Cognition, psychiatric symptoms, and functionality in patients with post-COVID-19 chronic pain

Abstract

Introduction
Chronic pain is among the ten most prevalent diseases worldwide affecting 50% of the general population and up to 63.3% of post-COVID-19 patients. The association between pain and cognitive alterations, increased presence of psychiatric symptoms and loss of functionality is well known in various pathologies, however, little is known in patients with post-COVID-19 syndrome.
Objective
To analyze the cognitive state, psychiatric symptoms and functionality in patients with chronic pain post-COVID-19.
Methodology
A cross-sectional descriptive study was conducted at the National Institute of Neurology and Neurosurgery (registry 126/23), in which participants aged 18 to 59 years with a history of COVID-19 were included. The sample was divided into two groups considering the presence/absence of pain. Application of the Cognitive Complaint Questionnaire (COBRA), the Montreal Cognitive Assessment (MoCA), digits in direct and reverse order, Trail Making Test and Five-digit Test, Beck’s anxiety and depression inventories, SCL-90 Symptom List and the Bayer daily activities questionnaire.
Results
We included 65 participants of whom 16 (25%) reported chronic pain, 12 (75%) referred to generalized body pain, 3 presented headache (18.8%) and one person reported chest pain (6.3%). Statistically significant differences were identified between the groups with and without pain in age (p=.013) and number of post-COVID sequelae (p=.001), being the group with pain, the oldest and more sequelae. The cognitive tests, anxiety and depression inventories, as well as functionality did not show differences between groups; however, it was identified that the group with pain presents more subjective cognitive complaint (CSQ) and somatization symptoms (p<.05) than the group without pain.

Conclusions
The prevalence of chronic pain in the sample studied was lower than that reported in other studies. Post-COVID-19 patients with chronic pain present cognitive state, anxiety symptoms, depression and similar functionality to patients without pain, however, they have a greater number of somatization symptoms and CSF that may contribute to prolonged perception of pain. It is necessary to incorporate other pain study techniques in order to identify explanatory mechanisms and therapeutic targets for these patients.