Investigating the Relationship between Types of Pain and Inflammatory Factors: A Retrospective Cohort
-
Masoud Hatefi
,
Ahmed Hasan Ajeel Alhachami
,
Mustafa Saleem
,
Seyed Hossein Aghamiri
,
Amir Sherafat
,
Aminollah Vasigh
,
Shahram Kargar
,
Mahdieh Razi
Abstract
Background: Pain is a recognized complication of COVID-19, and identifying the factors influencing it is crucial for diagnosis. Given the significance of pain assessment in viral patients, this study aimed to determine the relationship between different pain types and inflammatory markers in COVID-19 patients.
Methods: This registered registry study included 2,780 COVID-19 patients hospitalized in Ilam City. Data collection involved using a patient demographic form and a researcher’s checklist to assess pain status. Data was primarily gathered by reviewing patient files at referral hospitals admitting COVID-19 cases. If necessary, information was missing from the file, researchers collected supplementary data through clinical examinations and patient interviews. All collected data was then entered into SPSS software, version 16.
Results: The prevalence of pain types was high: back pain in 2,067 patients (77.2%), neck pain in 2,060 (77%), headache in 2,219 (82.9%), and myalgia in 2,419 (90.4%). Results indicated that the ESR level was statistically significantly higher (P<0.05) in patients experiencing pain in areas such as the neck, back, and head compared to other patients. Furthermore, a significant relationship was found between CRP status and the status of all types of pain (P<0.05).
Conclusion: The findings demonstrate a significant association between the pain condition and the inflammatory factors (ESR and CRP) in COVID-19 patients. Due to COVID-19 being an emerging disease, further research in this area is recommended.
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[7] Vasigh A, Tarjoman A, Borji M. The effect of spiritual-religious interventions on patients' pain status: Systematic review. Anaesth Pain Intensive Care. 2018;22(4).
[8] Cramer JD, Johnson JT, Nilsen ML. Pain in head and neck cancer survivors: prevalence, predictors, and quality-of-life impact. Otolaryngol Head Neck Surg. 2018; 159(5):853-8.
[9] Ośmiałowska E, Misiąg W, Chabowski M, Jankowska-Polańska B. Coping strategies, pain, and quality of life in patients with breast cancer. J Clin Med. 2021;10(19):4469.
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[11] Gaskin DJ, Richard P. The economic costs of pain in the United States. J Pain. 2012;13(8):715-24.
[12] Bagheri Sheykhangafshe F, Farahani H, Dehghani M, Fathi-Ashtiani A. Examining the Relationship between Mental Health and Chronic Pain in Children and Adolescents: A Systematic Review Study. J Rafsanjan Univ Med Sci. 2023;22(6):617-36.
[13] Hatefi M, Parvizi R, Borji M, Tarjoman A. Effect of self-management program on pain and disability index in elderly men with osteoarthritis. Anesth Pain Med. 2019;9(4).
[14] Rahmatian A, Bastani E, Shokri F, Karbasfrushan A. Prevalence of Hemiplegic Shoulder Pain in Iran: A Systematic Review and Meta-analysis. Anesth Pain Med. 2023;13(3).
[15] van Hecke O, Torrance N, Smith BH. Chronic pain epidemiology–where do lifestyle factors fit in? Br J Pain. 2013;7(4):209-17.
[16] Azhough R, Jalali P, Dashti MR, Taher S, Aghajani A. Intradermal methylene blue analgesic application in posthemorrhoidectomy pain management: a randomized controlled trial. Front Surg. 2024;11:1354328.
[17] Fine PG. Long-term consequences of chronic pain: mounting evidence for pain as a neurological disease and parallels with other chronic disease states. Pain Med. 2011;12(7):996-1004.
[18] Lam CM, Sanderson M, Vu DT, Sayed D, Latif U, Chadwick AL, et al. Musculoskeletal and neuropathic pain in COVID-19. Diagnostics. 2024;14(3):332.
[19] Adibi A, Jamshidbeigi H, Jamshidbeigi T, Mozafari A, Sahebi A. Anxiety and obsession following the COVID-19 outbreak. Iran J Psychiatry Behav Sci. 2020;14(2).
