Do interventional pain procedures increase the risk of COVID-19?

Year 2022, Volume: 39 Issue: 1, 226 - 231, 01.01.2022

Mustafa Kurçaloğlu İbrahim Apak Özgür Şentürk Heval Can Bilek Bora Uzuner Fatih Özkan Fuat Güldoğuş

Abstract

This study's main aim was to evaluate the risk of COVID-19 in patients who were performed interventional pain procedures during the pandemic. The secondary aim was to evaluate if steroid injection in the procedures increases the risk of COVID-19. In this retrospective study, the records of patients who were performed interventional pain procedures (Group I) and were only examined (Group E) between the 1st of April and 30th of November 2020 were evaluated. The rate of COVID-19 infection in the first sixty days after the hospital visit was recorded. Results of patients who were injected steroids during the procedures were also evaluated. The records of 885 patients were investigated. While 485 of them were in Group I, 400 of them were in Group E. A total of 30 patients had COVID-19 in the assessment period. COVID-19 infection rates were similar between groups. Infection rates were not increased in patients who received steroids. The infection rate was significantly higher in the first 15 days after the hospital visit in both groups comparing the remaining 45 days. We conclude that neither interventional pain procedures nor single dose steroid injections increase the risk of COVID-19. However, ‘coming to hospital’ is a promoting factor itself. We assume that our results are also valid for all kinds of outpatient procedures. We suggest obeying the precaution recommendation guidelines of international communities during the pandemic.

