“Post-COVID syndrome”: The focus is on musculoskeletal pain
A. E. Karateev,
V. N. Amirdzhanova,
E. L. Nasonov,
A. M. Lila,
L. I. Alekseeva,
E. Yu. Pogozheva,
E. S. Filatova,
V. A. Nesterenko https://doi.org/10.47360/1995-4484-2021-255-262
Abstract
Combating the consequences of COVID-19, a disease caused by the new coronavirus infection SARS-CoV-2, is a serious and very urgent task facing modern medicine. COVID-19 often has a severe course and is accompanied by multiple organ damage, systemic immune inflammation, coagulopathy, neuroendocrine and metabolic disorders. Even with a relatively favorable course, the consequences of SARS-CoV-2 infection can be degenerative changes in many organs (pulmonary fibrosis, cardiosclerosis), various functional and psychoemotional disorders. As a result, in 10–50% of patients, various unpleasant symptoms persist for a long time after the acute manifestations of COVID-19 subside and the virus is eliminated. This pathology is referred to as “post-COVID syndrome” (PCS). The main elements of PCS are chronic pain, fatigue, and psychoemotional problems. Functional disorders, autoimmune processes, and severe psychological distress after COVID-19 can cause the development and exacerbation of diseases characterized by chronic pain and fatigue, such as fibromyalgia and chronic fatigue syndrome. Therapy and prevention of PCS include correction of functional disorders, pain control, and consistent physical, psychological, and social rehabilitation.
About the Authors
A. E. Karateev
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
115522, Moscow, Kashirskoye Highway, 34A
V. N. Amirdzhanova
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
115522, Moscow, Kashirskoye Highway, 34A
E. L. Nasonov
V.A. Nasonova Research Institute of Rheumatology;
I.M. Sechenov First Moscow State Medical University of the Ministry of Health Care of Russian Federation (Sechenov University)
Russian Federation
Russian Federation
115522, Moscow, Kashirskoye Highway, 34A;
119991, Moscow, Trubetskaya str., 8, building 2
A. M. Lila
V.A. Nasonova Research Institute of Rheumatology;
Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
115522, Moscow, Kashirskoye Highway, 34A;
125993, Moscow, Barrikadnaya str., 2/1, building 1
L. I. Alekseeva
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
115522, Moscow, Kashirskoye Highway, 34A
E. Yu. Pogozheva
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
115522, Moscow, Kashirskoye Highway, 34A
E. S. Filatova
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
115522, Moscow, Kashirskoye Highway, 34A
V. A. Nesterenko
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
115522, Moscow, Kashirskoye Highway, 34A
References
1. Nasonov EL. Coronavirus disease 2019 (COVID-19): Reflections of a rheumatologist. NauchcnoPrakticheskaya Revmatologia = Rheumatology Science and Practice. 2020;58(2):123-132 (In Russ.). doi: 10.14412/1995-4484-2020-123-132
2. Spreeuwenberg P, Kroneman M, Paget J. Reassessing the global mortality burden of the 1918 influenza pandemic. Am J Epidemiol. 2018;187(12):2561-2567. doi: 10.1093/aje/kwy191
3. COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU). URL: https://origin-coronavirus.jhu.edu/map.html. (Accessed: 18th April 2021) .
4. Darif D, Hammi I, Kihel A, El Idrissi Saik I, Guessous F, Akarid K. The pro-inflammatory cytokines in COVID-19 pathogenesis: What goes wrong? Microb Pathog. 2021;18(153):104799. doi: 10.1016/j.micpath.2021.104799
5. Capaccione KM, Yang H, West E, Patel H, Ma H, Patel S, et al. Pathophysiology and imaging findings of COVID-19 infection: An organ-system based review. Acad Radiol. 2021;28(5):595-607. doi: 10.1016/j.acra.2021.01.022
6. Oronsky B, Larson C, Hammond TC, Oronsky A, Kesari S, Lybeck M, et al. A review of persistent post-COVID syndrome (PPCS). Clin Rev Allergy Immunol. 2021;20:1-9. doi: 10.1007/s12016-021-08848-3
