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Patel J, Javed S. Myofascial pain syndrome and SARS-CoV-2: a case series. Pain Manag 2021; 12:255-260. [PMID: 34601951 PMCID: PMC8491650 DOI: 10.2217/pmt-2021-0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SARS-CoV-2 is a novel virus that has caused a plethora of dysfunctions and changes in the human body. Our goal in this case study series was to demonstrate the relationship that coronavirus has had in newly diagnosing patients with myofascial pain syndrome (MFPS). Medical records were obtained from a pain clinic that demonstrated the effects of this virus on patients who developed MFPS between March 2020 and December 2020. Chart reviews were performed and demonstrated patients who had a history of chronic pain had subsequent episodes of worsening exacerbations of pain, more specifically trigger points, after being diagnosed with coronavirus. MFPS and SARS-CoV-2 are proposed to be correlated amongst chronic pain patients. Potential pathological mechanisms include coronavirus-induced hypoxic muscle dysfunctions as well as psychological stress triggering pain receptors, leading to myofascial pain syndrome. COVID-19, the disease caused by the SARS-CoV-2 virus, may cause many problems and changes in the human body. In this case series, we propose a relationship between COVID-19 and myofascial pain syndrome (MFPS), a kind of chronic muscle pain affecting connective tissue in the muscles. Medical records of people who developed MFPS after a diagnosis of COVID-19 between March 2020 and December 2020 were obtained from a pain clinic. Chart reviews demonstrated that the three people with chronic pain included in this case series had episodes of worsening pain, more specifically in focal points, after being diagnosed with COVID-19. COVID-19 is suggested to have affected the development of MFPS in these chronic pain patients. Potential mechanisms of this relationship include different types of stress leading to MFPS.
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Affiliation(s)
- Jaldhi Patel
- Department of Anesthesiology, University of Texas Health & Sciences Center, Houston, TX, USA
| | - Saba Javed
- Department of Pain Management, University of Texas Health & Sciences Center, Houston, TX, USA
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Willi S, Lüthold R, Hunt A, Hänggi NV, Sejdiu D, Scaff C, Bender N, Staub K, Schlagenhauf P. COVID-19 sequelae in adults aged less than 50 years: A systematic review. Travel Med Infect Dis 2021; 40:101995. [PMID: 33631340 PMCID: PMC7898978 DOI: 10.1016/j.tmaid.2021.101995] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 02/03/2021] [Accepted: 02/09/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND There is emerging evidence of long-term sequelae in a considerable proportion of COVID-19 patients after recovery and the spectrum and severity of such sequelae should be systematically reviewed. This review aims to evaluate the available evidence of all intermediate and long-term COVID-19 sequelae affecting formerly healthy adults. METHODS A systematic literature search of Embase, WHO, Scopus, Pubmed, Litcovid, bioRxiv and medRxiv was conducted with a cutoff date of the 17th September 2020 according to PRISMA guidelines and registered in PROSPERO (CRD42020208725). Search terms included "COVID-19", "coronavirus disease 2019", "SARS-CoV-2", "sequelae" and "consequence*". Publications on adult participants, with a confirmed SARS-CoV-2 infection were included. Elderly (>50 years old) and children (<18 years old) were excluded. Bias assessment was performed using a modified Newcastle-Ottawa Scale. RESULTS A total of 31 papers were included. Study types included prospective and retrospective cohort studies, cross-sectional studies and case reports. Sequelae persistence since infection spanned 14 days to three months. Sequelae included persistent fatigue (39-73% of assessed persons), breathlessness (39-74%), decrease in quality of life (44-69%), impaired pulmonary function, abnormal CT findings including pulmonary fibrosis (39-83%), evidence of peri-/perimyo-/myocarditis (3-26%), changes in microstructural and functional brain integrity with persistent neurological symptoms (55%), increased incidence of psychiatric diagnoses (5.8% versus 2.5-3.4% in controls), incomplete recovery of olfactory and gustatory dysfunction (33-36% of evaluated persons). CONCLUSIONS A variety of organ systems are affected by COVID-19 in the intermediate and longer-term after recovery. Main sequelae include post-infectious fatigue, persistent reduced lung function and carditis. Careful follow-up post COVID 19 is indicated to assess and mitigate possible organ damage and preserve life quality.
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Affiliation(s)
- Sandra Willi
- University of Zurich, Epidemiology, Biostatistics and Prevention Institute, WHO Collaborating Centre for Travel Medicine, Competence Centre for Military Medicine and Biology, Hirschengraben 84, 8001, Zurich, Switzerland; Institute of Evolutionary Medicine, University of Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland.
| | - Renata Lüthold
- Institute of Evolutionary Medicine, University of Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland
| | - Adam Hunt
- Institute of Evolutionary Medicine, University of Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland
| | - Nadescha Viviane Hänggi
- Institute of Evolutionary Medicine, University of Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland
| | - Donikë Sejdiu
- Institute of Evolutionary Medicine, University of Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland
| | - Camila Scaff
- Institute of Evolutionary Medicine, University of Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland
| | - Nicole Bender
- Institute of Evolutionary Medicine, University of Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland
| | - Kaspar Staub
- Institute of Evolutionary Medicine, University of Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland; Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland
| | - Patricia Schlagenhauf
- University of Zurich, Epidemiology, Biostatistics and Prevention Institute, WHO Collaborating Centre for Travel Medicine, Competence Centre for Military Medicine and Biology, Hirschengraben 84, 8001, Zurich, Switzerland
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Abstract
Due to the pandemic of corona virus disease 2019 (COVID-19), the stroke medical care system is unavoidably undergoing major changes such as a decrease in the number of stroke patients receiving consultation, delay in consultation, and a decrease in the number of intravenous thrombolysis and mechanical thrombectomy procedures. Stroke incidence in COVID-19 patients is approximately 1.1%. The features of stroke with COVID-19 have been elucidated: higher incidence in ischemic stroke than hemorrhagic stroke, increasing number of young patients, high D-dimer levels, and higher risk in elderly patients with cardiovascular risk factors such as hypertension and diabetes. In patients with COVID-19, venous thromboembolism is more common than arterial thromboembolism, and stroke is more common than acute coronary syndrome. Protected code stroke (PCS) has been proposed which provides safe, effective and prompt treatment under complete infection control.
