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Chronic pain characteristics in COVID-19 survivors after an ICU stay. A cross-sectional study
Valéria Martinez1, Mikhail Dziadzko2, Juan Tamayo3
1Service d'Anesthésie douleur, Hôpital Raymond Poincaré, Assistance Publique Hôpitaux de Paris, 104 boulevard Raymond Poincaré, F-92380 Garches, France; INSERM, U-987, Hôpital Ambroise Paré, Centre d'Evaluation et de Traitement de la Douleur, Boulogne Billancourt, F-92100, France; Université Versailles Saint-Quentin, 55 avenue de Paris, Versailles F-78035, France.
Background:
The onset and characteristics of chronic pain following an intensive care unit (ICU) stay for COVID-19 have never been thoroughly investigated.
Study Design:
A multicenter cohort study was conducted to describe chronic pain, according to ICD-11, among COVID-19 survivors. The chronic pain was assessed during face-to-face consultations with a pain specialist.
Results:
Among 204 COVID-19 ICU survivors, 143 patients with mean age of 60 ± 14 years were included nine months after discharge from the ICU. More than half (54%) of patients experienced new-onset chronic pain. In total, 102 different forms of pain were reported in these patients. Secondary pain was the most frequent type, comprising musculoskeletal (40%), post-traumatic (34%), neuropathic (25%), and visceral (13%). Primary chronic pain was rare (7%). The three most common sites of pain were the shoulders, chest, and head. Pain was moderate to severe in 75% of cases, and higher intensity was associated with a greater impact on daily life. Anxiety, depression, post-traumatic stress, perceived stress, and debilitating pain were frequently associated. Intubation was more frequent in patients with chronic pain. Specialized pain centre follow-up was required for 21% of the survivors, which represented 40% of the patients who developed new-onset chronic pain.
Conclusion:
New-onset chronic pain is common after an ICU stay for COVID-19 and may manifest in various forms. Secondary pain caused by ICU management is the most frequent. Patients should undergo screening after ICU discharge to facilitate prompt, thorough, and personalized pain management.
Clinical Trial Registration:
NCT04940208.
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