Treatment options for localized and widespread post-covid pain

Edit, V.

Data on the new coronavirus caused disease and its treatment have been accumulating for more than a year. There are four main disease courses: no or mild symptoms, unavoidable hospitalisation, severe or lethal outcome, and permanent or posthoc manifestations. The last course is usually referred to as post-COVID syndrome. As a part of the acute and post-COVID symptomatology there were published pain perceptions with frequent but heterogeneous localisation. It is practical to classify them by the origin of pain: nociceptive/inflammatory, peripheral neuropathic or central. Additionally, we have to clear which phase is the post-COVID patient in i.e. the patient has the prolonged COVID- or persistent post-COVID syndrome. However, in addition to an acute general inflammatory reaction, a true inflammation of joints and muscles is very rare in the musculoskeletal system. The diffuse musculoskeletal pain, chronic fatigue, generalised anxiety and depressive disposition manifest themselves in both acute and persistent forms. Their explanation is essentially of neurological nature: there are para-infectious “neuro-inflammation”, i.e. neuropathic and central mechanisms in the background. Accordingly, therapeutic options must be chosen while concerning the neuropharmacological action mechanisms of analgesics. Elderly patients at high iatrogenic risk and with multiple co-morbidities may be treated transdermal instead of oral drug administration. © 2021 Literatura Medica Publishing House. All rights reserved.