A COVID-19 patient with intense burning pain
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CASE REPORT
A COVID-19 patient with intense burning pain Feyzullah Aksan 1 & Eric Andrew Nelson 2
&
Kristin A. Swedish 1
Received: 10 June 2020 / Revised: 17 July 2020 / Accepted: 22 July 2020 # Journal of NeuroVirology, Inc. 2020
Abstract A woman in her forties with asthma and COPD was admitted to a general medical floor with respiratory symptoms, body aches, and anosmia. Reverse transcription polymerase chain reaction detected severe acute respiratory syndrome coronavirus-2. Admission labs, including biomarkers of the systemic immunological dysfunction seen in many cases of coronavirus disease 2019 (COVID-19), were within normal ranges. On the second day of admission, she developed neck and back pain that was constant, burning in quality, and exacerbated by light touch and heat. Wearing clothing caused pain and interfered with her sleep. The area was tender to light finger stroke. The patient was given acetaminophen, NSAIDs, and opioids with no relief of pain. However, gabapentin was effective. At follow-up 1 month later, her symptoms were improved and still relieved by gabapentin. Neuropathic pain was seen in over 2% of COVID-19 patients in one observational study. The pain seen in our case was bilateral, involved an area innervated by multiple levels of spinal nerves, and was limited to the back. While it is rare, a significant number of COVID-19 patients are afflicted by neuropathic pain, and our case illustrates that gabapentin may be effective. Keywords COVID-19 . SARS-CoV-2 . Neuropathic pain . Neuralgia . Gabapentin
Case description A woman in her forties came to a hospital with a 4-day history of worsening dry cough, dyspnea, generalized body aches, and chills. A day before the onset of these symptoms, she had lost her senses of taste and smell. A housemate had recently tested positive for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) by reverse transcription polymerase chain reaction (RT-PCR). Our patient had hypertension, obesity, COPD, and asthma since childhood with one intubation more than 10 years earlier. She had smoked cigarettes on some but not all days since early adulthood. She took albuterol, budesonide/formoterol, montelukast, and losartan at home. Except for elevated blood pressure and mild tachypnea, her vital signs were within normal limits. Her physical examination was unremarkable. RT-PCR detected SARS-CoV-2.
* Eric Andrew Nelson [email protected] 1
Department of Internal Medicine, Montefiore Wakefield Campus, 600 East 233rd Street, Bronx, NY 10466, USA
2
Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center, 111 E 210th Street, Bronx, NY 10467, USA
Admission labs, including biomarkers of immune dysfunction seen with coronavirus disease 2019 (COVID-19) (interleukin6, fibrinogen, D-dimer, lactate dehydrogenase, creatine kinase, and C-reactive protein), were within normal ranges. A chest x-ray showed a small area of increased density overlying the lower left lung, and the patient was diagnosed with COVID-19 pneumonia. We continued her home me
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