Pain Complaints and Intubation Risk in COVID-19 Patients: A Retrospective Cross-Sectional Analysis

Area of Science:

• Medical research
• Epidemiology
• Clinical informatics

Background:

• The COVID-19 pandemic has highlighted the need to understand disease severity markers.
• Pain is a common symptom, but its correlation with critical care needs like intubation is understudied.
• Existing research often overlooks the significance of pain reports in predicting COVID-19 patient outcomes.

Purpose of the Study:

• To investigate the relationship between reported pain in COVID-19 patients and the likelihood of requiring intubation.
• To analyze pain complaints as a potential indicator of disease severity and need for life-sustaining treatment.
• To explore variations in this relationship across different pain types and age groups.

Main Methods:

• Retrospective cross-sectional analysis of over 2.4 million COVID-19 patient records from the Epic Cosmos database (February 2020 - April 2023).
• Utilized validated billing codes to categorize pain complaints (abdominal pain, chest pain, myalgia, headache) and intubation status.
• Employed Pearson's chi-square analyses and odds ratio calculations, stratified by age groups.

Main Results:

• A statistically significant relationship (p < 0.00001) was found between pain presence and intubation status.
• Patients reporting any pain were less likely to be intubated (OR 0.58).
• Specific pain types showed reduced intubation likelihood: myalgia (OR 0.26), headache (OR 0.31), abdominal pain (OR 0.61), and chest pain (OR 0.86).

Conclusions:

• Pain complaints in COVID-19 patients are negatively correlated with the need for emergency intubation.
• The absence of pain may suggest a poorer prognosis, although further research is required.
• Hospitalized COVID-19 patients without pain may require closer clinical monitoring due to potential poor prognosis.