, Hedegaard JN, Fernández-de-Las-Peñas C, Arendt-Nielsen L. Prevalence and Risk Factors of De Novo Widespread Post-COVID Pain in Nonhospitalized COVID-19 Survivors: A Nationwide Exploratory Population-Based Survey. THE JOURNAL OF PAIN 2024; 25:1-11. [PMID: 37633573 DOI: 10.1016/j.jpain.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/12/2023] [Accepted: 08/19/2023] [Indexed: 08/28/2023]
Abstract
This survey investigated the prevalence of de novo widespread musculoskeletal post-COVID pain and risk factors for its development in nonhospitalized COVID-19 survivors. A nationwide exploratory cross-sectional study was conducted, including a cohort of 593,741 Danish residents who had suffered from a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection from March 2020 to December 2021. A questionnaire was distributed to the Danish population via the digital mail system (e-Boks). Self-reported demographic data, previous medical comorbidities (diagnosed), socioeconomic data, time of infection, prior chronic pain conditions (diagnosed), development of de novo widespread pain after infection, pain medication, and pain intensity information were collected. Responders consisted of 130,443 nonhospitalized participants (58.2% women; mean age: 50.2 years). At a mean of 14.4 (standard deviation 6.0) months after infection, 6,875 (5.3%) patients reported the presence of de novo widespread musculoskeletal post-COVID pain. Almost 75% of the patients reported a moderate to severe intensity of the pain. In conclusion, de novo widespread post-COVID pain was present in 5.3% of nonhospitalized COVID-19 survivors 1 year after infection (14.4 ± 6.0 months). Older age, female sex, higher BMI, and history of migraine, whiplash, stress, type-2 diabetes, neurological disorders, and lower socioeconomic status were risk factors associated with the development of de novo widespread post-COVID pain in nonhospitalized patients. As de novo widespread pain is considered a sign of sensitization, this group will require specialized pain management attention. PERSPECTIVE: This article presents de novo widespread post-COVID pain prevalence in a cohort of 130,443 citizens infected with COVID-19. The study identifies potential risk factors associated with the development of these new pain symptoms. The results may increase focus on this patient group and potentially help identify predictors for postinfection pain development.
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Affiliation(s)
- Brian D Ebbesen
- Center for Neuroplasticity and Pain, Department of Health Science and Technology, School of Medicine, Aalborg University, Aalborg, Denmark; Department of Gastroenterology & Hepatology, Mech-Sense, Clinical Institute, Aalborg University Hospital, Aalborg, Denmark
| | - Rocco Giordano
- Center for Neuroplasticity and Pain, Department of Health Science and Technology, School of Medicine, Aalborg University, Aalborg, Denmark
| | - Juan Antonio Valera-Calero
- Center for Neuroplasticity and Pain, Department of Health Science and Technology, School of Medicine, Aalborg University, Aalborg, Denmark; Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Complutense University of Madrid, Madrid, Spain; Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Jakob Nebeling Hedegaard
- Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - César Fernández-de-Las-Peñas
- Center for Neuroplasticity and Pain, Department of Health Science and Technology, School of Medicine, Aalborg University, Aalborg, Denmark; Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - Lars Arendt-Nielsen
- Center for Neuroplasticity and Pain, Department of Health Science and Technology, School of Medicine, Aalborg University, Aalborg, Denmark; Department of Gastroenterology & Hepatology, Mech-Sense, Clinical Institute, Aalborg University Hospital, Aalborg, Denmark; Steno Diabetes Center North Denmark, Clinical Institute, Aalborg University Hospital, Aalborg, Denmark
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Rada I, Ortiz MS, Cabieses B. [Health-related quality of life in Chileans from vulnerable communes]. GACETA SANITARIA 2023; 37:102328. [PMID: 37783060 DOI: 10.1016/j.gaceta.2023.102328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 06/02/2023] [Accepted: 08/05/2023] [Indexed: 10/04/2023]
Abstract
OBJECTIVE The COVID-19 pandemic and the resulting social and health crisis impacted the well-being of the population. Health-related quality of life (HRQoL) could be affected, mainly in conditions of social vulnerability. The objective was to analyze the HRQoL and the psychometric properties of the EQ-5D instrument in adult Chilean population from vulnerable communes of the Metropolitan Region. METHOD Cross-sectional study carried out during quarantine period April to June 2021. Five hundred adults residing in Chilean communes were selected and completed a structured questionnaire by video-call, including the EQ-5D instrument. Descriptive analyzes and confirmatory factor analyzes of the traditional reflective model were performed. RESULTS The age of the sample was 36.36±12.41 years, the majority reported having a secondary education level and being employed. Regarding the EQ-5D instrument, the most affected dimensions were pain/discomfort and anxiety/depression. The global health status was 73.0±19.71 points. The model showed an adequate fit: χ2=6.992, p=0.221, CFI=0.996, TLI=0.993, RMSEA=0.028 (90% CI: 0.000-0.073) and SRMR=0.067. In addition, the items of the scale were good indicators of the construct of interest. CONCLUSIONS In a pandemic context, the population was mostly affected by pain/discomfort and anxiety/depression. The EQ-5D instrument is a useful tool to estimate CRSV in the Chilean population in the context of pandemic. In addition, the psychometric evidence supports the dimensionality of the construct and the potential utility of decomposing its analysis.