Keywords

COVID-19, Steroid, pain, pandemic, outbreak

References

• 1. Arca KN, Smith JH, Chiang CC et al. COVID-19 and Headache Medicine: A Narrative Review of Non-Steroidal Anti-Inflammatory Drug (NSAID) and Corticosteroid Use. Headache. 2020; 0:1-11. DOI: 10.1111/head.13903
• 2. Baj J, Karakuła-Juchnowicz H, Grzegorz Teresinski G, et al. COVID-19: Specific and non-specific clinical manifestations and symptoms: the current state of knowledge. Journal of Clinical Medicine. 2020, 9, 1753. DOI:10.3390/jcm9061753225.
• 3. Brenner EJ, Ungaro RC, Gearry RB et al. Corticosteroids, but not TNF antagonists, are associated with adverse COVID-19 outcomes in patients with inflammatory bowel diseases: results from an international registry. Gastroenterology. 2020; 159:481–491. DOI: 10.1053/j.gastro.2020.05.032
• 4. Cauda F, Palermo S, Costa T, et al. Gray matter alterations in chronic pain: A network-oriented meta-analytic approach. Neuroimage Clinical 2014;4:676-686. DOI: 10.1016/j.nicl.2014.04.007
• 5. Chen T, Wu D, Chen H et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: Retrospective study. BMJ 2020. 368, m1091. DOI: 10.1136/bmj.m1091.
• 6. Cohen SP, Baber ZB, Buvanendran A et al. Pain Management Best Practices from Multispecialty Organizations during the COVID-19 Pandemic and Public Health Crises. Pain Medicine. 2020 Nov 7;21(7):1331-1346. DOI: 10.1093/pm/pnaa127
• 7. Davies JM, Carroll ML, Li H et al. Budesonide and Formoterol Reduce Early Innate Anti-Viral Immune Responses In Vitro. PLoS ONE. 6(11): e27898. DOI: 10.1371/journal.pone.0027898
• 8. Deer T, Sayed D, Pope J et al. Emergence from the coronavirus disease 2019 pandemic and the care of chronic pain: guidance for the interventionalist. Anesthesia Analgesia. 2020 Aug;131(2):387-394. DOI: 10.1213/ANE.0000000000005000.
• 9. Du Z, Xu X, Wu Y et al. Serial interval of COVID-19 among publicly reported confirmed cases. Emerging Infectious Diseases. 2020; 26(6). DOI: 10.3201/eid2606.200357
• 10. Erçalık T, Ayyıldız A, Gencer-Atalay K et al. Pain Symptoms in COVID-19. American Journal of Physical Medicine & Rehabilitation. Articles Ahead of Print. DOI: 10.1097/PHM.0000000000001699
• 11. Halpin DMG, Singh D, Hadfield RM. Inhaled corticosteroids and COVID-19: a systematic review and clinical perspective. The European Respiratory Journal. 2020; 55: 2001009. DOI: 10.1183/13993003.01009-2020
• 12. Han D, Li R, Han Y, Zhang R, Jinming Li J. COVID-19: Insight into the asymptomatic SARS-COV-2 infection and transmission. International Journal of Biological Sciences. 2020; 16(15): 2803-2811. DOI: 10.7150/ijbs.48991.
• 13. Helmy YA, Fawzy M, Elaswad A et al. The COVID-19 pandemic: a comprehensive review of taxonomy, genetics, epidemiology, diagnosis, treatment, and control. Journal of Clinical Medicine. 2020 Apr; 9(4): 1225. DOI:10.3390/jcm9041225
• 14. Li JY, You Z, Wang Q et al. The epidemic of 2019-novel-coronavirus (2019-nCoV) pneumonia and insights for emerging infectious diseases in the future. Microbes and Infection. 22 (2020) 80-85. DOI: 10.1016/j.micinf.2020.02.002
• 15. Li LQ, Huang T, Wang YQ et al. COVID‐19 patients' clinical characteristics, discharge rate, and fatality rate of meta‐analysis. Journal of Medical Virology. 2020;1–7. DOI: 10.1002/jmv.25757
• 16. Li Q, Med M, Guan X, Wu P, Wang X. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia. The new England journal of medicine. 2020; 382:1199-207. DOI: 10.1056/NEJMoa2001316.
• 17. Lotfi M, Hamblin MR, Rezaeif N. COVID-19: Transmission, prevention, and potential therapeutic opportunities. Clinica Chimica Acta. 508 (2020) 254–266. DOI: 10.1016/j.cca.2020.05.044
• 18. Kremer C, Ganyani T, Chen D et al. Authors' response: Estimating the generation interval for COVID-19 based on symptom onset data Euro Surveillance. 2020 Jul;25(29):2001269. DOI: 10.2807/1560-7917.ES.2020.25.29.2001269
• 19. Mattos-Silvaa P, Felixa NS, Silvaa PL et al. Pros and cons of corticosteroid therapy for COVID-19 patients. Respiratory Physiology & Neurobiology Volume 280, September 2020, 103492. DOI: 10.1016/j.resp.2020.103492
• 20. Murphy MT, Latif U. Pain during COVID-19: A comprehensive review and guide for the interventionalist. Pain Practice. 2021 Jan;21(1):132-143. DOI: 10.1111/papr.12976.
• 21. Quinten C, Coens C, Mauer M, et al. Baseline quality of life as a prognostic indicator of survival: a meta-analysis of individual patient data from EORTC clinical trials. The Lancet Oncology. 2009; 10:865-871. DOI: 10.1016/S1470-2045(09)70200-1
• 22. Rockwell KL, Gilroy AS. Incorporating Telemedicine as Part of COVID-19 Outbreak Response Systems. The American Journal of Managed Care 2020;26(4):147-148. DOI: 10.37765/ajmc.2020.42784
• 23. Shanthanna H, Strand NH, Provenzano DA et al. Caring for patients with pain during the COVID-19 pandemic: consensus recommendations from an international expert panel. Anaesthesia. 2020 Jul;75(7):935-944. DOI:10.1111/anae.15076
• 24. Simpson JL, Carroll M, Yang IA. Reduced Antiviral Interferon Production in Poorly Controlled Asthma Is Associated With Neutrophilic Inflammation and High-Dose Inhaled Corticosteroids. Chest. 2016 Mar;149(3):704-13. DOI: 10.1016/j.chest.2015.12.018.
• 25. Smith D, Wilkie R, Uthman O, Jordan JL, McBeth J. Chronic pain and mortality: a systematic review. PLoS One 2014;9:e99048. DOI: 10.1371/journal.pone.0099048
• 26. Williamson EJ, Walker AJ, Bhaskaran K et al. Factors associated with COVID-19 related death using OpenSAFELY. Nature. 2020 Aug;584(7821):430-436. DOI: 10.1038/s41586-020-2521-4
• 27. Youssef J, Novosad SA, Winthrop KL. Infection risk and safety of corticosteroid use. Rheumatic Diseases Clinics of North America. 2016 February; 42(1): 157–176. DOI: 10.1016/j.rdc.2015.08.00