Background

Coronavirus disease 2019 (COVID-19) has affected numerous patients worldwide. Symptoms of COVID-19 are variable, but often include fever, cough, headache, fatigue, breathing difficulties, and loss of smell or taste. Neurological complications include cerebrovascular incidents, acute polyneuropathy and myelitis. The aim of this prospective cross-sectional study was to establish the prevalence of chronic pain in COVID-19 patients.

Methods

COVID-19 survivors voluntarily participated to our study. All patients were clinically examined by a neurologist. Pain was assessed with the use of the painDETECT and the DN4 questionnaires.

Results

Fifty-two COVID019 patients (33% males, mean age 48±16 years) and 52 age and gender matched healthy volunteers participated. Patients were evaluated on average 4±3 months after being diagnosed with COVID-19. From the classic acute COVID-19 symptoms, 50% had anosmia/hyposmia, 48% ageusia/hypogeusia, 48% fatigue, 40% cough, 39% headache, 35% myalgias and 31% fever.

The prevalence of chronic pain was 70% in the COVID-19 group and 73% in the healthy volunteer group. The most commonly reported painful area in both groups was lower back (35% in the COVID-19 group and 31% in the healthy control group).  In 7 patients chronic pain (6 neuropathic, 1 nociceptive) developed after COVID-19 whereas 3 patients reported worsening of their pre-existing chronic pain (2 neuropathic, 1 nociceptive).

In the COVID-19 group, patients with pain were significantly older compared to patients without (52±17 years vs 41±11 years, p=0.02). No differences between the two sub-groups were found regarding gender, BMI, COVID-19 symptoms,  COVID-19 symptoms duration or duration since COVID-19 infection.

Conclusions

Chronic pain is very prevalent in COVID-19 survivors and  its prevalence is similar to the prevalence observed in the general population. However, one in 5 COVID-19 survivors reports that chronic pain developed or deteriorated after their infection. Chronic pain, particularly neuropathic, should be considered as a symptom of the post-COVID syndrome.