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Affiliation(s)
- Isabel Rada
- Centro de Salud Global Intercultural, ICIM, Universidad del Desarrollo, Santiago de Chile, Chile; Programa de Doctorado en Ciencias e Innovación en Medicina, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago de Chile, Chile
| | - Manuel S Ortiz
- Departamento de Psicología, Laboratorio de Estrés y Salud, Universidad de La Frontera, Temuco, Chile
| | - Baltica Cabieses
- Centro de Salud Global Intercultural, ICIM, Universidad del Desarrollo, Santiago de Chile, Chile; Department of Health Sciences, University of York, York, United Kingdom.
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Akkemik O, Acikgoz A. Effect of the Ongoing Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Pandemic on Dental Service Utilization in Patients With Comorbidities. Cureus 2023; 15:e39926. [PMID: 37292106 PMCID: PMC10245075 DOI: 10.7759/cureus.39926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND The keystone of safe and effective patient management is to approach a patient with up-to-date medical information. Assessment of patients for their medical conditions has changed during the coronavirus disease 2019 (COVID-19) pandemic and the need for appropriate research infrastructure has increased. Considering an updated list of high-risk underlying conditions in the post-COVID-19 era, this study aimed to evaluate the utilization of dental services by patients with comorbidities during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. METHODS Data of patients with comorbidities seeking dental care at a dental school during the COVID-19 pandemic were retrospectively evaluated. Demographic variables (age, gender) and medical history of the participants were recorded. The patients were classified according to their diagnosis. Data were analyzed using descriptive statistics and Chi-square analysis. The significance level was determined at α=0.05. RESULTS The study included data from 1067 patient visits between September 1, 2020 and November 1, 2021. Among these patients, 406 (38.1%) were males and 661 (61.9%) were females, with a mean age of 38.28 ± 14.36 years. Comorbidities were identified in 38.3% of the patients with predominance in females (74.1% n=303). Single comorbidity was observed in 28.1% while multi-morbidity was detected in 10.2% of the cohort. The most prevalent comorbidity was hypertension (9.7%), followed by diabetes (6.5%), thyroid disorders (5%), various psychological diseases (4.5%), COVID-19 infection (4.5%), and different allergies (4%). The presence of one or more co-morbidities was observed mostly in the 50-59 years age group. CONCLUSIONS The seeking of dental care among the adult population with comorbidities was high during the SARS-CoV-2 pandemic. It would be beneficial to develop a template for obtaining a medical history from patients by taking full account of the consequences of the pandemic. The dental profession needs to respond accordingly.
