Management of patients with pain syndromes associated with COVID-19
https://doi.org/10.14412/2074-2711-2021-5-96-101
Abstract
The disease caused by the SARS-CoV-2 virus is multi-organ and involves almost all organs and systems. Myalgias and arthralgias and, in particular, back pain are common symptoms of COVID-19 and can be observed both at the onset of the disease and in the postcovid period. The causes of muscle and joint damage include both systemic inflammation and direct viral injury. Traditionally, musculoskeletal pain is treated with non-steroidal anti-inflammatory drugs. However, using this drug class in patients with COVID-19 requires caution due to the presence of comorbid diseases and possible complications of viral infection. The review discusses clinical variants and pathophysiological mechanisms of joints and muscles damage in patients with COVID-19 and treatment tactics for patients with musculoskeletal pain.
About the Authors
L. T. Akhmedzhanova
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
Russian Federation
Luiza Talgatovna Akhmedzhanova
Department of Nervous System Diseases and Neurosurgery, N.V. Sklifosovsky Institute of Clinical Medicine
11, Rossolimo St., Build. 1, Moscow 119021
T. M. Ostroumova
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
Russian Federation
Department of Nervous System Diseases and Neurosurgery, N.V. Sklifosovsky Institute of Clinical Medicine
11, Rossolimo St., Build. 1, Moscow 119021
O. A. Solokha
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
Russian Federation
Department of Nervous System Diseases and Neurosurgery, N.V. Sklifosovsky Institute of Clinical Medicine
A.Ya. Kozhevnikov Clinic of Nervous System Diseases
11, Rossolimo St., Build. 1, Moscow 119021
References
1. Karaarslan F, Demircioglu Güneri F, Kardes S. Postdischarge rheumatic and musculoskeletal symptoms following hospitalization for COVID-19: prospective follow-up by phone interviews. Rheumatol Int. 2021 Jul;41(7):1263-71. doi: 10.1007/s00296-021-04882-8
2. Jiang F, Yang WL, Wang JW, et al. Pain during and after coronavirus disease 2019: Chinese perspectives. Pain Rep. 2021 May 10;6(1):e931. doi: 10.1097/PR9.0000000000000931. eCollection 2021.
3. Zhou Y, Han T, Chen J, et al. Clinical and autoimmune characteristics of severe and critical cases of COVID-19. Clin Transl Sci. 2020 Nov;13(6):1077-86. doi: 10.1111/cts.12805. Epub 2020 May 14.
4. Drozdzal S, Rosik J, Lechowicz K, et al. COVID-19: pain management in patients with SARS-CoV-2 infection-molecular mechanisms, challenges, and perspectives. Brain Sci. 2020 Jul 20;10(7):465. doi: 10.3390/brain-sci10070465
5. Abdullahi A, Candan SA, Abba MA, et al. Neurological and Musculoskeletal Features of COVID-19: A Systematic Review and Meta-Analysis. Front Neurol. 2020 Jun 26;11:687. doi: 10.3389/fneur.2020.00687. eCollection 2020.
6. Murat S, Dogruoz Karatekin B, Icagasioglu A, et al. Clinical presentations of pain in patients with COVID-19 infection. Ir J Med Sci. 2021 Aug;190(3):913-7. doi: 10.1007/s11845-020-02433-x. Epub 2020 Nov 14.
7. Li LQ, Huang T, Wang YQ, et al. COVID-19 patients' clinical characteristics, discharge rate, and fatality rate of meta-analysis. J Med Virol. 2020 Jun;92(6):577-83. doi: 10.1002/jmv.25757. Epub 2020 Mar 23.
8. Fernandez-de-Las-Penas C, Rodriguez-Jimenez J, Fuensalida-Novo S, et al. Myalgia as a symptom at hospital admission by severe acute respiratory syndrome coronavirus 2 infection is associated with persistent musculoskeletal pain as long-term post-COVID sequelae: a case-control study. Pain. 2021 Apr 8. doi: 10.1097/j.pain.0000000000002306. Online ahead of print.
9. Chen G, Wu D, Guo W, et al. Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest. 2020 May 1;130(5):2620-9. doi: 10.1172/JCI137244
10. Weng LM, Su X, Wang XQ. Pain Symptoms in Patients with Coronavirus Disease (COVID-19): A Literature Review. J Pain Res. 2021 Jan 26;14:147-59. doi: 10.2147/JPR.S269206. eCollection 2021.
11. Mao L, Jin H, Wang M, et al. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol. 2020 Jun 1;77(6):683-90. doi: 10.1001/jamaneurol.2020.1127
12. Joob B, Wiwanitkit V. Arthralgia as an initial presentation of COVID-19: Observation. Rheumatol Int. 2020 May;40(5):823. doi: 10.1007/s00296-020-04561-0. Epub 2020 Mar 28.
