COVID and pain medicine: not just telemedicine and delayed procedures

Spine & Nerve

In this week's episode of the Spine & Nerve podcast, Dr. Nicolas Karvelas and Dr. Brian Joves discuss how pain medicine has been affected by COVID-19. This pandemic has caused so much devastation for our patients, including some who directly experienced COVID-19 infection and those who have had to weigh seeking medical care against risking infection. It has also impacted our practice as we work to create a safe environment for patients and accommodate their needs.

More and more research is emerging on a persistent syndrome following acute COVID-19 infection. Although we don't understand its entire clinical picture, it appears most patients with post-COVID-19 syndrome (over 50%) have significant fatigue, and a significant percentage of patients (about 20%) have persistent pain. We can anticipate this syndrome presenting a growing challenge to the broader medical community, given both the vast number of COVID-19 patients worldwide and the historical difficulty of treating similar post-viral syndromes.

Multiple risk factors associated with acute COVID-19 infection could increase the chance of developing a post-infectious syndrome. For instance, the virus enters cells through the ACE-2 receptor which is present throughout the body, making it possible to spread beyond the respiratory system to the vasculature, neural, and muscle tissues. At the individual and community level, many patients are experiencing isolation, barriers to health care, and worsening of mental health conditions which can exacerbate symptoms such as chronic pain.

Listen as the doctors discuss the evidence behind the emerging entity of post-COVID-19 syndrome, as well as the challenges and necessity of delivering multi-disciplinary treatment in this COVID-19 era.

As always, we greatly appreciate the effort of all involved in the management of this challenging pandemic, and our thoughts and prayers are with all who have been affected.

This podcast is for information and educational purposes only, it is not meant to be medical or career advice. If anything discussed may pertain to you, please seek council with your healthcare provider. The views expressed are those of the individuals expressing them, the may not represent the views of Spine & Nerve.

References:

1. Kemp HI, Corner E, Colvin LA. Chronic pain after COVID-19: implications for rehabilitation. Br J Anaesth. 2020;125(4):436-440.

2. Characteristics, Symptom Management, and Outcomes of 101 Patients With COVID-19 Referred for Hospital Palliative Care. Journal of Pain and Symptom Management. 2020.

3. Persistent Symptoms in Patients After Acute COVID-19. JAMA. August 2020.