[20] Nourmohammadi H, Dehkordi AH, Adibi A, Amin Hashemipour SM, Abdan M, Fakhri M, et al. Seroprevalence of COVID‐19 in Blood Donors: A Systematic Review and Meta‐Analysis. Adv Virol. 2022;2022(1):9342680.
[21] Shokri M, Karimian M, Mansouri F, Mahdikhani S, Borji M, Solaimanizadeh L, et al. Laboratory and radiologic findings in pediatrics with COVID-19: A systematic review. Arch Clin Infect Dis. 2020;15(3).
[22] Smer A, Squires RW, Bonikowske AR, Allison TG, Mainville RN, Williams MA. Cardiac complications of COVID-19 infection and the role of physical activity. J Cardiopulm Rehabil Prev. 2023;43(1):8-14.
[23] Ahmad I, Rathore FA. Neurological manifestations and complications of COVID-19: A literature review. J Clin Neurosci. 2020;77:8-12.
[24] Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13.
[25] Zhang J-j, Dong X, Cao Y-y, Yuan Y-d, Yang Y-b, Yan Y-q, et al. Clinical characteristics of 140 patients infected with SARS‐CoV‐2 in Wuhan, China. Allergy. 2020;75(7):1730-41.
[26] Widyadharma IPE, Sari NNSP, Pradnyaswari KE, Yuwana KT, Adikarya IPGD, Tertia C, et al. Pain as clinical manifestations of COVID-19 infection and its management in the pandemic era: a literature review. Egypt J Neurol Psychiatry Neurosurg. 2020;56(1):121.
[27] Sá KN, Moreira L, Baptista AF, Yeng LT, Teixeira MJ, Galhardoni R, et al. Prevalence of chronic pain in developing countries: systematic review and meta-analysis. Pain Rep. 2019;4(6):e779.
[28] Matsuda M, Huh Y, Ji R-R. Roles of inflammation, neurogenic inflammation, and neuroinflammation in pain. J Anesth. 2019;33:131-9.
[29] Pinto EM, Neves JR, Laranjeira M, Reis J. The importance of inflammatory biomarkers in non-specific acute and chronic low back pain: a systematic review. Eur Spine J. 2023;32(9):3230-44.
[30] Fernández-de-Las-Peñas C, Giordano R, Díaz-Gil G, Gómez-Esquer F, Ambite-Quesada S, Palomar-Gallego MA, et al. Post-COVID pain is not associated with inflammatory polymorphisms in people who had been hospitalized by COVID-19. J Clin Med. 2022;11(19):5645.
[31] Maamar M, Artime A, Pariente E, Fierro P, Ruiz Y, Gutiérrez S, et al. Post-COVID-19 syndrome, low-grade inflammation and inflammatory markers: a cross-sectional study. Curr Med Res Opin. 2022;38(6):901-9.
[32] Badakhsh B, Mansouri F, Gholami A, Karimian M, Kafashian M, Khorshidi A, et al. Prevalence of different pain patterns in patients with COVID-19: A systematic review and meta-analysis. Anaesth Pain Intensive Care. 2020;24(2):141-50.
[33] Weng L-M, Su X, Wang X-Q. Pain symptoms in patients with coronavirus disease (COVID-19): a literature review. J Pain Res. 2021:147-59.
[34] Sampaio Rocha‐Filho PA. Headache associated with COVID‐19: Epidemiology, characteristics, pathophysiology, and management. Headache: The Journal of Head and Face Pain. 2022;62(6):650-6.
[35] Fernández‐de‐las‐Peñas C, Navarro‐Santana M, Gómez‐Mayordomo V, Cuadrado ML, García‐Azorín D, Arendt‐Nielsen L, et al. Headache as an acute and post‐COVID‐19 symptom in COVID‐19 survivors: A meta‐analysis of the current literature. Eur J Neurol. 2021;28(11):3820-5.
[36] Sampaio Rocha-Filho PA, Magalhães JE. Headache associated with COVID-19: Frequency, characteristics and association with anosmia and ageusia. Cephalalgia. 2020;40(13):1443-51.
[37] Purabdollah M, Rahmani A. Relationship between sleep, pain and inflammatory markers in patients with rheumatoid arthritis. J Caring Sci. 2017;6(3):249.