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Affiliation(s)
- Ozlem Akkemik
- Dentomaxillofacial Radiology, Baris Medical Imaging Center, Izmir, TUR
| | - Aydan Acikgoz
- Dentomaxillofacial Radiology, Faculty of Dentistry, Yeni Yuzyil University, Istanbul, TUR
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El-Tallawy SN, Perglozzi JV, Ahmed RS, Kaki AM, Nagiub MS, LeQuang JK, Hadarah MM. Pain Management in the Post-COVID Era-An Update: A Narrative Review. Pain Ther 2023; 12:423-448. [PMID: 36853484 PMCID: PMC9971680 DOI: 10.1007/s40122-023-00486-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 02/06/2023] [Indexed: 03/01/2023] Open
Abstract
An extensive computer search (from January 2020 to January 2023) was conducted including literature from the PubMed, Scopus, MEDLINE, Web of Science, and EMBASE databases. According to preset criteria, a total of 58 articles were included in this review article. Generally, any patient who becomes infected with COVID-19 can develop post-COVID-19 conditions. The course of COVID-19 is divided into three main stages: acute COVID-19 (up to 4 weeks), post-acute COVID-19 (from 4 to 12 weeks), and post-COVID (from 12 weeks to 6 months). If a more protracted course of COVID (over 6 months) is demonstrated, the term "long-COVID" is used. Although the acute stage of COVID-19 infection most commonly manifests with acute respiratory symptoms, one very common symptom of the disease is pain, while the most common symptoms of post-COVID syndrome are shortness of breath, dry cough, fatigue, loss of olfactory and gustatory function, tightness and chest pain, sleep and mood disturbances, body aches, muscle and joint pain, sore throat, fever, and persistent headaches. All observations demonstrated a high incidence of chronic pain syndromes of various localization in the post- and long-COVID period. Post-COVID chronic pain might include a newly developed chronic pain as a part of post-viral syndrome; worsening of preexisting chronic pain due to the associated changes in the medical services, or a de novo chronic pain in healthy individuals who are not infected with COVID. Chronic pain during and post-COVID-19 pandemic is an important health issue due to the significant impacts of pain on the patients, health care systems, and society as well. Therefore, it is important that patients with chronic pain receive effective treatment according to their specific needs. Accordingly, the main goal of this review article is to provide a broad description about the post-COVID pain and to explore the impact of long COVID-19 on chronic pain patients, and also to give brief reports about the prevalence, risk factors, possible mechanisms, different presentations, and the management tools through a systematic approach.
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Affiliation(s)
- Salah N. El-Tallawy
- Anesthesia and Pain Department, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
- Anesthesia Department, Faculty of Medicine, Minia University and NCI, Cairo University, Giza, Egypt
| | | | - Rania S. Ahmed
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Abdullah M. Kaki
- Anesthesiology and Pain Medicine, International Medical Center, Jeddah, Saudi Arabia
| | | | | | - Mamdouh M. Hadarah
- Anesthesia and Pain Management, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
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Valladales-Restrepo LF, Gaviria-Mendoza A, Machado-Duque ME, Prado-Echeverry JA, Cortés-Navarro JL, Machado-Alba JE. Chronic pain and continuity of analgesic treatment during the COVID-19 pandemic. Pain Pract 2023; 23:359-367. [PMID: 36514870 DOI: 10.1111/papr.13197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 11/28/2022] [Accepted: 12/05/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Chronic pain can trigger both physical and mental health complications. During the COVID-19 pandemic, patients with chronic diseases have had reduced access to some medications. OBJECTIVE To determine the pharmacological management of patients with chronic pain and its continuity during the COVID-19 pandemic. METHODS This was a retrospective longitudinal study of the continuity of analgesic use in patients with chronic pain between September 1, 2019 and February 28, 2021 based on a drug dispensing database. Survival analysis was performed until the discontinuation of chronic analgesics. RESULTS A total of 12,701 patients who were being treated for chronic pain were identified. Their median age was 70.3 years, and 74.4% were women. The pain of rheumatological origin was the most frequent etiology (46.1%); the most used medications were nonopioid analgesics (78.9%), pain modulators (24.8%) and opioid analgesics (23.3%). A total of 76.1% of the patients experienced interruptions in their management during the study period. The median time to the first interruption of treatment was 5.0 months (95% CI: 4.8-5.2). Those who were treated for oncological pain experienced a greater number of interruptions in their management. CONCLUSIONS The pharmacological management of patients with chronic pain is heterogeneous, and this real-world study showed that a high proportion of patients experienced an interruption of pain management during the 12 months following the onset of the COVID-19 pandemic.
