Sheren Gaulbert, OTHR

In May 2020, after months of over fifty symptoms, including a resurgence of old pain and some new ones, Sheren came across a British Medical Journal article that mentioned a myriad of fluctuating symptoms that sounded very familiar. Sheren had not experienced any severe respiratory symptoms, anosmia, or high temperature, but she ticked the boxes for what patients had started calling Long COVID, or Long Haul COVID (recent NIH proposed name: post-acute sequelae of SARS-CoV-2 infection, or PASC). She then kicked into a self-management routine and joined Long COVID Support Group on Facebook (which at the time only had a few hundred members, now over 36,000), and later Facebook COVID-19 Research Involvement Group when it was launched.

In this presentation, Sheren will share experiences from other members of the support group, and insights from her own lived experience, including things she wished she had done differently, the highs and lows, micro-pacing including with cognitive tasks, managing persisting pain along with Long COVID symptoms, assessing when to reach out to a doctor, how best to be heard and communicate with clinicians who may not be familiar with Long COVID to access appropriate care pathways, and how to deal with conflicting advice.

With the widespread effects of COVID, already persistent pain issues can be exacerbated. This presentation will cover the need to recognize these factors, such as post-exertional malaise (PEM), and its severity. Also highlighted is the importance of having a set-back plan in place and reevaluating needed, however likely they are to change; assessing for baseline markers, combined with pacing, and recognizing the potential need to reach out to a wider team or when medical support is necessary to recover and get back on track.

COVID-19 infection may present with symptoms of joint pains, muscle aches, headaches, abdominal pain, fever, cough, shortness of breath and many others. People with chronic pain may already have some of these symptoms on a daily basis, and they may take medications that could mask some of these symptoms. There are some medications commonly used to treat chronic pain that could be stopped during an acute episode of COVID-19 or any other acute viral infection like the Flu. However, there are pain medications that need to be continued even during an acute viral infection to avoid severe withdrawal symptoms. There might be situations where opioids need to be increased or reduced, depending on the overall situation of the COVID-19 infection. In this session we will discuss how to manage the acute symptoms of a viral infection and how to manage chronic pain in the face of an acute viral infection, especially when it involves opioids, anti-inflammatories, anti-depressants, anti-convulsants, sedatives and benzodiazepines.

Post-Acute Sequela of COVID-19 include several symptoms derived from the effects of the virus on various body systems, complications derived from severe infection including the post-intensive care syndrome, pre-existing comorbidities affecting also the older population. Exacerbation of existing painful conditions as well as development of new pain is frequent in COVID-19 survivors three to eleven months after hospital discharge. During this educational session we will inform main chronic symptoms developed by COVID-19 survivors; describe main painful conditions presented by COVID-19 survivors and introduce the rationale for strategies to maintain a pain management regime with managing COVID-19.