Pain Perception At Rest And With Movement Following Coronavirus Disease

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The long-term effects of COVID-19 are unknown, especially regarding the development of chronic pain. PURPOSE: To investigate pain perception at rest and with movement in people post COVID-19 and control participants. METHODS: Participants with and without post COVID-19 attended one research session. Pain perception was assessed by the following: 1) clinical questionnaires 2) pressure pain thresholds (PPTs) and 3) during movement. Clinical pain assessments include the Short-Form McGill Pain Rating Index (PRI) and the PROMIS Pain Intensity Scale (5-point numerical rating scale). The PROMIS Scale was used by participants with COVID-19 to rate their worst pain intensity during acute infection and by both groups to rate current pain intensity. PPTs were measured at the quadriceps muscle with a computerized pressure algometer. Movement-evoked pain was measured pre-, post-, and peak during submaximal cycling and spirometry using an 11-point numerical rating scale. RESULTS: Fifty-eight people post COVID-19 (41 women, 42.6 yrs., 7.5 mo. post-infection) and 29 controls (20 women, 36.7 yrs.) participated in the protocol. For COVID-19 participants, the worst PROMIS pain intensity was distributed as follows: No Pain (n = 8), Mild (n = 7), Moderate (n = 15), Severe (n = 20), Very Severe (n = 8). PROMIS current pain intensity was significantly different between groups (p = 0.04); although both groups reported none-mild current pain intensity. For PRI, post COVID-19 participants had mild-moderate pain quality and control participants reported none/mild pain quality (p = 0.08). There were no differences in PPTs (p = 0.32). Movement-evoked pain was minimal (pre-, post-, and peak) with submaximal cycling and spirometry testing. No differences were reported between groups except for peak spirometry pain (p = 0.049). CONCLUSIONS: Participants with COVID-19 reported higher pain intensity at rest than controls over a prolonged duration, indicating that they are at risk for the development of chronic pain. The higher pain intensity in the mild-moderate COVID cases did not translate to differences in movement-evoked pain or pressure pain perception. Supported by Marquette University Funding: Institute for Women’s Leadership, Public Health and Equity, and Athletic and Human Performance Research Center.