Although a rare presentation among patients hospitalized with COVID-19, a prospective case series found that some patients develop neuropathic pain (NeuP). These findings were published in the Archives of Rehabilitation Research and Clinical Translation.
Eight consecutive cases of patients who presented with NeuP at a single tertiary care center in India were followed for 1 month. NeuP was evaluated using the verbal rating scale (VRS) and Douleur Neruopathique (DN4) instruments. Mild NeuP was defined as VRS scores 1-3, moderate as VRS scores 4-7, and severe as VRS scores 7-10.
Seven of the 8 patients presenting with NeuP were men, they ranged in age from 24 to 68 years, BMI ranged between 21.3 to 27.1 kg/m2, 6 of the patients had no comorbidities, and 6 had moderate to severe COVID-19. Six of the 8 patients received corticosteroids and oxygen support for their COVID-19.
Most patients reported mild to moderate pain and 2 reported severe pain. NeuP onset between days 4 and 11 of their COVID-19 infection. One patient received no treatment for their NeuP. After receiving gabapentinoids with or without antidepressants, the remaining 7 patients had some relief from pain.
At the 1 month follow-up, half of patients reported lingering, mild NeuP symptoms. Patients who still had symptoms at follow-up had had moderate to severe COVID-19, they had taken azithromycin, and had symptoms of depression.
This study was limited by the short follow-up duration. It remains unclear whether the patients with persistent NeuP symptoms will have long-term effects.
The study authors concluded that due to the large burden of COVID-19, many patients could develop neuropathic pain. “Early diagnosis and proper management are of prior importance to prevent its persistence,” the study authors noted. “If left untreated, the pain symptoms can persist in a substantial proportion of patients and prolong recovery thereby affecting the quality of life.”
Jena D, Sahoo J, Barman A, Dalai A, Patel S. Neuropathic pain in hospitalized COVID-19 patients: A prospective case-series. Arch Rehabil Res Clin Transl. 2022;100188. doi:10.1016/j.arrct.2022.100188