Pain management and COVID-19

The still present COVID-19 pandemic, lasting for over 1.5 years, has put the health care systems in a challenging situation. Prioritizing other aspects, pain patients have been practically abandoned, probably because Pain Medicine is not perceived as a priority for the patients. The organization of Pain Clinics and the cares for in-hospital pain management is reduced for quantity and quality [1].

This challenging situation has also been victim of some misinformation. One of them was diffused at the very beginning of the pandemic. The use of NSAIDs, and especially of ibuprofen, was accused to be responsible for an increased risk of potential infection by SARS-CoV [2]. The subtle pathophysiologic mechanism behind this was supposed to be the action of ibuprofen on the angiotensin-converting enzyme 2 (ACE2), also involved in the action of coronoviruses. The shocking theory had obvious consequences, especially for its diffusion in the media, but was rejected immediately after [3] and also reviewed by the same authors [4]. Immediately after, other authors have expressed their perplexities on the topic [5]. Then, all the connections between COVID-19 and NSAIDs were summarized in an extensive review article [6].

The one above is just one of the examples of the disastrous consequences of COVID-19 pandemics on the poor patients suffering for pain, both acute and chronic. Other connected problems were related to the organization of the pain clinics and the network for home care for suffering pain patients.

All these topics will be illustrated and summarized during the lecture. The congress will be an excellent occasion to also collect opinions and feedbacks of the attending Colleagues.

[1] Puntillo F, Giglio M, Brienza N, Viswanath O, Urits I, Kaye AD, et al. Impact of COVID-19 pandemic on chronic pain management: Looking for the best way to deliver care. Best Practice & Research Clinical Anaesthesiology. 2020; 34: 529–537.

[2] Fang L, Karakiulakis G, Roth M. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? The Lancet Respiratory Medicine. 2020; 8: e21.

[3] Varrassi G. Warning against the Use of Anti-Inflammatory Medicines to Cure COVID-19: Building Castles in the Air. Advances in Therapy. 2020; 37: 1705–1707.

[4] Fang L, Karakiulakis G, Roth M. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? Authors’ reply. Lancet Resp Med. 2020; 8: e32–e33.

[5] Pergolizzi JV, Varrassi G, Magnusson P, LeQuang JA, Leopoulou M, Paladini A, et al. The concern about ACE/ARB and COVID-19: Time to hold your horses! Journal of the American Pharmacists Association. 2020; 60: e88–e90.

[6] Pergolizzi JV Jr, Varrassi G, Magnusson P, LeQuang JA, Paladini A, Taylor R, et al. COVID-19 and NSAIDS: A Narrative Review of Knowns and Unknowns. Pain and Therapy. 2020; 9: 353–358.