Papers of the Week

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.