Chronic pain and COVID-19 hospitalisation and mortality: a UK Biobank cohort study

Hastie, C. E. , Foster, H. M.E. , Jani, B. D. , O'Donnell, C. A. , Ho, F. K., Pell, J. P. , Sattar, N. , Katikireddi, S. V. , Mair, F. S. and Nicholl, B. I. (2023) Chronic pain and COVID-19 hospitalisation and mortality: a UK Biobank cohort study. Pain, 164(1), pp. 84-90. (doi: 10.1097/j.pain.0000000000002663) (PMID:35452027) (PMCID:PMC9756431)

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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 37-73 years between 2006-2010. Baseline exposure data, including chronic pain (>3 months, in at least 1 of 7 pre-specified body sites) and chronic widespread pain (>3 months, all over body), were linked to COVID-19 hospitalisations/mortality. Univariable/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 (LTC) count. Of 441,403 UK Biobank participants with complete data; 3,180 (0.7%) were hospitalised for COVID-19; 1,040 (0.2%) died from COVID-19. Chronic pain was associated with hospital admission for COVID-19 even after adjustment for all covariates (IRR 1.16; 95% CI 1.08 to 1.24; p<0.001), as was chronic widespread pain (IRR 1.33; 95% CI 1.06 to 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 to 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.

Item Type:Articles
Additional Information:Data variables prepared for a Versus Arthritis funded project (grant number 21970) were used in the current study (BIN, FMS, BDJ). HF is funded by a Medical Research Council (MRC) Clinical Research Training Fellowship (grant reference number MR/T001585/1). SVK acknowledges funding from a NRS Senior Clinical Fellowship (SCAF/15/02), the Medical Research Council (MC_UU_00022/2) and the Scottish Government Chief Scientist Office (SPHSU17).
Glasgow Author(s) Enlighten ID:Katikireddi, Professor Vittal and Jani, Dr Bhautesh and Hastie, Dr Claire and Ho, Dr Frederick and Foster, Dr Hamish and Pell, Professor Jill and Nicholl, Dr Barbara and Mair, Professor Frances and Sattar, Professor Naveed and O'Donnell, Professor Kate
Authors: Hastie, C. E., Foster, H. M.E., Jani, B. D., O'Donnell, C. A., Ho, F. K., Pell, J. P., Sattar, N., Katikireddi, S. V., Mair, F. S., and Nicholl, B. I.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
Journal Name:Pain
Publisher:Lippincott, Williams & Wilkins
ISSN (Online):1872-6623
Published Online:22 April 2022
Copyright Holders:Copyright © 2022 The Authors
First Published:First published in Pain 164(1): 84-90
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
301668Multimorbidity in Arthritis and persistent musculoskeletal Pain (MAP) StudyBarbara NichollVersus Arthritis (ARTRESUK)Ref: 21970SHW - General Practice & Primary Care
305234Using Big-data to Understand the Interactions between Lifestyle, Deprivation and health outcomes to support Intervention Development in deprived areas (BUILD): a mixed methods programmeCatherine O'DonnellMedical Research Council (MRC)MR/T001585?1SHW - General Practice & Primary Care
172690Understanding the impacts of welfare policy on health: A novel data linkage studySrinivasa KatikireddiOffice of the Chief Scientific Adviser (CSO)SCAF/15/02SHW - Public Health
3048230021Inequalities in healthAlastair LeylandMedical Research Council (MRC)MC_UU_00022/2HW - MRC/CSO Social and Public Health Sciences Unit
3048230071Inequalities in healthAlastair LeylandOffice of the Chief Scientific Adviser (CSO)SPHSU17HW - MRC/CSO Social and Public Health Sciences Unit