Nigel Knox, MD

Acute and novel pain syndromes emerging during acute and early post-acute COVID-19 onset are complex and varied. Evidence is accumulating regarding their nature and pathophysiological mechanisms as the pandemic progresses.

In the early stages of the pandemic, there was conflicting science on safety in the use of NSAIDs and other OTC medications during onset of symptoms without clear scientific evidence. This will be discussed with myths debunked. In addition, there are many whose use of prescribed medication has changed to OTC as a result of changes in their ability to consult their doctors and/or their ability to access prescription and non-pharmacological treatments.

Apart from pain symptoms at the onset of the viral infection, including myalgia, arthralgia, sore throat, headache and peripheral neuropathies, there are problems associated with during ICU treatment (procedural pain, prolonged mechanical ventilation, muscle wasting, and immobility during prone positioning) that may arise. COVID-19, despite its prevalence, is virtually unknown. For the treatment of pain, each patient requires an individual approach based on available knowledge and, more importantly, the patient’s condition and comorbidities.