Chronic pain after COVID-19: implications for rehabilitation

Abstract

Managing the immediate demands of the current coronavirus disease 2019 (COVID-19) global pandemic has tested many healthcare systems across the world, to their limits. As we move forward, new challenges resulting from the impact of this must be faced. In the months since the initial outbreak of COVID-19 in December 2019, worldwide there have been more than 7.5 millions cases of infection with the severe acute respiratory syndrome coronavirus-2 (SARS-Cov-2) reported. However, the rapidity of spread appears to be slowing, the curve is flattening in many countries, and attention is now turning towards how the international healthcare community will address the ongoing needs of those most significantly affected by the pandemic. Recent UK data (covering February - April 2020) suggests 17% of cases admitted to hospital require support in high dependency or critical care environments, and of those more than 50% require mechanical ventilation. About 20% of those requiring mechanical ventilation will be discharged with a further 27% receiving ongoing care. Critical care survival in other countries including Italy, USA, and China has been reported as 16 - 37%, although many cohorts include those receiving ongoing care in ICU.3e5 Given the number of global infections, this suggests a cohort of critically ill survivors of unprecedented size.
The treatment needs of COVID-19 survivors are not yet fully appreciated. Although initially assumed to be a respiratory disease, it is now clear that it affects a variety of systems. Multi-organ failure can occur, with reports of cardiac, renal, haematological, and neurological effects in the acute stages. It is likely, therefore, that these survivors will have significant multi-domain impairment requiring ongoing support. There has been a recent ‘call to action’ amongst the rehabilitation community to act quickly to ensure adequate resources to provide early phase, multidisciplinary interventions to promote physical and psychological recovery.

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DOI

https://doi.org/10.1016/j.bja.2020.05.021

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https://discovery.dundee.ac.uk/en/publications/770eb7c2-bd04-4997-aaf3-1eb6e30cd112