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Affiliation(s)
- Luis Fernando Valladales-Restrepo
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A, Pereira, Colombia
- Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia
| | - Andrés Gaviria-Mendoza
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A, Pereira, Colombia
- Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia
| | - Manuel Enrique Machado-Duque
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A, Pereira, Colombia
- Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia
| | - Julio Andrés Prado-Echeverry
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A, Pereira, Colombia
| | - Jorge Luis Cortés-Navarro
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A, Pereira, Colombia
| | - Jorge Enrique Machado-Alba
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A, Pereira, Colombia
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Chen JL, Ho ST, Sun WZ, Tsai YC, Cheng KI, Liu YC, Hsieh YJ, Wen YR, Wang PK, Sung CS, Yeh CC, Lin TC. Prescription Opioid Use among Patients with Chronic Noncancer Pain before and after the COVID-19 Outbreak in Taiwan: A Multicenter Prospective Observational Study. Healthcare (Basel) 2022; 10:healthcare10122460. [PMID: 36553984 PMCID: PMC9778017 DOI: 10.3390/healthcare10122460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The COVID-19 outbreak disrupted medical access for patients receiving chronic opioid therapy. This study investigated their prescription opioid dosages before and after the 2020 outbreak in Taiwan. METHODS A prospective questionnaire survey was conducted among registered outpatients receiving long-term opioids before July 2019 in Taiwan. The questionnaire included items from the Taiwanese Brief Pain Inventory and quality of life assessment. Follow-up surveys in outpatient departments through October 2020 were conducted to collect opioid prescription data. RESULTS After a mean of 531 days, the questionnaire responses of 103 of the initial 117 respondents were reviewed. Daily opioid doses decreased for 31 respondents (30.1%), remained roughly equivalent (defined as ±2.5%) for 27 (26.2%), and increased for 45 (43.7%) after the first wave of the pandemic. The use of strong opioids and nonopioid medications did not significantly differ among the three groups, but less fentanyl patch use was noted in the decreased-dose group after the outbreak. More than 70% of the patients received daily high-dose opioids (≥90 morphine milligram equivalents); moreover, 60% reported constipation. No deaths due to opioid overdose occurred during the study period. CONCLUSIONS The COVID-19 outbreak in 2020 did not interrupt access to long-term opioid prescriptions for most registered patients with chronic pain in Taiwan. Less fentanyl patch use was observed in participants whose opioid dose was tapering.
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Affiliation(s)
- Jia-Lin Chen
- Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Shung-Tai Ho
- Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
| | - Wei-Zen Sun
- Department of Anesthesiology, National Taiwan University Hospital, National Taiwan University, Taipei 10617, Taiwan
- Health Science & Wellness Center, National Taiwan University, Taipei 10617, Taiwan
| | - Yu-Chuan Tsai
- Department of Anesthesiology, Center of Pain Management, E-Da Cancer Hospital, School of Medicine, I-Shou University College of Medicine, Kaohsiung 82445, Taiwan
| | - Kuang-I Cheng
- Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
| | - Yen-Chin Liu
- Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
- Department of Anesthesiology, School of Post-Baccalaureate, College of Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
- Department of Anesthesiology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan
| | - Yi-Jer Hsieh
- Department of Anesthesiology, Changhua Christian Hospital, Changhua 50006, Taiwan
| | - Yeong-Ray Wen
- Department of Anesthesiology, China Medical University Hospital, China Medical University, Taichung 40447, Taiwan
| | - Po-Kai Wang
- Department of Anesthesiology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, School of Medicine, Tzu Chi University, Hualien 97004, Taiwan
| | - Chun-Sung Sung
- Department of Anesthesiology, Taipei Veterans General Hospital, Taipei 11217, Taiwan
| | - Chun-Chang Yeh
- Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Tso-Chou Lin
- Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Correspondence:
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Choi JI. Transition of COVID-19 to endemic phase and emergence of COVID-19 related neuropathic pain. Korean J Pain 2022; 35:237-239. [PMID: 35768978 PMCID: PMC9251396 DOI: 10.3344/kjp.2022.35.3.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 06/20/2022] [Accepted: 06/20/2022] [Indexed: 11/26/2022] Open
Affiliation(s)
- Jeong Il Choi
- Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School and Hospital, Gwangju, Korea
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Compton P, St Marie B. Coexisting Substance Use Disorder and Chronic Pain During COVID-19. Pain Manag Nurs 2022; 23:17-25. [PMID: 34620549 PMCID: PMC8418911 DOI: 10.1016/j.pmn.2021.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/29/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Peggy Compton
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, 19104-4217.