[38] Bilge N, Can FK, Alay H. The relationship of headache with inflammatory serum parameters and disease severity in COVID-19 patients. Duzce Med J. 2020;22(Special Issue):44-50.
[39] Sobhani S, Aryan R, Kalantari E, Soltani S, Malek N, Pirzadeh P, et al. Association between Clinical Characteristics and Laboratory Findings with Outcome of Hospitalized COVID‐19 Patients: A Report from Northeast Iran. Interdiscip Perspect Infect Dis. 2021;2021(1):5552138.
[40] Chen T, Wu D, Chen H, Yan W, Yang D, Chen G, et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ. 2020;368.
[41] Luo X, Zhou W, Yan X, Guo T, Wang B, Xia H, et al. Prognostic value of C-reactive protein in patients with coronavirus 2019. Clin Infect Dis. 2020;71(16):2174-9.
[42] Tomlins J, Hamilton F, Gunning S, Sheehy C, Moran E, MacGowan A. Clinical features of 95 sequential hospitalised patients with novel coronavirus 2019 disease (COVID-19), the first UK cohort. J Infect. 2020;81(2):e59-e61.
[43] Wang K, Zuo P, Liu Y, Zhang M, Zhao X, Xie S, et al. Clinical and laboratory predictors of in-hospital mortality in patients with coronavirus disease-2019: a cohort study in Wuhan, China. Clin Infect Dis. 2020;71(16):2079-88.
[44] Wang Y, Lu X, Li Y, Chen H, Chen T, Su N, et al. Clinical course and outcomes of 344 intensive care patients with COVID-19. Am J Respir Crit Care Med. 2020;201(11):1430-4.
[45] Zhang J, Liu P, Wang M, Wang J, Chen J, Yuan W, et al. The clinical data from 19 critically ill patients with coronavirus disease 2019: a single-centered, retrospective, observational study. J Public Health. 2020:1-4.
[46] Zhang J, Yu M, Tong S, Liu L-Y, Tang L-V. Predictive factors for disease progression in hospitalized patients with coronavirus disease 2019 in Wuhan, China. J Clin Virol. 2020; 127:104392.
[2] Mirkheshti A, Raji P, Komlakh K, Salimi S, Shakeri A. The efficacy of ultrasound-guided erector spinae plane block (ESPB) versus freehand ESPB in postoperative pain management after lumbar spinal fusion surgery: a randomized, non-inferiority trial. Eur Spine J. 2024;33(3):1081-8.
[3] Rikard SM. Chronic pain among adults—United States, 2019–2021. MMWR Morb Mortal Wkly Rep. 2023;72.
[4] Cohen SP, Vase L, Hooten WM. Chronic pain: an update on burden, best practices, and new advances. Lancet. 2021;397(10289):2082-97.
[5] Yazdi-Ravandi S, Taslimi Z, Saberi H, Shams J, Osanlo S, Nori G, et al. The role of resilience and age on quality of life in patients with pain disorders. Basic Clin Neurosci. 2013;4(1):24.
[6] Perrot S, Cohen M, Barke A, Korwisi B, Rief W, Treede R-D. The IASP classification of chronic pain for ICD-11: chronic secondary musculoskeletal pain. Pain. 2019;160(1):77-82.
[7] Vasigh A, Tarjoman A, Borji M. The effect of spiritual-religious interventions on patients' pain status: Systematic review. Anaesth Pain Intensive Care. 2018;22(4).
[8] Cramer JD, Johnson JT, Nilsen ML. Pain in head and neck cancer survivors: prevalence, predictors, and quality-of-life impact. Otolaryngol Head Neck Surg. 2018; 159(5):853-8.
[9] Ośmiałowska E, Misiąg W, Chabowski M, Jankowska-Polańska B. Coping strategies, pain, and quality of life in patients with breast cancer. J Clin Med. 2021;10(19):4469.
[10] Snijders RA, Brom L, Theunissen M, van den Beuken-van Everdingen MH. Update on prevalence of pain in patients with cancer 2022: a systematic literature review and meta-analysis. Cancers. 2023;15(3):591.
[11] Gaskin DJ, Richard P. The economic costs of pain in the United States. J Pain. 2012;13(8):715-24.
