• Pietro Falco, Daniel Litewczuk, Giulia Di Stefano, Eleonora Galosi, Caterina Leone, Gianfranco De Stefano, Giuseppe Di Pietro, Lorenzo Tramontana, Maria Rosa Ciardi, Patrizia Pasculli, Maria Antonella Zingaropoli, Lars Arendt-Nielsen, and Andrea Truini.
• Department of Human Neuroscience, Sapienza University, Rome, Italy.
• Pain. 2024 Sep 1; 165 (9): 200220102002-2010.

AbstractApproximately 10% to 20% of individuals with previous SARS-CoV-2 infection may develop long-COVID syndrome, characterized by various physical and mental health issues, including pain. Previous studies suggested an association between small fibre neuropathy and pain in long-COVID cases. In this case-control study, our aim was to identify small fibre neuropathy in patients experiencing painful long-COVID syndrome. Clinical data, quantitative sensory testing, and skin biopsies were collected from 26 selected patients with painful long-COVID syndrome. We also examined 100 individuals with past COVID-19 infection, selecting 33 patients with painless long-COVID syndrome, characterized mainly by symptoms such as brain fog and fatigue, and 30 asymptomatic post-COVID-19 controls. Demographic and clinical variables were compared among these groups. Among the 26 patients with painful long-COVID syndrome, 12 had skin biopsy and/or quantitative sensory testing abnormalities compatible with small fibre neuropathy. Demographic and clinical data did not differ across patients with small fibre neuropathy, patients with painless long-COVID syndrome, and asymptomatic post-COVID-19 controls. This case-control study showed that approximately 50% of patients experiencing painful long-COVID syndrome had small fibre neuropathy. However, in our patient cohort, this specific post-COVID-19 complication was unrelated to demographic and COVID-19 clinical variables. Approximately half of our sample of patients with painful long-COVID symptoms met diagnostic criteria for small fibre neuropathy.Copyright © 2024 International Association for the Study of Pain.

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