7. Summary of ICD coding for COVID-19. URL: http://www.whofic.org.za/SummaryICDcoding.pdf (Accessed: 18 April 2021).
8. McDonald LT. Healing after COVID-19: are survivors at risk for pulmonary fibrosis? Am J Physiol Lung Cell Mol Physiol. 2021;320(2):L257-L265. doi: 10.1152/ajplung.00238.2020
9. Zhang C, Wu Z, Li JW, Tan K, Yang W, Zhao H, et al. Discharge may not be the end of treatment: Pay attention to pulmonary fibrosis caused by severe COVID-19. J Med Virol. 2021;93(3):1378-1386. doi: 10.1002/jmv.26634
10. Budi EH, Schaub JR, Decaris M, Turner S, Derynck R. TGF-beta as a driver of fibrosis: Physiological roles and therapeutic opportunities. J Pathol. 2021;254(62). doi: 10.1002/path.5680
11. Shchendrygina A, Nagel E, Puntmann VO, Valbuena-Lopez S. COVID-19 myocarditis and prospective heart failure burden. Expert Rev Cardiovasc Ther. 2021;19(1):5-14. doi: 10.1080/14779072.2021.1844005
12. Ferrara F, Vitiello A. Scientific and pharmacological rationale for the treatment of cardiac damage caused by COVID-19. Discov Med. 2020;30(161):155-161.
13. Di Minno A, Ambrosino P, Calcaterra I, Di Minno MND. COVID-19 and venous thromboembolism: A meta-analysis of literature studies. Semin Thromb Hemost. 2020;46(7):763-771. doi: 10.1055/s-0040-1715456
14. Zuin M, Rigatelli G, Zuliani G, Roncon L. The risk of thrombosis after acute-COVID-19 infection. QJM. 2021;15:hcab054. doi: 10.1093/qjmed/hcab054
15. Higgins V, Sohaei D, Diamandis EP, Prassas I. COVID-19: from an acute to chronic disease? Potential long-term health consequences. Crit Rev Clin Lab Sci. 2020;21:1-23. doi: 10.1080/10408363.2020.1860895
16. Amann K, Boor P, Wiech T, Singh J, Vonbrunn E, Knöll A, et al. COVID-19 effects on the kidney. Pathologe. 2021;1:1-5. doi: 10.1007/s00292-020-00900-x
17. Askari H, Sanadgol N, Azarnezhad A, Tajbakhsh A, Rafiei H, Safarpour AR, et al. Kidney diseases and COVID-19 infection: causes and effect, supportive therapeutics and nutritional perspectives. Heliyon. 2021;7(1):e06008. doi: 10.1016/j.heliyon.2021.e06008
18. Lahiri D, Ardila A. COVID-19 pandemic: A neurological perspective. Cureus. 2020;29;12(4):e7889. doi: 10.7759/cureus.7889
19. Javed A. Neurological associations of SARS-CoV-2 infection: A systematic review. CNS Neurol Disord Drug Targets. 2021;16. doi: 10.2174/1871527320666210216121211
20. Bandeira IP, Schlindwein MAM, Breis LC, Peron JPS, Gonçalves MVM. Neurological complications of the COVID-19 pandemic: What have we got so far? Adv Exp Med Biol. 2021;1321:21-31. doi: 10.1007/978-3-030-59261-5_2
21. Rogers JP, Chesney E, Oliver D, Pollak TA, McGuire P, FusarPoli P, et al. Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: A systematic review and meta-analysis with comparison to the COVID-19 pandemic. Lancet Psychiatry. 2020;7(7):611-627. doi: 10.1016/S2215-0366(20)30203-0
22. Dani M, Dirksen A, Taraborrelli P, Torocastro M, Panagopoulos D, Sutton R, et al. Autonomic dysfunction in ‘long COVID’: Rationale, physiology and management strategies. Clin Med (Lond). 2021;21(1):e63-e67. doi: 10.7861/clinmed.2020-0896
23. Østergaard L. SARS CoV-2 related microvascular damage and symptoms during and after COVID-19: Consequences of capillary transit-time changes, tissue hypoxia and inflammation. Physiol Rep. 2021;9(3):e14726. doi: 10.14814/phy2.14726
