Background & Aims
Current evidence supports that up to 30% of individuals who survived a SARS-CoV-2 infection develop post-COVID symptoms still present two years after the infection (1). Post-COVID pain is present in up to 20% of COVID-19 survivors (2) in hospitalized and non-hospitalized individuals (3). The development of post-COVID pain can range from localized symptoms (e.g., headache, joint pain, muscle pain) to widespread symptoms (4).
The development of vaccines has marked the incidence and progression of the disease by decreasing the risk of mortality and severity; however, the effect of vaccines on post-COVID symptoms varies depending on whether the vaccinations are given before or after infection but also on the number of doses (boosters) received (5,6).
This study aimed to investigate the possible prevalence differences of post-COVID pain symptoms in a cohort of hospitalized and non-hospitalized COVID-19 survivors with respect to the number of COVID-19 vaccine doses received.
Methods
Participants were included if they had at least one SARS-CoV-2 infection (a positive reverse transcription polymerase chain reaction test, RT-PCR) between March 2020 and December 2021. Both hospitalized and non-hospitalized individuals were included. A peer-reviewed self-administered survey (SurveyXact, Rambøll Management Consulting A/S) was sent via Digital Post (a national public system for electronic emails) in August 2022 (in average 20 months post-infection). The survey investigated the presence, type of pain (see table), and features of pain symptoms developed after SARS-CoV-2 infection. Electronic health data records from hospitalization were collected from the Danish Health Data Authority (DHDA) and RT-PCR test data for all participants. The presence and characteristics of post-COVID pain were analyzed depending on the number of COVID-19 vaccine doses (boosters) received (one, two, three, or more).
Results
Data from 17,938 COVID-19 survivors (1,687 hospitalized and 16,296 non-hospitalized) were included. The prevalence of post-COVID pain symptoms was, generally, higher for those individuals who had received 4 vaccine doses for all types of pain (all, P<0.001) except joint pain that increased from dose 1 to 3 and then dropped again. (P<0.001). The severe pain intensity rating (4-point Likert Scale from Mild, over Moderate and Severe, to Very Severe) was reported by a significantly greater number of individuals with a higher number of vaccine doses (P<0.001) while a mild and moderate intensity score was significantly lower with more doses except for individuals who received two doses (P<0.001).
Conclusions
This study is the first to investigate the differences in the prevalence of post-COVID pain symptoms in a large nationwide population stratified on the number of vaccine doses received from the COVID-19 infection and until data collection (in average 20 months post-infection). The results revealed that prevalence and severity of post-COVID pain was higher in individuals who had received a higher number of vaccine doses. This observation requires more through investigations to elucidate the phenomena behind.
References
1: Fernández-de-las-Peñas C, Notarte KI, Macasaet R, Velasco JV, Catahay JA, Therese Ver A, Chung W, Valera-Calero JA, Navarro-Santana M. Persistence of post-COVID symptoms in the general population two years after SARS-CoV-2 infection: A systematic review and meta-analysis. J Infect. 2023 Dec 13:S0163-4453(23)00590-X.
2: Fernández-de-las-Peñas C, Navarro-Santana M, Plaza-Manzano G, Palacios-Ceña D, Arendt-Nielsen L. Time course prevalence of Post-COVID pain symptoms of musculoskeletal origin in patients who had survived to SARS-CoV-2 infection: A systematic review and meta-analysis. Pain. 2022; 163: 1220-1231.
3: Yuan N, Lv ZH, Sun CR, Wen YY, Tao TY, Qian D, Tao FP, Yu JH. Post-acute COVID-19 symptom risk in hospitalized and non-hospitalized COVID-19 survivors: A systematic review and meta-analysis. Front Public Health. 2023; 11: 1112383.
4: Castaldo M, Ebbesen BD, Fernández-de-las-Peñas C, Arendt-Nielsen L, Giordano R. COVID-19 and musculoskeletal pain: An overview of the current knowledge. Minerva Anestesiol. 2023; 89: 1134-1142.
5: Watanabe A, Iwagami M, Yasuhara J, Takagi H, Kuno T. Protective effect of COVID-19 vaccination against long COVID syndrome: A systematic review and meta-analysis. Vaccine. 2023; 41: 1783-1790.
6: Notarte KI, Catahay JA, Velasco JV, Pastrana A, Ver AT, Pangilinan FC, Peligro PJ, Casimiro M, Guerrero JJ, Gellaco MML, Lippi G, Henry BM, Fernández-de-las-Peñas C. Impact of COVID-19 vaccination on the risk of developing long-COVID and on existing long-COVID symptoms: A systematic review. EClinicalMedicine. 2022; 53: 101624.
Presenting Author
Brian Duborg Ebbesen
Poster Authors
Brian Ebbesen
MSc
Aalborg University
Lead Author
Rocco Giordano
Center for Neuroplasticity and Pain, HST, Faculty of Medicine, Aalborg University, Aalborg, DK
Lead Author
Juan Antonio Valera-Calero
prof
Universidad Complutense de Madrid, Madrid, Spain
Lead Author
César Fernández-de-las-Peñas
dr med sci
Universidad Rey Juan Carlos (URJC), Madrid, Spain
Lead Author
Lars Arendt-Nielsen
PhD
Aalborg University
Lead Author
Topics
- Epidemiology