[12] Bagheri Sheykhangafshe F, Farahani H, Dehghani M, Fathi-Ashtiani A. Examining the Relationship between Mental Health and Chronic Pain in Children and Adolescents: A Systematic Review Study. J Rafsanjan Univ Med Sci. 2023;22(6):617-36.
[13] Hatefi M, Parvizi R, Borji M, Tarjoman A. Effect of self-management program on pain and disability index in elderly men with osteoarthritis. Anesth Pain Med. 2019;9(4).
[14] Rahmatian A, Bastani E, Shokri F, Karbasfrushan A. Prevalence of Hemiplegic Shoulder Pain in Iran: A Systematic Review and Meta-analysis. Anesth Pain Med. 2023;13(3).
[15] van Hecke O, Torrance N, Smith BH. Chronic pain epidemiology–where do lifestyle factors fit in? Br J Pain. 2013;7(4):209-17.
[16] Azhough R, Jalali P, Dashti MR, Taher S, Aghajani A. Intradermal methylene blue analgesic application in posthemorrhoidectomy pain management: a randomized controlled trial. Front Surg. 2024;11:1354328.
[17] Fine PG. Long-term consequences of chronic pain: mounting evidence for pain as a neurological disease and parallels with other chronic disease states. Pain Med. 2011;12(7):996-1004.
[18] Lam CM, Sanderson M, Vu DT, Sayed D, Latif U, Chadwick AL, et al. Musculoskeletal and neuropathic pain in COVID-19. Diagnostics. 2024;14(3):332.
[19] Adibi A, Jamshidbeigi H, Jamshidbeigi T, Mozafari A, Sahebi A. Anxiety and obsession following the COVID-19 outbreak. Iran J Psychiatry Behav Sci. 2020;14(2).
[20] Nourmohammadi H, Dehkordi AH, Adibi A, Amin Hashemipour SM, Abdan M, Fakhri M, et al. Seroprevalence of COVID‐19 in Blood Donors: A Systematic Review and Meta‐Analysis. Adv Virol. 2022;2022(1):9342680.
[21] Shokri M, Karimian M, Mansouri F, Mahdikhani S, Borji M, Solaimanizadeh L, et al. Laboratory and radiologic findings in pediatrics with COVID-19: A systematic review. Arch Clin Infect Dis. 2020;15(3).
[22] Smer A, Squires RW, Bonikowske AR, Allison TG, Mainville RN, Williams MA. Cardiac complications of COVID-19 infection and the role of physical activity. J Cardiopulm Rehabil Prev. 2023;43(1):8-14.
[23] Ahmad I, Rathore FA. Neurological manifestations and complications of COVID-19: A literature review. J Clin Neurosci. 2020;77:8-12.
[24] Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13.
[25] Zhang J-j, Dong X, Cao Y-y, Yuan Y-d, Yang Y-b, Yan Y-q, et al. Clinical characteristics of 140 patients infected with SARS‐CoV‐2 in Wuhan, China. Allergy. 2020;75(7):1730-41.
[26] Widyadharma IPE, Sari NNSP, Pradnyaswari KE, Yuwana KT, Adikarya IPGD, Tertia C, et al. Pain as clinical manifestations of COVID-19 infection and its management in the pandemic era: a literature review. Egypt J Neurol Psychiatry Neurosurg. 2020;56(1):121.
[27] Sá KN, Moreira L, Baptista AF, Yeng LT, Teixeira MJ, Galhardoni R, et al. Prevalence of chronic pain in developing countries: systematic review and meta-analysis. Pain Rep. 2019;4(6):e779.
[28] Matsuda M, Huh Y, Ji R-R. Roles of inflammation, neurogenic inflammation, and neuroinflammation in pain. J Anesth. 2019;33:131-9.
[29] Pinto EM, Neves JR, Laranjeira M, Reis J. The importance of inflammatory biomarkers in non-specific acute and chronic low back pain: a systematic review. Eur Spine J. 2023;32(9):3230-44.
[30] Fernández-de-Las-Peñas C, Giordano R, Díaz-Gil G, Gómez-Esquer F, Ambite-Quesada S, Palomar-Gallego MA, et al. Post-COVID pain is not associated with inflammatory polymorphisms in people who had been hospitalized by COVID-19. J Clin Med. 2022;11(19):5645.
