Pain Manifestations of COVID-19 and Their Association With Mortality: A Multicenter Prospective Observational Study — Mayo Clinic Proceedings

Knox N, Lee C, Moon JY, Cohen SP

The objective of this multicenter prospective study was to determine the prevalence and breakdown of pain symptoms among patients with coronavirus disease 2019 (COVID-19) infection admitted for non-pain symptoms and the association between the presence of pain and intensive care unit (ICU) admission and death. Data on the intensity and type of pain were collected on 169 patients with active severe acute respiratory syndrome coronavirus 2 infection at 2 teaching hospitals in the United States and Korea and on 8 patients with acute pain at another large teaching hospital between February 1, 2020, and June 15, 2020. Results showed that acute pain is common during active COVID-19 infection with the most common manifestations being headache, chest pain and spine pain. Individuals without pain were more likely to require intensive care and expire than those with pain. Reasons why pain may be associated with reduced mortality include that an intense systemic stimulus (eg, respiratory distress) might distract pain perception or that the catecholamine surge associated with severe respiratory distress might attenuate nociceptive signaling.

Knox N, Lee C, Moon JY, Cohen SP. (2021). Pain Manifestations of COVID-19 and Their Association with Mortality: A Multicenter Prospective Observational Study. Mayo Clinic Proceedings. https://doi.org/10.1016/j.mayocp.2020.12.014.