13. Chen T, Dai Z, Mo P, et al. Clinical characteristics and outcomes of older patients with coronavirus disease 2019 (COVID-19) in Wuhan, China: A single-centered, retrospective study. J Gerontol A Biol Sci Med Sci. 2020 Sep 16;75(9):1788-95. doi: 10.1093/gerona/glaa089
14. Mo P, Xing Y, Xiao Y, et al. Clinical characteristics of refractory COVID-19 pneumonia in Wuhan, China. Clin Infect Dis. 2020 Mar 16;ciaa270. doi: 10.1093/cid/ciaa270. Online ahead of print.
15. Vasiliadis AV, Tsatlidou M, Metaxiotis D, et al. Non-Respiratory Symptoms of Patients Infected with SARS-CoV-2 (Coronavirus Disease 2019): Lessons from Their Initial Presentation at the Hospital. Medicina (Kaunas). 2021 Apr 2;57(4):344. doi: 10.3390/medicina57040344
16. Mokuda S, Tokunaga T, Masumoto J, Sugiyama E. Angiotensin-converting Enzyme 2, a SARS-CoV-2 receptor, is upregulated by interleukin 6 through STAT3 signaling in synovial tissues. J Rheumatol. 2020 Oct 1;47(10):1593-5. doi: 10.3899/jrheum.200547. Epub 2020 Jul 1.
17. Siso-Almirall A, Brito-Zeron P, Conangla Ferrin L, et al. Long Covid-19: Proposed Primary Care Clinical Guidelines for Diagnosis and Disease Management. Int J Environ Res Public Health. 2021 Apr 20;18(8):4350. doi: 10.3390/ijerph18084350
18. Yong SJ. Long COVID or post-COVID-19 syndrome: putative pathophysiology, risk factors, and treatments. Infect Dis (Lond). 2021 May 22:1-18. doi: 10.1080/23744235.2021.1924397
19. Grech S, Borg JN, Cuschieri S. Back pain: An aftermath of Covid-19 pandemic? A Malta perspective. Musculoskeletal Care. 2021 Jun 6;10.1002/msc.1574. doi: 10.1002/msc.1574. Online ahead of print.
20. Arca M, Dönmezdil S, Durmaz ED. The effect of the COVID-19 Pandemic on anxiety, depression, and musculoskeletal system complaints in healthcare workers. Work. 2021;69(1):47-54. doi: 10.3233/WOR-205014
21. Karateev AE, Lila AM, Alekseeva LI. Management of patients with diseases of the musculoskeletal system during the COVID-19 pandemic. Terapiya. 2021;(1):68-77. doi: 10.18565/therapy.2021.1.68-77 (In Russ.).
22. Wong AY, MacKenna B, Morton CE, et al. Use of non-steroidal anti-inflammatory drugs and risk of death from COVID-19: an Open SAFELY cohort analysis based on two cohorts. Ann Rheum Dis. 2021 Jul;80(7):943-51. doi: 10.1136/annrheumdis-2020-219517
23. Drake TM, Fairfield CJ, Riinu Pius R, Knight SR. Non-steroidal anti-inflammatory drug use and outcomes of COVID-19 in the ISARIC Clinical Characterisation Protocol UK cohort: a matched, prospective cohort study. Lancet Rheumatol. 2021 Jul;3(7):e498-e506. doi: 10.1016/S2665-9913(21)00104-1
24. Robb CT, Goepp M, Rossi AG, Yao C. Non-steroidal anti-inflammatory drugs, prostaglandins, and COVID-19. Br J Pharmacol. 2020;177(21):4899-920. doi: 10.1111/bph.15206
25. Mao R, Qiu Y, He J-S, et al. Manifestations and prognosis of gastrointestinal and liver involvement in patients with COVID-19: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2020 Jul;5(7):667-78. doi: 10.1016/S2468-1253(20)30126-6. Epub 2020 May 12.
26. Chang WT, Toh HS, Liao CT, Yu WL. Cardiac Involvement of COVID-19: A Comprehensive Review. Am J Med Sci. 2021 Jan;361(1):14-22. doi: 10.1016/j.amjms.2020.10.002. Epub 2020 Oct 6.
27. Yang X, Tian S, Guo H. Acute kidney injury and renal replacement therapy in COVID-19 patients: A systematic review and meta-analysis. Int Immunopharmacol. 2021 Jan;90:107159. doi: 10.1016/j.intimp.2020.107159. Epub 2020 Nov 3.