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Poggiali E, De Iaco F. The pain in the Emergency Department: Choosing and treating wisely before and during the COVID-19 era. EMERGENCY CARE JOURNAL 2021. [DOI: 10.4081/ecj.2021.9903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Pain is a frequent reason for referral to the Emergency Department (ED). Adequate management of pain is a moral and ethical imperative. If not correctly treated, acute pain can cause physical and psychological complications, and become chronic with severe consequences such as anxiety, depression, and social isolation. As consequence, emergency clinicians should treat pain as soon as possible, avoiding delays even in case of acute abdominal pain. Pain management is particularly complex in the elderly and emergency clinicians should always consider AGS Beers criteria ® to avoid inappropriate medications, severe side-effects, and drug-drug interactions. Pain is also a common cause of delirium in older patients. The SARS CoV-2 infection not only can cause acute pain, but also exacerbate chronic pain, particularly in the elderly, who are at high risk to be infected. Looking at all this evidence, emergency clinicians should treat pain with different strategies according to their experience and cultural background, making the right choice for each patient. This work is a critical review of the pain management in the ED, with a particular attention on the effects of COVID-19 in the EDs. We conducted a systematic search of the following databases: PubMed, Google Scholar, Science Direct, Medline from 2000 to 2020, using the keywords of “pain”, “emergency”, “COVID19”, “elderly”, “palliative care”, “ketamine”, “dexmedetomidine”, and “post-traumatic stress disorder”. The aim of this review is to help emergency clinicians to correctly manage pain in the ED with a new point of view regarding the pain management in COVID-19 patients.
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Prevalence and risk factors of musculoskeletal pain symptoms as long-term post-COVID sequelae in hospitalized COVID-19 survivors: a multicenter study. Pain 2021; 163:e989-e996. [PMID: 34913880 DOI: 10.1097/j.pain.0000000000002564] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/01/2021] [Indexed: 10/19/2022]
Abstract
This study investigated the prevalence of long-term musculoskeletal post-COVID pain and their risk factors in a large cohort of COVID-19 survivors. A multicenter cohort study including patients hospitalised due to COVID-19 in five hospitals of Madrid (Spain) during the first wave of the pandemic was conducted. Hospitalisation and clinical data were collected from medical records. Patients were scheduled for a telephone interview after hospital discharge for collecting data about the musculoskeletal post-COVID pain. Anxiety/depressive levels and sleep quality were likewise assessed. From 2,000 patients recruited, a total of 1,969 (46.4% women, age: 61, SD: 16 years) were assessed on average at 8.4 (SD 1.5) months after discharge. At the time of the study, 887 (45% women) reported musculoskeletal post-COVID pain. According to the presence of previous pain symptoms, the prevalence of "de novo" (new-onset) musculoskeletal post-COVID pain was 74.9%, whereas 25.1% experienced an increase of previous symptoms (exacerbated COVID-related pain). Female gender (OR1.349, 95%CI 1.059-1.720), previous history of musculoskeletal pain (OR1.553, 95%CI 1.271-1.898), the presence of myalgia (OR1.546, 95%CI 1.155-2.070) and headache (1.866, 95%CI 1.349-2.580) as COVID-19 associated onset symptoms, and days at hospital (OR1.013, 95%CI 1.004-1.022) were risk factors associated musculoskeletal post-COVID pain. In conclusion, musculoskeletal post-COVID pain is present in 45.1% of COVID-19 survivors at eight months after hospital discharge with most patients developing "de novo" post-COVID pain. Female gender, history of musculoskeletal pain, presence of myalgias and headache as COVID-19 symptoms at the acute phase, and days at hospital were risk factors associated with musculoskeletal post-COVID pain.
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Abstract
The article highlights the pathogenesis, clinical manifestations of lesions of the central and peripheral nervous system that have arisen or persist in patients in the postcoid period (Long-COVID-19). Their correct assessment, the use of effective methods of complex treatment, targeted neurorehabilitation contribute to the reversibility of functional disorders, prevention, reduction of disability, improvement of quality of life indicators, prevention of the progression of cognitive, emotional, behavioral disorders initiated by SARS-CoV-2.
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ŞAHİN EM, OCAK Ö, DEMİRAL C, DÖNMEZ B. COVİD-19 Symptoms at First Admission to Hospital. KONURALP TIP DERGISI 2021. [DOI: 10.18521/ktd.893195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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