Prevalence and characteristics of new-onset pain in COVID-19 survivours, a controlled study.

BACKGROUND: We assessed whether COVID-19 is associated with de novo pain and de novo chronic pain (CP). METHODS: This controlled cross-sectional study was based on phone interviews of patients discharged from hospital after COVID-19 compared to the control group composed of individuals hospitalized during the same period due to non-COVID-19 causes. Patients were classified as having previous CP based on the ICD-11/IASP criteria, de novo pain (i.e. any new type of pain, irrespective of the pain status before hospital stay), and de novo CP (i.e. persistent or recurring de novo pain, lasting more than 3 months) after COVID-19. We assessed pain prevalence and its characteristics, including headache profile, pain location, intensity, interference, and its relationship with fatigue, and persistent anosmia. Forty-six COVID-19 and 73 control patients were included. Both groups had similar sociodemographic characteristics and past medical history. RESULTS: Length of in-hospital-stay and ICU admission rates were significantly higher amongst COVID-19 survivours, while mechanical ventilation requirement was similar between groups. Pre-hospitalisation pain was lower in COVID-19 compared to control group (10.9% vs. 42.5%; p = 0.001). However, the COVID-19 group had a significantly higher prevalence of de novo pain (65.2% vs. 11.0%, p = 0.001), as well as more de novo headache (39.1%) compared to controls (2.7%, p = 0.001). New-onset CP was 19.6% in COVID-19 patients and 1.4% (p = 0.002) in controls. These differences remained significant (p = 0.001) even after analysing exclusively (COVID: n = 40; controls: n = 34) patients who did not report previous pain before the hospital stay. No statistically significant differences were found for mean new-onset pain intensity and interference with daily activities between both groups. COVID-19 pain was more frequently located in the head/neck and lower limbs (p < 0.05). New-onset fatigue was more common in COVID-19 survivours necessitating inpatient hospital care (66.8%) compared to controls (2.5%, p = 0.001). COVID-19 patients who reported anosmia had more new-onset pain (83.3%) compared to those who did not (48.0%, p = 0.024). CONCLUSION: COVID-19 was associated with a significantly higher prevalence of de novo CP, chronic daily headache, and new-onset pain in general, which was associated with persistent anosmia. SIGNIFICANCE: There exists de novo pain in a substantial number of COVID-19 survivours, and some develop chronic pain. New-onset pain after the infection was more common in patients who reported anosmia after hospital discharge.

Derivação ventriculoatrial percutânea – Nota técnica / Derivation percutaneous atrial ventricle - Technical Note

Descrição passo a passo de técnica de derivação ventriculoatrial utilizando punção cervical percutâneapor técnica de Seldinger. O objetivo é demonstrar e difundir entre os neurocirurgiões brasileiros umaforma alternativa segura, rápida e e'caz de introdução e instalação de cateter venoso até o átrio direito,sem necessidade de dissecção venosa convencional. São vantagens a redução do tempo cirúrgico eo melhor resultado cosmético, sem aumento signi'cativo do custo...

Step-by-step technique using ventriculoatrial shunt through percutaneous cervical puncture by Seldinger’s technique. The goal is to demonstrate and spread among Brazilian neurosurgeons an alternative safe, fast and effective way to introduce and install venous catheter up to the right atrium without the need for conventional venous dissection. Advantages of the method are shorter surgical time and better cosmetic results, without significant increase in the cost...