Chronic pain characteristics in COVID-19 survivors after an ICU stay. A cross-sectional study

Valéria Martinez (1, 2, 3) , Mikhail A. Dziadzko (4, 5) , Juan Tamayo (2) , Sébastien Schitter (2) , Leah Guichard (2) , Florine Richeux (4) , Stephanie Roggerone (4) , Patricia E. Branche (4) , Leo Schlaefflin (6) , Youri Nacto (2, 7) , Tiago Antunes (2) , I. Negre (6) , Djillali Annane (2, 7) , Frédéric Aubrun (4, 5)

1 LPPD - Physiopathologie et Pharmacologie Clinique de la Douleur
2 Hôpital Raymond Poincaré (Garches) [GHU AP-HP Université Paris-Saclay]
3 Hôpital Ambroise Paré [AP-HP]
4 Hôpital de la Croix-Rousse [CHU - HCL]
5 RESHAPE - Inserm U1290 - UCBL1 - Research on Healthcare Performance
6 Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
7 UVSQ Santé - Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil

Background: The onset and characteristics of chronic pain following an intensive care unit (ICU) stay for COVID-19 have never been thoroughly investigated. Study design: A multicenter cohort study was conducted to describe chronic pain, according to ICD-11, among COVID-19 survivors. The chronic pain was assessed during face-to-face consultations with a pain specialist. Results: Among 204 COVID-19 ICU survivors, 143 patients with mean age of 60 ± 14 years were included nine months after discharge from the ICU. More than half (54%) of patients experienced new-onset chronic pain. In total, 102 different forms of pain were reported in these patients. Secondary pain was the most frequent type, comprising musculoskeletal (40%), post-traumatic (34%), neuropathic (25%), and visceral (13%). Primary chronic pain was rare (7%). The three most common sites of pain were the shoulders, chest, and head. Pain was moderate to severe in 75% of cases, and higher intensity was associated with a greater impact on daily life. Anxiety, depression, post-traumatic stress, perceived stress, and debilitating pain were frequently associated. Intubation was more frequent in patients with chronic pain. Specialized pain centre follow-up was required for 21% of the survivors, which represented 40% of the patients who developed new-onset chronic pain. Conclusion: New-onset chronic pain is common after an ICU stay for COVID-19 and may manifest in various forms. Secondary pain caused by ICU management is the most frequent. Patients should undergo screening after ICU discharge to facilitate prompt, thorough, and personalized pain management. Clinical trial registration: NCT04940208.

Mots clés: Chronic pain; COVID-19; ICD 11; Intensive care unit; SARS-COV2 infection (severe acute respiratory syndrome coronavirus)

Domaines: Sciences du Vivant [q-bio]

Valéria Martinez, Mikhail A. Dziadzko, Juan Tamayo, Sébastien Schitter, Leah Guichard, et al.. Chronic pain characteristics in COVID-19 survivors after an ICU stay. A cross-sectional study. Anaesthesia Critical Care & Pain Medicine, 2023, 42 (6), ⟨10.1016/j.accpm.2023.101267⟩. ⟨hal-04190820⟩