Rehab Magdy1, Ragaey A Eid2, Wael Fathy3, Manar M Abdel-Aziz4, Raghda E Ibrahim4, Ahmed Yehia5, Mostafa S Sheemy6, Mona Hussein7. 1. Department of Neurology, Cairo University, Cairo, Egypt. 2. Department of Tropical Medicine, Beni-Suef University, Beni-Suef, Egypt. 3. Department of Anesthesia, Surgical ICU and Pain Management, Beni-Suef University, Beni-Suef, Egypt. 4. Department of Clinical & Chemical Pathology, Beni-Suef University, Beni-Suef, Egypt. 5. Department of Internal Medicine, Beni-Suef University, Beni-Suef, Egypt. 6. Department of Medical Microbiology and Immunology, Beni-suef University, Beni-Suef, Egypt. 7. Department of Neurology, Beni-Suef University, Beni-Suef, Egypt.
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.
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.
Authors: César Fernández-de-Las-Peñas; Manuel Herrero-Montes; Diego Ferrer-Pargada; Sheila Izquierdo-Cuervo; Domingo Palacios-Ceña; Lars Arendt-Nielsen; Juan Torres-Macho; Paula Parás-Bravo Journal: Pain Med Date: 2022-06-08 Impact factor: 3.637
Authors: César Fernández-de-Las-Peñas; Paula Parás-Bravo; Diego Ferrer-Pargada; Ignacio Cancela-Cilleruelo; Jorge Rodríguez-Jiménez; Jo Nijs; Lars Arendt-Nielsen; Manuel Herrero-Montes Journal: Pain Pract Date: 2022-06-27 Impact factor: 3.079