Hospital admission is associated with disability and late musculoskeletal pain in individuals with long COVID

Ricardo Bezerra Duarte Neto; Luis Felipe Fonseca Reis; Arthur de Sá Ferreira; Dângelo José de Andrade Alexandre; Renato Santos de Almeida

doi:10.3389/fresc.2023.1186499

Hospital admission is associated with disability and late musculoskeletal pain in individuals with long COVID

Front Rehabil Sci. 2023 Oct 27:4:1186499. doi: 10.3389/fresc.2023.1186499. eCollection 2023.

Authors

Ricardo Bezerra Duarte Neto¹, Luis Felipe Fonseca Reis^{1

2}, Arthur de Sá Ferreira¹, Dângelo José de Andrade Alexandre³, Renato Santos de Almeida^{1

4

5}

Affiliations

¹ Post Graduation Program in Rehabilitation Sciences, Augusto Motta University Center (UNISUAM), Rio de Janeiro, Brazil.
² Physiotherapy Department. Rio de Janeiro Military Police Rehabilitation Center (CFRPM-RJ), Rio de Janeiro, Brazil.
³ Physiotherapy Department. Rio de Janeiro Ortophaedic Trauma Institute (INTO), Rio de Janeiro, Brazil.
⁴ Physiotherapy Department. Serra dos Órgãos University Center (UNIFESO), Teresópolis, Brazil.
⁵ Physiotherapy Department, Rio de Janeiro Federal Institute (IFRJ), Rio de Janeiro, Brazil.

Abstract

Background: The acute clinical repercussions of SARS-CoV-2 infection have been widely studied. However, the possible late repercussions of long COVID have not yet been well defined in the literature.

Objectives: To identify the presence of pain and musculoskeletal disability in patients with Long COVID and also to identify predictive factors for pain intensity in this population.

Methods: In this cross-sectional and retrospective observational study individuals with Long COVID symptoms were included. It was collected musculoskeletal disability measures, data from patient-related outcome measures and variables from a COVID-19 outpatient service database. Associations and sub-group analyses were performed considering the variables pain, disability and hospitalization. Linear regression was performed to identify predictive factors for pain intensity in Long COVID patients.

Results: We evaluated 195 patients and most of them (57%) presented musculoskeletal pain in one area of the body. Pain sub-group presented worse disability indices and worse clinical course during hospitalization. Hospitalized patients presented worse disability indices comparing to non-hospitalized. Significant correlations were found between pain and days of non-invasive oxygen support (r = 0.21; p = 0.003); days in intensive care unit (r = 0.22; p = 0.002) and days in invasive mechanical ventilation (r = 0.35; p = 0.001). Hospitalized individuals showed a higher chance of presenting late musculoskeletal pain (OR = 1.42: 95%CI 1.09-2.04). Days in intensive care unit (β = 0,234: P = 0,001) and days in invasive mechanical ventilation (β = 0.764: P = 0.001) were predictors of pain intensity [F(2,192) = 18.559; R² = 0.231; p = 0.001].

Conclusion: Individuals with Long COVID presented musculoskeletal pain and disability. Hospitalized patients showed a greater chance of having musculoskeletal pain. Days in intensive care unit and days in invasive mechanical ventilation were predictors of late musculoskeletal pain intensity.

Keywords: disability; hospitalization; long-COVID; musculoskeletal pain; physical therapy.

Grants and funding

This study was supported by the Fundação Carlos Chagas Filho de Apoio à Pesquisa do Estado do Rio de Janeiro (FAPERJ, No. E-26/211.104/2021) and Coordenação de Aperfeiçoamento de Pessoal (CAPES, Finance Code 001; No. 88881.708719/2022-01, and No. 88887.708718/2022-00).