Korean J Pain.  2022 Apr;35(2):209-223. 10.3344/kjp.2022.35.2.209.

Impact of coronavirus disease 2019 on patients with chronic pain: multicenter study in Korea

• John H
• John H
• Lim YH
• Lim YH
• Hong SJ
• Hong SJ
• Jeong JH
• Jeong JH
• Choi HR
• Choi HR
• Park SK
• Kim JE
• Kim Bs
• Kim JH

• KMID: 2527772
• DOI: http://doi.org/10.3344/kjp.2022.35.2.209

Abstract

Background
The coronavirus disease 2019 (COVID-19) pandemic has caused significant changes. This study aimed to investigate the impact of COVID-19 on patients with chronic pain.
Methods
Patients with chronic pain from 23 university hospitals in South Korea participated in this study. The anonymous survey questionnaire consisted of 25 questions regarding the following: demographic data, diagnosis, hospital visit frequency, exercise duration, time outside, sleep duration, weight change, nervousness and anxiety, depression, interest or pleasure, fatigue, daily life difficulties, and self-harm thoughts. Depression severity was evaluated using the Patient Health Questionnaire-9 (PHQ-9). Logistic regression analysis was used to investigate the relationship between increased pain and patient factors.
Results
A total of 914 patients completed the survey, 35.9% of whom had decreased their number of visits to the hospital, mostly due to COVID-19. The pain level of 200 patients has worsened since the COVID-19 outbreak, which was more prominent in complex regional pain syndrome (CRPS). Noticeable post-COVID-19 changes such as exercise duration, time spent outside, sleep patterns, mood, and weight affected patients with chronic pain. Depression severity was more significant in patients with CRPS. The total PHQ-9 average score of patients with CRPS was 15.5, corresponding to major depressive orders. The patients’ decreased exercise duration, decreased sleep duration, and increased depression were significantly associated with increased pain.
Conclusions
COVID-19 has caused several changes in patients with chronic pain. During the pandemic, decreased exercise and sleep duration and increased depression were associated with patients’ increasing pain.

Keyword

Chronic Pain; Complex Regional Pain Syndrome; Coronavirus; COVID-19; Depression; Fatigue; Pandemics; Physical Distancing; Sleep; Social Isolation; Surveys and Questionnaires

Figure

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  Fig. 1 Decrease in hospital visit frequency in patients after the COVID-19 outbreak. COVID-19: coronavirus disease 2019, CSP: chronic spinal pain, PHN: post-herpetic neuralgia, CRPS: complex regional pain syndrome.

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  Fig. 2 Reasons of hospital visit changes after the COVID-19 outbreak (A) according to diseases and (B) in terms of the entire patient population. COVID-19: coronavirus disease 2019.

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  Fig. 3 Changes in exercise duration after the COVID-19 outbreak. COVID-19: coronavirus disease 2019, CSP: chronic spinal pain, PHN: post-herpetic neuralgia, CRPS: complex regional pain syndrome.

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  Fig. 4 Decrease in hours of day-out after the COVID-19 outbreak. COVID-19: coronavirus disease 2019, CSP: chronic spinal pain, PHN: post-herpetic neuralgia, CRPS: complex regional pain syndrome.

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  Fig. 5 Changes in daily life after the COVID-19 outbreak. COVID-19: coronavirus disease 2019.

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  Fig. 6 Depression severity after the COVID-19 outbreak in connection with the Patient health Questionnaire-9. COVID-19: coronavirus disease 2019.

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  Fig. 7 Depression severity after the COVID-19 outbreak in connection with the Patient Health Questionnaire-9 of patients with (A) CRPS, (B) PHN, and (C) CSP. COVID-19: coronavirus disease 2019, CSP: chronic spinal pain, PHN: post-herpetic neuralgia, CRPS: complex regional pain syndrome.

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