28. Dooley M, Spencer C, Dunn C. Aceclofenac: a reappraisal of its use in the management of pain and rheumatic disease. Drugs. 2001;61(9):1351-78. doi: 10.2165/00003495-200161090-00012
29. Patel PB, Patel TK. Efficacy and safety of aceclofenac in osteoarthritis: a meta-analysis of randomized controlled trials. Eur J Rheumatol. 2017 Mar;4(1):11-8. doi: 10.5152/eurjrheum.2017.160080. Epub 2017 Mar 1.
30. Castellsague J, Riera-Guardia N, Calingaert B, et al. Individual NSAIDs and upper gastrointestinal complications: a systematic review and meta-analysis of observational studies (the SOS project). Drug Saf. 2012 Dec 1;35(12):1127-46. doi: 10.2165/11633470-000000000-00000
31. Masclee GMC, Straatman H, Arfe A, et al. Risk of acute myocardial infarction during use of individual NSAIDs: A nested case-control study from the SOS project. PLoS One. 2018 Nov 1;13(11):e0204746. doi: 10.1371/journal.pone.0204746. eCollection 2018.
32. Schink T, Kollhorst B, Varas Lorenzo C, et al. Risk of ischemic stroke and the use of individual non-steroidal anti-inflammatory drugs: A multi-country European database study within the SOS Project. PLoS One. 2018 Sep 19;13(9):e0203362. doi: 10.1371/journal.pone.0203362. eCollection 2018.
33. Karateev AE, Tsurgan AV. Aceclofenac: the experience of Russian studies. Sovremennaya Revmatologiya = Modern Rheumatology Journal. 2017;11(4):89-94. doi: 10.14412/1996-7012-2017-4-89-94 (In Russ.).
34. Karateev AE. Evaluation of the population safety of nonsteroidal anti-inflammatory drugs in the framework of the PanEuropean SOS program: focus on aceclofenac. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2020:12(2):109-13. doi: 10.14412/2074-2711-2020-2-109-113 (In Russ.).
35. Karateev AE, Pogozheva EYu, Filatova ES, et al. Factors affecting the results of analgesic therapy. Results of the Russian multicentre study of NOTE (NSAID: Open-label Trial of Efficacy). Terapevticheskiy Archiv. 2018;(6):65-74. doi: 10.26442/terarkh201890665-73 (In Russ.).
36. Sterne JAC, Murthy S, Diaz JV, et al. Association between administration of systemic corticosteroids and mortality among critically ill patients with COVID-19: a meta-analysis. JAMA. 2020 Oct 6;324(13):1330-41. doi: 10.1001/jama.2020.17023
37. Abdel Shaheed C, Maher CG, Williams KA, McLachlan AJ. Efficacy and tolerability of muscle relaxants for low back pain: Systematic review and meta-analysis. Eur J Pain. 2017 Feb;21(2):228-37. doi: 10.1002/ejp.907. Epub 2016 Jun 22.
38. Parfenov VA, Yakhno NN, Kukushkin ML, et al. Acute nonspecific (musculoskeletal) low back pain. Guidelines of the Russian Society for the Study of Pain (RSSP). Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2018;10(2):411. doi: 10.14412/2074-2711-2018-2-4-11 (In Russ.).
39. Parfenov VA, Yakhno NN, Davydov OS, et al. Chronic nonspecific (musculoskeletal) low back pain. Guidelines of the Russian Society for the Study of Pain (RSSP). Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2019;11(2S):7-16. doi: 10.14412/2074-2711-2019-2S-7-16 (In Russ.).
40. Karasavvidis T, Hirschmann MT, Kort NP, et al. Home-based management of knee osteoarthritis during COVID-19 pandemic: literature review and evidence-based recommendations. J Exp Orthop. 2020 Jul 19;7(1):52. doi: 10.1186/s40634-020-00271-5
41. Mazzei D, Ademola A, Abbott J, et al. Are education, exercise and diet interventions a cost-effective treatment to manage hip and knee osteoarthritis? A systematic review. Osteoarthritis Cartilage. 2021 Apr;29(4):456-70. doi: 10.1016/j.joca.2020.10.002. Epub 2020 Nov 14.
Review
Supporting agencies: This article has been supported by «Gedeon Richter Pharma» LLC.
For citations:
Akhmedzhanova L.T., Ostroumova T.M., Solokha O.A. Management of patients with pain syndromes associated with COVID-19. Neurology, Neuropsychiatry, Psychosomatics. 2021;13(5):96-101. (In Russ.) https://doi.org/10.14412/2074-2711-2021-5-96-101
Views: 302
Email this article 