Background & Aims
Coronavirus disease 2019 (COVID-19) has caused a global pandemic with over 774 million people infected worldwide. While there has been a substantial progress of scientific knowledge with regards to prevention and treatment, accumulating evidence implies that some of the patients can develop long-term health complications after the acute phase. This condition is commonly known as “long COVID.” Some of the most common long COVID-like symptoms include cough, fatigue, shortness of breath, and memory deficits. While the epidemiology of long COVID-like symptoms remains unclear, it has been reported that risk factors include female sex, socioeconomic deprivation, smoking, and obesity. Although these factors are also known to be confounding factors for chronic pain (CP), no relationship between CP and long COVID-like symptoms has been reported thus far. In this study, we used the large-scale internet-based epidemiological data to analyze the interaction effect of CP on the symptoms.
Methods
Supported by an internet research agency, internet-based, self-reported questionnaires were randomly distributed to 32,000 panelists in September 2022. We collected data including age, sex, history of CP and COVID-19, and presence of long COVID-like symptoms (gastrointestinal disorder; back pain; limb/joint pain; headache; chest pain; shortness of breath; dizziness; sleep disorder; hearing loss; taste disorder; smell disorder; memory deficits; loss of concentration; hair loss; sexual dysfunction; fatigue; cough; fever) within the latest week. Participants were categorized into ones with and without CP. Demographic data, history of COVID-19, and presence of the symptoms were compared between the 2 groups. Participants were then categorized into 4 groups based on the history of CP and COVID-19, and prevalence of the symptoms was analyzed using the Chi-square test. Multivariable logistic regression analysis was applied to analyze the interaction effect of CP and COVID-19 on the symptoms.
Results
A total of 28,619 participants responded to the survey. Participants with CP showed significantly higher prevalence of all long COVID-like symptoms including dizziness (72.5%, p<0.0001), loss of concentration (62.5%, p<0.0001), memory deficits (42.8%, p<0.0001), and shortness of breath (40.4%, p<0.0001). In people with both CP and COVID-19, significantly higher prevalence of taste disorder, smell disorder, memory deficits, hearing loss, cough, fever, hair loss, chest pain, shortness of breath, dizziness, sexual dysfunction, headache, gastrointestinal disorder, sleep disorder, loss of concentration, and fatigue were observed compared to ones lacking either or both CP and COVID-19. In the multivariable regression analysis, the interaction effect of CP and COVID-19 was related to the increased prevalence of taste disorder, smell disorder, memory deficits, hearing loss, cough, fever, hair loss, shortness of breath, dizziness, sexual dysfunction, headache, and gastrointestinal disorder.
Conclusions
Chronic pain was significantly associated with the long COVID-like symptoms, and coexisting of chronic pain and the history of COVID-19 increased prevalence of the symptoms. In fact, our result poses a possibility that these symptoms may not solely represent the long-term effect of COVID-19, but chronic pain may be a risk factor for them.
References
Subramanian A, Nirantharakumar K, Hughes S, et al. Symptoms and risk factors for long COVID in non-hospitalized adults. Nat Med. 2022 Aug;28(8):1706-1714.
Presenting Author
Saki Takaoka
Poster Authors
Topics
- Epidemiology