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Chronic pain characteristics in COVID-19 survivors after an ICU stay. A cross-sectional study - 22/09/23

Doi : 10.1016/j.accpm.2023.101267 
Valéria Martinez a, b, c, , Mikhail Dziadzko d, e, Juan Tamayo a, Sébastien Schitter a, Leah Guichard a, Florine Richeux d, Stephanie Roggerone d, Patricia Branche d, Leo Schlaefflin f, Youri Nacto a, c, Tiago Antunes a, Isabelle Negre f, Djillali Annane g, h, Frederic Aubrun d, e
a Service d'Anesthésie douleur, Hôpital Raymond Poincaré, Assistance Publique Hôpitaux de Paris, 104 boulevard Raymond Poincaré, F-92380 Garches, France 
b INSERM, U-987, Hôpital Ambroise Paré, Centre d’Evaluation et de Traitement de la Douleur, Boulogne Billancourt, F-92100, France 
c Université Versailles Saint-Quentin, 55 avenue de Paris, Versailles F-78035, France 
d Service d'Anesthésie Réanimation Chirurgicale, Hospices Civils de Lyon, Groupement Hospitalier Nord Hôpital de la Croix-Rousse, 103 Grande Rue de la Croix-Rousse, Lyon F-69317, France 
e INSERM, U-1290, laboratoire RESHAEPE, Université Claude Bernard Lyon 1, Lyon F-69008, France 
f Hôpitaux Universitaires Paris-Sud (AP-HP), Centre d’Evaluation et de Traitement de la Douleur, Hôpital de Bicêtre, Le Kremlin Bicêtre Cedex, France 
g Service de Réanimation médicale, Hôpital Raymond Poincaré, Assistance Publique Hôpitaux de Paris, 104 boulevard Raymond Poincaré, F-92380 Garches, France 
h Université Versailles Saint-Quentin, 55 avenue de Paris, Versailles, F-78035, France 

Corresponding author at: Service d'Anesthésie, Hôpital Raymond Poincaré, Assistance Publique Hôpitaux de Paris, 104 boulevard Raymond Poincaré, F-92380 Garches, France.Service d'AnesthésieHôpital Raymond PoincaréAssistance Publique Hôpitaux de Paris104 boulevard Raymond PoincaréGarchesF-92380France

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Abstract

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.

Il testo completo di questo articolo è disponibile in PDF.

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


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Vol 42 - N° 6

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