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Long-Covid and Pain: Pathophysiology and Management

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Abstract

Purpose of Review

Since its origin on December 12, 2019, SARS-CoV-2 has shaken the globe, and while pandemic restrictions have lifted, many individuals who survived the acute viral infection continue to suffer chronically from complications for months and even years.

Recent Findings

The physiologic, multi-organ complications related to this viral infection can be severe. The ongoing symptoms of SAR-CoV-2 extending beyond 4 weeks are referred to as Long-Covid, with the most common complaints being related to pain. As the pathophysiology continues to be investigated, the current hypothesis is that the angiotensin-converting enzyme 2 (ACE2) receptor plays a major role in the spread of the virus throughout multiple organ systems leading to pain, inflammation, fibrosis, and vasoconstriction. Currently, there is limited research regarding the pathophysiology of Long-Covid and why there is such variability amongst patients in regard to severity, duration, and organ system involvement.

Summary

This review attempts to outline the current understanding of Long-Covid pathophysiology and summarizes management strategies, particularly pain control, for those currently affected by its symptoms and their treating providers.

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Data Availability

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Author information

Authors and Affiliations

  1. Department of Emergency Medicine, Henry Ford Health, Detroit, MI, USA

    Richard Rice

  2. Department of Anesthesia & Pain Medicine, Henry Ford Health, Detroit, MI, USA

    Breanna Lauinger, Arif Valliani, Luis Escano Volquez & Sarah Money

  3. Department of Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor, MI, USA

    SriKrishna Chandran

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  4. Arif Valliani
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Contributions

Richard Rice, MD Primary author of the body of the manuscript. Breanna Lauinger, MD Primary author of the abstract portion of the manuscript, secondary editor of the manuscript. SriKrishna Chandran, MD Secondary editor of the manuscript; checked reference accuracy. Arif Valliani Secondary editor of the manuscript; added a reference to the reference list with appropriate citation. Luis Escano Volquez, MD Secondary editor of the manuscript; added two additional references with appropriate citations to the body of the manuscript. Corresponding author: Sarah Money, MD Primary investigator for the manuscript; secondary editor of the manuscript.

Corresponding author

Correspondence to Sarah Money.

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The authors declare no competing interests.

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Rice, R., Lauinger, B., Chandran, S. et al. Long-Covid and Pain: Pathophysiology and Management. Curr Emerg Hosp Med Rep 11, 165–168 (2023). https://doi.org/10.1007/s40138-023-00276-1

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