Characteristics and Risk Factors of Persistent Neuropathic Pain in Recovered COVID-19 Patients

• Published in: Pain medicine (Malden, Mass.) Mass.), 2022-04, Vol.23 (4), p.774-781
• Main Authors: Magdy, Rehab, Eid, Ragaey A, Fathy, Wael, Abdel-Aziz, Manar M, Ibrahim, Raghda E, Yehia, Ahmed, Sheemy, Mostafa S, Hussein, Mona
• Format: Article
• Language: English
• Subjects: Antibiotics; Axons; Azithromycin; Brief Report; Care and treatment; Case-Control Studies; Coronaviruses; COVID-19; COVID-19 - complications; Cytoplasmic filaments; Ferritin; Health aspects; Humans; Medical personnel; Mental depression; Mental disorders; Neuralgia; Neuralgia - diagnosis; Neuralgia - epidemiology; Neuralgia - etiology; Neurological diseases; Pain; Pain management; Pain perception; Patients; Risk Factors; Severe acute respiratory syndrome coronavirus 2
• ISSN: 1526-2375; 1526-4637
• DOI: 10.1093/pm/pnab341

Abstract Objectives To assess risk factors for persistent neuropathic pain in subjects recovered from coronavirus disease 2019 (COVID-19) and to study the serum level of neurofilament light chain (NFL) in those patients. Design Case-control study. Setting Persistent post-COVID-19 pain. Subjects In total, 45 patients with post-COVID-19 pain and another 45 age and sex-matched healthcare workers who recovered from COVID-19 without pain. Methods The included participants were subjected to medical history taking, screening for depressive disorders, comprehensive neurological examination, and pain evaluation using the Douleur Neuropathique en 4 questions (DN4). All patients who had a score at least 4/10 on DN4 were included. The serum NFL level was measured for both groups at the time of patients’ enrollment. Results The frequency of depression, moderate and severe COVID-19 cases, disease duration and serum ferritin were significantly higher in the cases with post-COVID-19 pain than controls. Binary logistic regression revealed that depression, azithromycin use, moderate and severe COVID-19 increased the odds of post-COVID-19 pain by 4.462, 5.444, 4.901, and 6.276 times, respectively. Cases with post-COVID-19 pain had significantly higher NFL (11.34 ± 9.7, 95% confidence interval [CI]: 8.42–14.25) than control group (7.64 ± 5.40, 95% CI: 6.02–9.27), (P value = .029). Patients with allodynia had significantly higher NFL (14.96 ± 12.41, 95% CI: 8.58–21.35) compared to those without (9.14 ± 6.99, 95% CI: 6.43–11.85) (P value = .05). Discussion Depression, azithromycin, and moderate and severe COVID-19 are independent predictors of persistent post-COVID-19 pain. Serum NFL may serve as a potential biomarker for persistent neuropathic pain after COVID-19.