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Affiliation(s)
| | | | - Makoto Nakajima
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University
| | - Mitsuharu Ueda
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University
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Fraiman P, Godeiro Junior C, Moro E, Cavallieri F, Zedde M. COVID-19 and Cerebrovascular Diseases: A Systematic Review and Perspectives for Stroke Management. Front Neurol 2020; 11:574694. [PMID: 33250845 PMCID: PMC7674955 DOI: 10.3389/fneur.2020.574694] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 08/27/2020] [Indexed: 01/08/2023] Open
Abstract
Importance: Reported cerebrovascular events in patients with COVID-19 are mainly ischemic, but hemorrhagic strokes and cerebral venous sinus thrombosis (CSVT), especially in critically ill patients, have also been described. To date, it is still not clear whether cerebrovascular manifestations are caused by direct viral action or indirect action mediated by inflammatory hyperactivation, and in some cases, the association may be casual rather than causal. Objective: To conduct a systematic review on the cerebrovascular events in COVID-19 infection. Evidence review: A comprehensive literature search on PubMed was performed including articles published from January 1, 2020, to July 23, 2020, using a suitable keyword strategy. Additional sources were added by the authors by reviewing related references. The systematic review was conducted in accordance with the PRISMA guidelines. Only articles reporting individual data on stroke mechanism and etiology, sex, age, past cardiovascular risk factors, COVID symptoms, admission NIHSS, D-dimer levels, and acute stroke treatment were selected for the review. Articles that did not report the clinical description of the cases were excluded. A descriptive statistical analysis of the data collected was performed. Finding: From a total of 1,210 articles published from January 1, 2020, to July 23, 2020, 80 articles (275 patients), which satisfied the abovementioned criteria, were included in this review. A total of 226 cases of ischemic stroke (IS), 35 cases of intracranial bleeding, and 14 cases of CVST were found. Among patients with IS, the mean age was 64.16 ±14.73 years (range 27-92 years) and 53.5% were male. The mean NIHSS score reported at the onset of stroke was 15.23 ±9.72 (range 0-40). Primary endovascular thrombectomy (EVT) was performed in 24/168 patients (14.29%), intravenous thrombolysis (IVT) was performed in 17/168 patients (10.12%), and combined IVT+EVT was performed in 11/168 patients (6.55%). According to the reported presence of large vessel occlusion (LVO) (105 patients), 31 patients (29.52%) underwent primary EVT or bridging. Acute intracranial bleeding was reported in 35 patients: 24 patients (68.57%) had intracerebral hemorrhage (ICH), 4 patients (11.43%) had non-traumatic subarachnoid hemorrhage (SAH), and the remaining 7 patients (20%) had the simultaneous presence of SAH and ICH. Fourteen cases of CVST were reported in the literature (50% males), mean age 42.8 years ±15.47 (range 23-72). Treatment was reported only in nine patients; seven were treated with anticoagulant therapy; one with acetazolamide, and one underwent venous mechanical thrombectomy. Conclusion: Cerebrovascular events are relatively common findings in COVID-19 infection, and they could have a multifactorial etiology. More accurate and prospective data are needed to better understand the impact of cerebrovascular events in COVID-19 infection.
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Affiliation(s)
- Pedro Fraiman
- Division of Neurology, Hospital Universitario Onofre Lopes, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Clecio Godeiro Junior
- Division of Neurology, Hospital Universitario Onofre Lopes, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Elena Moro
- Division of Neurology, Centre Hospitalier Universitaire of Grenoble, Grenoble Institut of Neuroscience, Grenoble Alpes University, Grenoble, France
| | - Francesco Cavallieri
- Neurology Unit, Neuromotor & Rehabilitation Department, Azienda Unitá Sanitaria Locale - Istituto di Ricovero e Cura a Carattere Scientifico di Reggio Emilia, Reggio Emilia, Italy.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Marialuisa Zedde
- Neurology Unit, Neuromotor & Rehabilitation Department, Azienda Unitá Sanitaria Locale - Istituto di Ricovero e Cura a Carattere Scientifico di Reggio Emilia, Reggio Emilia, Italy
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Polosa R, Spinicci M, Prisco D. "COVID-19: diagnosis, management and prognosis": a new topical collection of Internal and Emergency Medicine. Intern Emerg Med 2020; 15:747-750. [PMID: 32734430 PMCID: PMC7391015 DOI: 10.1007/s11739-020-02461-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 07/23/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Riccardo Polosa
- Dipartimento Di Medicina Clinica E Sperimentale (MEDCLIN), University of Catania, Catania, Italy.
- Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Catania, Italy.
| | - Michele Spinicci
- Dipartimento Di Medicina Sperimentale E Clinica (DMSC), Università Di Firenze, Florence, Italy
- SOD Malattie Infettive E Tropicali, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Domenico Prisco
- Dipartimento Di Medicina Sperimentale E Clinica (DMSC), Università Di Firenze, Florence, Italy
- SOD Medicina Interna Interdisciplinare, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
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