[31] Maamar M, Artime A, Pariente E, Fierro P, Ruiz Y, Gutiérrez S, et al. Post-COVID-19 syndrome, low-grade inflammation and inflammatory markers: a cross-sectional study. Curr Med Res Opin. 2022;38(6):901-9.
[32] Badakhsh B, Mansouri F, Gholami A, Karimian M, Kafashian M, Khorshidi A, et al. Prevalence of different pain patterns in patients with COVID-19: A systematic review and meta-analysis. Anaesth Pain Intensive Care. 2020;24(2):141-50.
[33] Weng L-M, Su X, Wang X-Q. Pain symptoms in patients with coronavirus disease (COVID-19): a literature review. J Pain Res. 2021:147-59.
[34] Sampaio Rocha‐Filho PA. Headache associated with COVID‐19: Epidemiology, characteristics, pathophysiology, and management. Headache: The Journal of Head and Face Pain. 2022;62(6):650-6.
[35] Fernández‐de‐las‐Peñas C, Navarro‐Santana M, Gómez‐Mayordomo V, Cuadrado ML, García‐Azorín D, Arendt‐Nielsen L, et al. Headache as an acute and post‐COVID‐19 symptom in COVID‐19 survivors: A meta‐analysis of the current literature. Eur J Neurol. 2021;28(11):3820-5.
[36] Sampaio Rocha-Filho PA, Magalhães JE. Headache associated with COVID-19: Frequency, characteristics and association with anosmia and ageusia. Cephalalgia. 2020;40(13):1443-51.
[37] Purabdollah M, Rahmani A. Relationship between sleep, pain and inflammatory markers in patients with rheumatoid arthritis. J Caring Sci. 2017;6(3):249.
[38] Bilge N, Can FK, Alay H. The relationship of headache with inflammatory serum parameters and disease severity in COVID-19 patients. Duzce Med J. 2020;22(Special Issue):44-50.
[39] Sobhani S, Aryan R, Kalantari E, Soltani S, Malek N, Pirzadeh P, et al. Association between Clinical Characteristics and Laboratory Findings with Outcome of Hospitalized COVID‐19 Patients: A Report from Northeast Iran. Interdiscip Perspect Infect Dis. 2021;2021(1):5552138.
[40] Chen T, Wu D, Chen H, Yan W, Yang D, Chen G, et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ. 2020;368.
[41] Luo X, Zhou W, Yan X, Guo T, Wang B, Xia H, et al. Prognostic value of C-reactive protein in patients with coronavirus 2019. Clin Infect Dis. 2020;71(16):2174-9.
[42] Tomlins J, Hamilton F, Gunning S, Sheehy C, Moran E, MacGowan A. Clinical features of 95 sequential hospitalised patients with novel coronavirus 2019 disease (COVID-19), the first UK cohort. J Infect. 2020;81(2):e59-e61.
[43] Wang K, Zuo P, Liu Y, Zhang M, Zhao X, Xie S, et al. Clinical and laboratory predictors of in-hospital mortality in patients with coronavirus disease-2019: a cohort study in Wuhan, China. Clin Infect Dis. 2020;71(16):2079-88.
[44] Wang Y, Lu X, Li Y, Chen H, Chen T, Su N, et al. Clinical course and outcomes of 344 intensive care patients with COVID-19. Am J Respir Crit Care Med. 2020;201(11):1430-4.
[45] Zhang J, Liu P, Wang M, Wang J, Chen J, Yuan W, et al. The clinical data from 19 critically ill patients with coronavirus disease 2019: a single-centered, retrospective, observational study. J Public Health. 2020:1-4.
[46] Zhang J, Yu M, Tong S, Liu L-Y, Tang L-V. Predictive factors for disease progression in hospitalized patients with coronavirus disease 2019 in Wuhan, China. J Clin Virol. 2020; 127:104392.
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How to Cite
1.
Hatefi M, Ajeel Alhachami AH, Saleem M, Aghamiri SH, Sherafat A, Vasigh A, Kargar S, Razi M. Investigating the Relationship between Types of Pain and Inflammatory Factors: A Retrospective Cohort. Arch Anesth & Crit Care. 2026;.