24. De Giorgio MR, Di Noia S, Morciano C, Conte D. The impact of SARS-CoV-2 on skeletal muscles. Acta Myol. 2020;1;39(4):307-312. doi: 10.36185/2532-1900-034
25. Somasundaram NP, Ranathunga I, Ratnasamy V, Wijewickrama PSA, Dissanayake HA, Yogendranathan N, et al. The impact of SARS-CoV-2 virus infection on the endocrine system. J Endocr Soc. 2020;2;4(8):bvaa082. doi: 10.1210/jendso/bvaa082
26. Ehrenfeld M, Tincani A, Andreoli L, Cattalini M, Greenbaum A, Kanduc D, et al. Covid-19 and autoimmunity. Autoimmun Rev. 2020;19(8):102597. doi: 10.1016/j.autrev.2020.102597
27. Dotan A, Muller S, Kanduc D, David P, Halpert G, Shoenfeld Y. The SARS-CoV-2 as an instrumental trigger of autoimmunity. Autoimmun Rev. 2021;19:102792. doi: 10.1016/j.autrev.2021.102792
28. Weng LM, Su X, Wang XQ. Pain symptoms in patients with coronavirus disease (COVID-19): A literature review. J Pain Res. 2021;26;14:147-159. doi: 10.2147/JPR.S269206
29. Walitt B, Bartrum E. A clinical primer for the expected and potential post-COVID-19 syndromes. Pain Rep. 2021;16;6(1):e887. doi: 10.1097/PR9.0000000000000887
30. Marinangeli F, Giarratano A, Petrini F. Chronic pain and COVID-19: Pathophysiological, clinical and organizational issues. Minerva Anestesiol. 2020. doi: 10.23736/S0375-9393.20.15029-6
31. Kemp Н, Corner Е, Colvin L. Chronic pain after COVID-19: Implications for rehabilitation. Br J Anaesth. 2020;125(4):436-440. doi: 10.1016/j.bja.2020.05.021
32. Galal I, Mohamed Hussein A, Amin M, Saad MM, Zayan HEE, Abdelsayed MZ, et al. Determinants of persistent post-COVID-19 symptoms: Value of a novel COVID-19 symptom score. The Egyptian Journal of Bronchology. 2021;15:10. doi: 10.1186/s43168-020-00049-4
33. Carfì A, Bernabei R, Landi F. Persistent symptoms in patients after acute COVID-19. JAMA. 2020;11;324(6):603-605. doi: 10.1001/jama.2020.12603
34. Halpin S, McIvor C, Whyatt G, Adams A, Harvey O, McLean L, et al. Postdischarge symptoms and rehabilitation needs in survivors of COVID-19 infection: A cross-sectional evaluation. J Med Virol. 2021;93(2):1013-1022. doi: 10.1002/jmv.26368
35. Jacobs L, Paleoudis E, Bari D, Nyirenda T, Friedman T, Gupta A, et al. Persistence of symptoms and quality of life at 35 days after hospitalization for COVID-19 infection. PLoS One. 2020;11;15(12):e0243882. doi: 10.1371/journal.pone.0243882
36. Meyer-Frießem CH, Gierthmühlen J, Baron R, Sommer C, Üçeyler N, Enax-Krumova EK. Pain during and after COVID-19 in Germany and worldwide: A narrative review of current knowledge. Pain Rep. 2021;20;6(1):e893. doi: 10.1097/PR9.0000000000000893
37. Soares FHC, Kubota GT, Fernandes AM, Hojo B, Couras C, Costa BV, et al. Prevalence and characteristics of new-onset pain in COVID-19 survivors, a controlled study. Eur J Pain. 2021. doi: 10.1002/ejp.1755
38. Huang C, Huang L, Wang Y, Li X, Ren L, Gu X, et al. 6-month consequences of COVID-19 in patients discharged from hospital: A cohort study. Lancet. 2021;397(10270):220-232. doi: 10.1016/S0140-6736(20)32656-8
39. Lopez-Leon S, Wegman-Ostrosky T, Perelman C, Sepulveda R, Rebolledo P, Cuapio A, et al. More than 50 long-term effects of COVID-19: A systematic review and meta-analysis. Res Sq. 2021:rs.3.rs-266574. doi: 10.21203/rs.3.rs-266574/v1
40. Himmels JPW, Qureshi SA, Brurberg KG, Gravningen KM. COVID-19: Long-term effects of COVID-19. Rapid review. URL: https://www.fhi.no/en/publ/2021/Long-Term-Effects-ofCOVID-19 (Accessed: 18th April 2021).
