Violeta De Pablos-Florido 1
Paula María Córdoba-Peláez 2
Paula María Jiménez-Gutiérrez 1

1 Virgen de las Nieves University Hospital (Granada)
2 Faculty of Science (Biochemistry), University of Granada (UGR)

Translated by:
Eva Aguilera-Parejo 4
Rania Bouanane-Hamed 4
Daniel Carmona-Molero 5
Juan Luis Ruiz-García 4
Sheila Vázquez-Ledo 6
David Vilas-Antelo 4

4 Faculty of Translation and Interpreting, University of Granada (UGR)
5 Faculty of Philosophy and Letters, University of Córdoba (UCO)
6 Faculty of Translation, University of Salamanca (USAL)


Introduction
The persistence of COVID-19 sequelae is very common 14 days after acute infection. The term “long-COVID” has been proposed in order to refer to all the secondary conditions to SARS-CoV-2 infection which continue or appear after its acute stage. One of the sequelae is chronic pain with non-demonstrated organ involvement. This systematic review aims to identify the most commonly reported painful sequelae and their incidence.

Methods
A search for articles documenting pain as a consequence of COVID-19 was conducted. The consulted databases were PubMed/Medline, Scopus, and Web of Science. Certain articles cited in the references of relevant articles were also incorporated. Depending on the detailed inclusion or exclusion criteria, three independent researchers carried out the selection. All the articles published before March 11th 2021 were included. This systematic review is based on the PRISMA guidelines.

Results
A total of 588 publications were identified, of which 11 met the inclusion criteria. Headache was the most frequently reported painful sequela, with a prevalence of up to 44% in some cases. Joint pain (19%-31%) and post-COVID thoracic pain (6%-28%) were notified. Persistent sore throat was reported in 32% of patients, as well as generalized pain, observed in up to 59% of the cases. Patient’s polyneuropathy that required admission to the internal care unit (ICU) was additionally notified. SARS-CoV-2 causes damage at the capillary microcirculation level, generating tissue hypoxia and inflammation, with the consequent increase in painful vascular-ischemic and inflammatory sequelae.

Conclusions
COVID-19 produces painful sequelae of various typologies. Subsequent studies are required in order to identify the characteristics of every different type of pain. This will allow an adequate symptomatologic management and an optimization of the available resources to face the challenges of the current pandemic in different healthcare areas.

Keywords: COVID-19, SARS-CoV-2, coronavirus, pain, painful sequelae, long-COVID, post-COVID, persistent COVID.



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