Prevalence and characteristics of new‐onset pain in COVID‐19 survivors, a controlled study

Soares, Felipe Henriques Carvalho; Kubota, Gabriel Taricani; Fernandes, Ana Mércia; Hojo, Bruno; Couras, Catarina; Costa, Bárbara Venturoti; da Silva Lapa, Jorge Dornellys; Braga, Luíza Mansur; de Almeida, Matheus Merula; da Cunha, Pedro Henrique Martins; Pereira, Vítor Hugo Honorato; de Morais, Adriano Donizeth Silva; Teixeira, Manoel Jacobsen; Ciampi de Andrade, Daniel

We assessed whether COVID‐19 is associated with de novo pain and de novo chronic pain (CP). This controlled cross‐sectional study was based on phone interviews of patients discharged from hospital after COVID‐19 compared to control group composed of individuals hospitalized during the same period due to non‐COVID‐19 causes. Patients were classifyed as having previous CP based on the ICD‐11/IASP criteria, de novo pain (i.e., any new type of pain, irrespective of the pain status before hospital stay), and de novo CP (i.e. persistent or recurring de novo pain, lasting more than 3 months) after COVID‐19. We asssessed pain prevalence and its characteristics, including headache profile, pain location, intensity, interference, and its relationship with fatigue, and persistent anosmia. Forty‐six COVID‐19 and 73 control patients were included. Both groups had similar sociodemographic characteristics and past medical history. Length of in‐hospital‐stay and ICU admission rates were significantly higher among COVID‐19 survivors, while mechanical ventilation requirement was similar between groups. Pre‐hospitalization pain was lower in COVID‐19 compared to control group (10.9% vs. 42.5%; P=0.001). However, COVID‐19 group had a significantly higher prevalence of de novo pain (65.2% vs. 11.0%, P=0.001), as well as more de novo headache (39.1%) compared to controls (2.7%, p=0.001). New‐onset CP was 19.6% in COVID‐19 patients and 1.4% (P=0.002) in controls. These differences remained significant (p=0.001) even after analyzing exclusively (COVID: n=40; controls: n=34) patients who did not report previous pain before hospital stay. No statistically significant differences were found for mean new‐onset pain intensity and interference with daily activities between both groups. COVID‐19 pain was more frequently located in the head/neck and lower limbs (P<0.05). New‐onset fatigue was more common in COVID‐19 survivors necessitating inpatient hospital care (66.8%) compared to controls (2.5%, p=0.001). COVID‐19 patients who reported anosmia had more new‐onset pain (83.3%) compared to those who did not (48.0%, P=0.024). COVID‐19 was associated with a significantly higher prevalence of de novo CP, chronic daily headache, and new‐onset pain in general, which was associated with persistent anosmia.