Causal relationship between COVID-19 and chronic pain: A mendelian randomization study

Area of Science:

• Epidemiology
• Genetics
• Pain Medicine

Background:

• COVID-19 can lead to persistent symptoms, including chronic pain, but the underlying mechanisms remain unclear.
• Establishing a causal link between COVID-19 and chronic pain is crucial for developing effective treatments.
• Mendelian randomization (MR) is a valuable statistical approach for inferring causality between an exposure and an outcome.

Purpose of the Study:

• To investigate the potential causal association between COVID-19 and the risk of developing chronic pain conditions.
• To explore whether COVID-19 severity influences the likelihood of experiencing different types of chronic pain.

Main Methods:

• Employed Mendelian randomization (MR) using instrumental variables (IVs) for COVID-19.
• Utilized inverse variance weighted (IVW), MR Egger, and weighted median methods for causal inference.
• Assessed heterogeneity with Cochran's Q statistic and pleiotropy using MR Egger intercept and MR-PRESSO tests. Multiple testing was corrected using Bonferroni. Statistical analyses were performed in R software.

Main Results:

• Hospitalized COVID-19 patients demonstrated a higher risk of lower leg joint pain compared to the general population.
• Suggestive associations were observed between COVID-19 hospitalization and back pain, headache, and widespread pain.
• Patients with severe COVID-19, particularly respiratory-confirmed cases, showed a suggestive increased risk of widespread pain.

Conclusions:

• COVID-19 severity is linked to an increased risk of pain in various body regions.
• Findings suggest a potential causal relationship between COVID-19 and chronic pain development.
• These insights can inform targeted interventions to alleviate the burden of long-COVID-related chronic pain.