REPRINTED WITH PERMISSION OF EFIC EJP: 27 (2023): 4453: A systematic review and meta-analysis of neuropathicpain associated with coronavirus disease 2019

Abstract

<br><b>Background and objective:</b> Neuropathic pain is an occasionally reported complication of coronavirus disease 2019(COVID-19) that has received increased attention in scientific literature. In this systematic review and meta-analysis, weaimed to provide information on the frequency of neuropathic pain associated with COVID-19.</br><br><b>Databases and data treatment:</b> We systematically reviewed and analysed literature regarding neuropathic pain associatedwith COVID-19. Literature searches were conducted in PubMed, EMBASE and Cochrane Library databases. We consideredprospective and retrospective studies published up until September 2022 (limitations included English language, full-textpublications and studies including at least 10 patients). A random effects meta-analysis was performed and heterogeneityand publication bias were assessed.</br><br><b>Results:</b> We identified 149 studies. We included 17 studies in the systematic review, and six studies reporting the frequencyof neuropathic pain in the acute/ subacute phase of COVID-19 in the meta-analysis. The estimated frequency of neuropathicpain ranged between 0.4 and 25%. Forest plot analysis showed that the random effect overall frequency was 10% (95%confidence interval: 515%), with a high level of heterogeneity (Chi<sup>2</sup> = 104; Tau<sup>2</sup> = 0.004; df = 5; I<sup>2</sup> = 95%; test for overalleffect: Z = 3.584; p < 0.0005). The overall risk of bias was moderate in all studies selected, particularly due to the poordescription of neuropathic pain diagnostic criteria.</br><br><b>Conclusions:</b> The pooled estimated frequency of neuropathic pain associated with COVID-19 should be considered withcaution due to the high heterogeneity across studies and the poor description of the neuropathic pain diagnostic criteriaapplied.</br><br><b>Significance:</b> Emerging evidence supports the development of neuropathic pain as a complication of COVID-19. However,longitudinal studies enrolling consecutive patients with COVID-19 that detail the diagnostic criteria for neuropathic pain areneeded to better assess the frequency of this condition.</br>