【原】COVID后疼痛综合征（一）

 英语晨读 ·

山东省立医院疼痛科英语晨读已经坚持10余年的时间了，每天交班前15分钟都会精选一篇英文文献进行阅读和翻译。一是可以保持工作后的英语阅读习惯，二是可以学习前沿的疼痛相关知识。我们会将晨读内容与大家分享，助力疼痛学习。

本次文献选自Fiala K, Martens J, Abd-Elsayed A. Post-COVID Pain Syndromes. Curr Pain Headache Rep. 2022 May;26(5):379-383. 本次学习由阎芳副主任医师主讲。

Abstract

Although the number of SARS-CoV-2 new cases may be declining due to the implementation of the vaccine in the USA, there is a rising cohort of people with long-term effects from the virus. These long-term effects include loss of taste, heart palpitations, and chronic pain syndromes. In this commentary, we assess the current literature to appraise the knowledge of long-term COVID-19 effects related to long-term pain syndromes including testicular pain, headache, chronic pain, and chest pain.

Keywords: post covid headache, post covid testicular pain, post covid syndrome, post covid chronic pain

摘要

尽管美国新冠肺炎新病例的数量可能因疫苗的使用而下降，但仍有越来越多的人受到病毒的长期影响。这些长期影响包括味觉丧失、心悸和慢性疼痛综合征。在本报道中，我们对现有文献进行分析，以评估新冠肺炎在长期疼痛综合征（包括睾丸疼痛、头痛、慢性疼痛和胸痛）方面的影响。

关键词：新冠肺炎后头痛 新冠肺炎后睾丸疼痛 新冠肺炎后综合征 新冠肺炎后慢性疼痛

Introduction

Emergent in human populations in 2019, the coronavirus disease (often referred to as COVID-19) is a respiratory condition caused by the viral agent, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) . As of November 28th, 2021, the World Health Organization has documented more than 259,000,000 global cases and 5,000,000 global deaths. More recently, the number of COVID-19 cases has been decreasing as the vaccine is being distributed largely. Although the amount of new cases is decreasing with the large-scale implementation of the COVID-19 vaccine, many long-term side-effects of the virus are affecting the people who have previously contracted the virus. Investigation of post-acute complications of coronavirus disease remains an emerging field. A meta-analysis by Lopez-Leon et al., conducted in January 2021, found that 80% of patients who have recovered from COVID-19 report at least 1 long-term symptom, defined as an effect beyond 2 weeks following acute infection. While the most common reported post-COVID manifestations are fatigue, headache, attention disorder, hair loss, and dyspnea, the CDC reports a long list of potential post-COVID symptoms including loss of smell or taste, dizziness, heart palpitations, chest pain, myalgias, depression, anxiety, and fever. Furthermore, there have been numerous documented accounts of atypical post-COVID symptoms that justify additional investigation. There have also been numerous published findings of atypical chronic pain associated with SARS-CoV-2 infection, particularly in patients who were admitted during part of their course of care.

前言

冠状病毒病（通常称为新冠肺炎）于2019年在人群中出现，是一种由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的呼吸系统疾病。截至2021年11月28日，世界卫生组织记录了超过2.59亿新冠全球感染病例和500万全球死亡病例。最近，随着疫苗的大量使用，新冠肺炎病例数量一直在减少。尽管随着新冠肺炎疫苗的大规模使用，新病例数量正在减少，但该病毒的许多长期副作用正在影响既往感染过该病毒的人。冠状病毒病急性期后后遗症的研究仍然是一个新兴领域。Lopez-Leon等人于2021年1月进行的荟萃分析发现，80%的新冠肺炎康复后患者报告了至少一种长期症状，定义为急性感染后2周以上的影响。尽管报告的最常见的新冠肺炎后症状是疲劳、头痛、注意力障碍、脱发和呼吸困难，但CDC报告了一长串潜在的新冠肺炎后症状，包括嗅觉或味觉丧失、头晕、心悸、胸痛、肌痛、抑郁、焦虑和发烧。此外，有大量记录在案的非典型新冠肺炎后症状，还需要进一步的研究和调查。也有许多已发表的与新冠肺炎感染相关的非典型慢性疼痛的研究结果，主要集中在新冠治疗过程中有过住院经历的患者。

A literature search was performed to identify research articles related to development of various kinds of chronic pain following a COVID-19 infection.

我们进行了文献检索，检索目标是与新冠肺炎感染后发生各种慢性疼痛相关的研究文章。

PubMed and Google Scholar were used to search the terms (post covid headache) OR (post covid testicular pain) OR (post covid syndrome) OR (post covid chronic pain). Filters were applied to include clinical trials, meta-analyses, systematic reviews, randomized controlled trials, and only articles published within the past 2 years. Papers were additionally appraised by two reviewers based on availability of full text articles and the discussion of specific patient cases and symptoms documented outside of a hospital context. There were no disagreements, and no relevant articles were excluded. A total of 30 articles were discussed in this commentary.

检索的数据库包括PubMed和谷歌学术。检索关键词是（新冠肺炎后头痛）或（新冠肺炎后睾丸疼痛）或（新冠肺炎后综合征）或（新冠肺炎后慢性疼痛）。筛选文章类型包括临床试验、荟萃分析、系统性综述、随机对照试验，以及仅搜索过去两年内发表的文章。另外，还有两位审稿人根据全文文章的可用性以及用非医疗文书记录的特定患者病例和症状的讨论对论文进行了评估。没有意见分歧，所有相关文章均纳入分析。本文共纳入分析了30篇文章。

Given the limited available literature on long-term, post-infection symptoms in SARS-CoV-2 patients, it is important that researchers diligently investigate all possible post-COVID symptoms and work to identify potential mechanisms of their occurrence. An increased breadth of knowledge on post-COVID complications will not only improve long-term patient outcomes but may also provide insight into interventions that can be taken during acute illness to avoid lasting impacts on patient quality of life. In this commentary, we discuss the available literature on chronic pain, long-lasting testicular pain, headache, and chest pain in patients following SARS-CoV-2 infection in order to assess the incidence of these cases, potential risk factors, and possible mechanisms to explain the occurrence of these phenomena.

鉴于目前有关新冠肺炎感染后长期症状的文献有限，研究者必须认真调查所有可能的新冠肺炎后症状，并努力确定其发生的潜在机制。增加对新冠肺炎后并发症的认知广度不仅可以改善患者的长期预后，还可以深入了解急性疾病期间可以采取的干预措施，以避免对患者生活质量产生持久影响。在这篇评论中，我们讨论了新冠肺炎感染后患者慢性疼痛、长期睾丸疼痛、头痛和胸痛的现有文献，以评估这些并发症的发生率、潜在风险因素以及解释这些现象发生的可能机制。