Sevgi Gümüş Atalay1, Pınar Borman1, Ayşegül Yaman2, Evren Yaşar1

1Department of Physical Medicine and Rehabilitation, University of Health Sciences, Ankara City Hospital, Ankara, Türkiye
2Department of Physical Medicine and Rehabilitation, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Türkiye

Keywords: Musculoskeletal pain, neuropathic pain, post-COVID-19.

Abstract

Objectives: This study aimed to evaluate the neuropathic component of chronic musculoskeletal pain in post-coronavirus disease 2019 (COVID-19) and examine the relationship between neuropathic pain and clinical and demographic characteristics.

Patients and methods: This cross-sectional study included 163 adult patients (85 females, 78 males; mean age: 41.7±4.3 years; range, 22 to 50 years) with post-COVID-19 musculoskeletal pain between February 1, 2021, and April 30, 2021. Demographic and clinical characteristics, including age, sex, affected site, duration, and severity of post-COVID-19 musculoskeletal pain using the Visual Analog Scale (VAS), as well as a neuropathic component of pain using the Leeds assessment of neuropathic symptoms and signs (LANSS), were collected. The most common post-COVID-19 symptoms, presence of hospitalization, and length of hospital stay during active COVID-19 infection were recorded from the patient records.

Results: The mean duration and severity of pain were 7.85±1.53 months and 5.09±1.95, respectively. Half of the patients were hospitalized, and the mean length of hospital stay was 12.15±18.06 days. The most common pain sites were upper and lower back pain, followed by leg and arm pain. A total of 92 (56.4%) patients had previously received pharmacological or nonpharmacological treatment for post-COVID-19 musculoskeletal pain. Based on the LANSS (scores >12), 31 (19%) patients had neuropathic pain. There was a significant correlation between the presence of neuropathic pain and pulmonary involvement/symptoms. The presence and length of hospital stay were correlated with LANNS scores (p<0.05). The frequency, LANSS scores, and VAS-pain scores of the patients with and without neuropathic pain were similar between male and female patients (p>0.05).

Conclusion: The neuropathic component of chronic musculoskeletal pain may be common, as one-fifth of our patients had neuropathic pain as assessed by the LANNS. Therefore, the awareness of post-COVID-19 chronic neuropathic musculoskeletal pain should be increased. We believe that focusing on the identification of pain phenotypes would provide adequate and tailored chronic neuropathic musculoskeletal pain management in the post-COVID-19 period.

Citation: Gümüş Atalay S, Borman P, Yaman A, Yaşar E. Neuropathic component of chronic musculoskeletal pain in patients with postcoronavirus disease 2019: A cross-sectional study. Arch Rheumatol 2024;39(3):436-446. doi: 10.46497/ArchRheumatol.2024.9990.

Ethics Committee Approval

The study protocol was approved by the Ankara City Hospital Ethics Committee (date: 10.02.2021, no: E2-21-72). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Author Contributions

Conceptualization and design: P.B., S.GA.; Control/supervision, critical review: E.Y., A.Y., S.GA; Data collection and/or processing, writing the article: P.B., S.GA; Analysis and/or interpretation: A.Y., P.B., S.GA E.Y.; Literature review: P.B., S.GA; E.Y., A.Y.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.