Clinical Challenge: Chronic Pain and COVID-19

Chronic pain patients may be more susceptible to COVID-19, and if infected with the virus, may face different consequences than others.

“There is a complex relationship between chronic pain and the immune system,” said Samer Narouze, MD, PhD, of Western Reserve Hospital in Cuyahoga Falls, Ohio.

“Generally speaking, chronic pain patients can be considered immunocompromised, mainly because so many are elderly and have multiple comorbidities,” he noted. “Many also are on long-term opioid therapy, and this is known to interact with the immune system.

“Since this virus affects respiration, there is no doubt that patients on opioids are at an elevated risk of sedation, opioid-induced respiratory depression, and increased mortality,” Fudin said. “Although there have been no specific studies about COVID-19 patients, I’m confident that for persons on one or more sedating drugs in addition to opioids, the risk is even higher,” he added. 


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