41. Attal N, Martinez V, Bouhassira D. Potential for increased prevalence of neuropathic pain after the COVID-19 pandemic. Pain Rep. 2021;6(1):e884. doi: 10.1097/PR9.0000000000000884
42. Mohabbat AB, Mohabbat NML, Wight EC. Fibromyalgia and chronic fatigue syndrome in the age of COVID-19. Mayo Clin Proc Innov Qual Outcomes. 2020;4(6):764-766. doi: 10.1016/j.mayocpiqo.2020.08.002
43. Komaroff AL, Bateman L. Will COVID-19 lead to myalgic encephalomyelitis/chronic fatigue syndrome? Front Med (Lausanne). 2021;7:606824. doi: 10.3389/fmed.2020.606824
44. Wostyn P. COVID-19 and chronic fatigue syndrome: Is the worst yet to come? Med Hypotheses. 2021;146:110469. doi: 10.1016/j.mehy.2020.110469
45. Li Y, Scherer N, Felix L, Kuper H. Prevalence of depression, anxiety and post-traumatic stress disorder in health care workers during the COVID-19 pandemic: A systematic review and meta-analysis. PLoS One. 2021;16(3):e0246454. doi: 10.1371/journal.pone.0246454
46. Parisi S, Borrelli R, Bianchi S, Fusaro E. Viral arthritis and COVID-19. Lancet Rheumatol. 2020;2(11):e655-e657. doi: 10.1016/S2665-9913(20)30348-9
47. Gasparotto M, Framba V, Piovella C, Doria A, Iaccarino L. PostCOVID-19 arthritis: A case report and literature review. Clin Rheumatol. 2021:1-6. doi: 10.1007/s10067-020-05550-1
48. Nalbandian A, Sehgal K, Gupta A. Post-acute COVID-19 syndrome. Nat Med. 2021;27(4):601-615. doi: 10.1038/s41591-021-01283-z
49. Chandrashekara S, Jaladhar P, Paramshetti S, Ramachandran V, Nizar SF, Kori D. Post COVID inflammation syndrome: Different manifestations caused by the virus. J Assoc Physicians India. 2020;68(12):33-34.
50. Wong AY, MacKenna B, Morton CE, Schultze A, Walker AJ, Bhaskaran K, et al. Use of non-steroidal anti-inflammatory drugs and risk of death from COVID-19: An OpenSAFELY cohort analysis based on two cohorts. Ann Rheum Dis. 2021 Jan 21. doi: 10.1136/annrheumdis-2020-219517
51. Demeco A, Marotta N, Barletta M, Pino I, Marinaro C, Petraroli A, et al. Rehabilitation of patients post-COVID-19 infection: A literature review. J Int Med Res. 2020;48(8):300060520948382. doi: 10.1177/0300060520948382
52. Candan SA, Elibol N, Abdullahi A. Consideration of prevention and management of long-term consequences of post-acute respiratory distress syndrome in patients with COVID-19. Physiother Theory Pract. 2020;36(6):663-668. doi: 10.1080/09593985.2020.1766181
53. Yang YC, Chou CL, Kao CL. Exercise, nutrition, and medication considerations in the light of the COVID pandemic, with specific focus on geriatric population: A literature review. J Chin Med Assoc. 2020;83(11):977-980. doi: 10.1097/JCMA.0000000000000393
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For citations:
Karateev A.E., Amirdzhanova V.N., Nasonov E.L., Lila A.M., Alekseeva L.I., Pogozheva E.Yu., Filatova E.S., Nesterenko V.A. “Post-COVID syndrome”: The focus is on musculoskeletal pain. Rheumatology Science and Practice. 2021;59(3):255-262. (In Russ.) https://doi.org/10.47360/1995-4484-2021-255-262
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