Chronic pain and COVID-19 hospitalisation and mortality: a UK Biobank cohort study. Issue 1 (22nd January 2023)

• Record Type: Journal Article
• Authors: Hastie, Claire E.; Foster, Hamish M.E.; Jani, Bhautesh D.; O'Donnell, Catherine A.; Ho, Frederick K.; Pell, Jill P.; Sattar, Naveed; Katikireddi, Srinivasa V.; Mair, Frances S.; Nicholl, Barbara I.
• Is Part Of: Pain. Volume 164:Issue 1(2023)
• Page Start: 84
• Page End: 90
• Publication Date: 2023-01-22
• Subjects: Chronic pain -- COVID-19 -- hospitalisation -- mortality; Pain -- Periodicals; Douleur -- Périodiques; Anesthésie -- Périodiques; Pain; Electronic journals; Periodicals; Electronic journals; 616.0472
• DOI: 10.1097/j.pain.0000000000002663
• Languages: English
• ISSNs: 0304-3959

Abstract

Abstract : Supplemental Digital Content is Available in the Text. Chronic pain is associated with increased risk of hospitalisation due to COVID-19, and this risk increases with the number of pain sites. Abstract: The risk of COVID-19 in those with chronic pain is unknown. We investigated whether self-reported chronic pain was associated with COVID-19 hospitalisation or mortality. UK Biobank recruited 502, 624 participants aged 37 to 73 years between 2006 and 2010. Baseline exposure data, including chronic pain (>3 months, in at least 1 of 7 prespecified body sites) and chronic widespread pain (>3 months, all over body), were linked to COVID-19 hospitalisations or mortality. Univariable or multivariable Poisson regression analyses were performed on the association between chronic pain and COVID-19 hospitalisation and Cox regression analyses of the associations with COVID-19 mortality. Multivariable analyses adjusted incrementally for sociodemographic confounders, then lifestyle risk factors, and finally long-term condition count. Of 441, 403 UK Biobank participants with complete data, 3180 (0.7%) were hospitalised for COVID-19 and 1040 (0.2%) died from COVID-19. Chronic pain was associated with hospital admission for COVID-19 even after adjustment for all covariates (incidence rate ratio 1.16; 95% confidence interval [CI] 1.08-1.24; P < 0.001), as was chronic widespread pain (incidence rate ratio 1.33; 95% CI 1.06-1.66; P = 0.012). There was clear evidence of a dose-response relationship with number of pain sites (fully adjusted global P -value < 0.001). After adjustment for all covariates, there was no association between chronic pain (HR 1.01; 95% CI 0.89-1.15; P = 0.834) but attenuated association with chronic widespread pain (HR 1.50, 95% CI 1.04-2.16, P -value = 0.032) and COVID-19 mortality. Chronic pain is associated with higher risk of hospitalisation for COVID-19, but the association with mortality is unclear. Future research is required to investigate these findings further and determine whether pain is associated with long COVID.