Post-COVID 19 and Neuropathic Pain

Objective: In this study, we compared neuropathic pain in post-COVID patients with a healthy control group who did not have COVID-19. We aimed to draw attention to neuropathic pain in the post-COVID period. Patients and methods: A total of 169 individuals participated in the study. 89 cases constituted the postCOVID group and 80 cases constituted the control group. In our case series, patients were in the post-COVID period and the control groups were assessed with the Douleur Neuropathique 4 (DN4) and Self-Leeds Assessment of Neuropathic Symptoms and Sign (SLANSS) questionnaire for neuropathic pain. Results: The age, gender, clinical and demographic features of the participants were not statistically different between the groups (p < 0.01). A Mann-Whitney test indicated that both S-LANSS and DN4 total scores were greater for the postCOVID group (Mdn = 2) than for the control group (Mdn = 5). The U values for S-LANSS and DN4 were 1941.500 and 1938.0 respectively. Both p values < 0.001. Conclusion: COVID-19 causes long-term complications, including pain. The etiopathogenesis and treatment of COVID-19 related pain syndromes, which we will see in the coming years, will be revealed by extensive and long-term studies. With this study, which will shed light on the process of COVID and neuropathic pain, it was tried to draw attention to the pain that has an important place in the quality of life in post-COVID-19 patients. OrIgINAL ArTIcLE *Corresponding author: Sinan ELIAÇIK, Department of Neurology, Hitit University School of Medicine, Turkey, Tel: 05426657563 1Department of Neurology, Hitit University School of Medicine, Turkey 2Department of Infection Disease and Microbiology, Hitit University School of Medicine, Turkey COVID-19 became a public health crisis that strongly influenced the psychological and physical health of the general population. Muscle pain is one of the most frequent symptoms among COVID-19 patients besides having fever, cough, and dyspnea. A study that involved 59,254 COVID-19 patients from 11 countries revealed that muscle pain occurred to 36% of the patients [1]. To date, the increased or de novo risk of neuropathic pain after COVID-19 has not been clearly established. In this study, we compared the frequency of neuropathic pain in PCR-negative patients in the third month after COVID infection with a similar control group. The aim of this cohort study will be to determine the presence of neuropathic pain in the post-COVID-19 period. Douleur Neuropathique 4 (DN4) and SelfLeeds Assessment of Neuropathic Symptoms and Sign (S-LANSS) scores will be used to screen for neuropathic pain. Patients and Methods The study was a cross-sectional prospective study approved by Hitit University School of Medicine Ethics Committee (349/06.01.2021) and conducted by STROBE guidelines for reporting observational studies (www. strobestatement.org) and the Declaration of Helsinki. All participants gave their informed consent for this study. A total of 169 individuals participated in the study. 89 cases constituted the post-COVID group and 80 cases constituted the control group. The patient group was formed from randomly selected cases who applied to the neurology outpatient clinic in the third month of post-COVID and were PCR negative. There was no difference between the groups in terms of age Introduction Neuropathic pain is a frequent condition caused by a lesion or disease of the central or peripheral somatosensory nervous system. Neuropathy is complex pathophysiology that is not yet fully elucidated, which contributes to underassessment and under treatment. Check for updates ISSN: 2474-3658 DOI: 10.23937/2474-3658/1510247 ELIAÇIK et al. J Infect Dis Epidemiol 2022, 8:247 • Page 2 of 4 • reliability studies were conducted in our country, were used [2,3]. In the study, individuals with a DN4 score of more than four, and S-LANSS score of 12 or more, and those who defined neuropathic pain with both tests were evaluated as having neuropathic pain. Statistical Analysis and Results Statistical analyzes in this study were performed using the SPSS (Version 22.0, SPSS Inc. Chicago, IL, USA Hitit University Licensed) package program. A total of 169 individuals participated in the study. 52.7% (n = 89) of the participants were in the patient group and 47.3% (n = 80) were in the control group. The age and gender of the participants were not statistically different between the groups (p = 0.810). A Mann-Whitney test indicated that both S-LANSS and DN4 total scores were greater for the post-COVID group (Mdn = 2) than for the control group (Mdn = 5). The U values for S-LANSS and DN4 were 1941.500 and 1938.0 respectively. Both p values < 0.001 (Table 1). The median duration of neuropathic pain after COVID in the patient group was an average of 15 days. The most common neuropathic complaint in the post-COVID group; tingling, numbness and burning. We did not detect a prominent localization area in its anatomical distribution. We also found a significant difference between the mean Visual Analog Scale (VAS) values of the control and post-COVID-19 groups. The mean of VAS was 5.35 (n = 89) in the post-COVID 19 group and 2.86 (n = 80) in the control group (p < 0.001) (Table 2).