Clinical Characteristics and Mechanisms of Musculoskeletal Pain in Long COVID

Abstract

Objective: Musculoskeletal (MSK) pain is being increasingly reported by patients as one of the most common persistent symptoms in post-COVID-19 syndrome or Long COVID. However, there is a lack of understanding of its prevalence, characteristics, and underlying pathophysiological mechanisms. The objective of this review is to identify and describe the features and characteristics of MSK pain in Long COVID patients.

Methods: The narrative review involved a literature search of the following online databases: MEDLINE (OVID), EMBASE (OVID), CINAHL, PsyclNFO, and Web of Science (December 2019 to February 2022). We included observational studies that investigated the prevalence, characteristics, risk factors and mechanisms of MSK pain in Long COVID. After screening and reviewing the initial literature search results, a total of 35 studies were included in this review.

Results: The overall reported prevalence of MSK pain in Long COVID ranged widely from 0.3% to 65.2%. The pain has been reported to be localized to a particular region or generalized and widespread. No consistent pattern of progression of MSK pain symptoms over time was identified. Female gender and higher BMI could be potential risk factors for Long COVID MSK pain, but no clear association has been found with age and ethnicity. Different pathophysiological mechanisms have been hypothesized to contribute to MSK pain in Long COVID including increased production of proinflammatory cytokines, immune cell hyperactivation, direct viral entry of neurological and MSK system cells, and psychological factors.

Conclusion: MSK pain is one of the most common symptoms in Long COVID. Most of the current literature on Long COVID focuses on reporting the prevalence of persistent MSK pain. Studies describing the pain characteristics are scarce. The precise mechanism of MSK pain in Long COVID is yet to be investigated. Future research must explore the characteristics, risk factors, natural progression, and underlying mechanisms of MSK pain in Long COVID.

Metadata

Item Type:	Article
Authors/Creators:	Khoja, O Silva Passadouro, B Mulvey, M https://orcid.org/0000-0002-6357-3848 Delis, I https://orcid.org/0000-0001-8940-5036 Astill, S https://orcid.org/0000-0002-9443-6934 Tan, AL https://orcid.org/0000-0002-9158-7243 Sivan, M https://orcid.org/0000-0002-0334-2968
Copyright, Publisher and Additional Information:	© 2022 Khoja et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License.
Keywords:	post-COVID-19 syndrome, post-acute COVID-19, chronic pain
Dates:	Published: June 2022 Published (online): 17 June 2022 Accepted: 13 May 2022
Institution:	The University of Leeds
Academic Units:	The University of Leeds > Faculty of Biological Sciences (Leeds) > School of Biomedical Sciences (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Institute of Rheumatology & Musculoskeletal Medicine (LIRMM) (Leeds) > Musculoskeletal Medicine & Imaging (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Institute of Rheumatology & Musculoskeletal Medicine (LIRMM) (Leeds) > Rehabilitation Medicine (Leeds)
Depositing User:	Symplectic Publications
Date Deposited:	05 Jul 2022 12:43
Last Modified:	05 Jul 2022 12:43
Status:	Published
Publisher:	Dove Press
Identification Number:	10.2147/jpr.s365026
Open Archives Initiative ID (OAI ID):	oai:eprints.whiterose.ac.uk:188414

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Clinical Characteristics and Mechanisms of Musculoskeletal Pain in Long COVID

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