Inflammatory Mechanisms of long COVID Chronic Pain
Research type
Research Study
Full title
In search of a biomarker for long COVID: systemic inflammation and chronic pain
IRAS ID
323071
Contact name
Gary Stephens
Contact email
Sponsor organisation
University of Reading
Duration of Study in the UK
1 years, 11 months, 28 days
Research summary
Approximately 10% of acute COVID patients are left with long-lasting symptoms, including shortness of breath, brain fog, debilitating fatigue and widespread pain; these multiorgan symptoms are collectively termed ‘long-COVID’. The Office for National Statistics estimates that up to 1.8 million people in the UK are suffering with long-COVID and there has been an urgent call for better understanding and research into disease mechanisms. A diverse range of mechanisms have been proposed, including over-excitability of the immune and nervous system, autonomic system dysfunction and blood clotting abnormalities. Pain is one of the most common symptoms, according to our pilot study and pooled prevalence data (Taramova et al, 2022; Aiyegbusi et al., 2021). This immune system-derived inflammation does not respond well to pain-killers such as paracetamol, NSAIDs, opioids or gabapentinoids (Taramova et al, 2022). Our pilot study showed that less than 2% of our local long-COVID population were able to tolerate strong medications, indicating a need to identify novel biomarkers and targets. Currently, there is no literature available on the systemic impact of inflammation, or why long-COVID-induced inflammation does not respond well to treatment. Furthermore, as the inflammatory response is a "cascade", early treatment may be effective at managing this. Biomarkers and predictive markers may help in preventing issues, pre-symptomatically. Therefore, we will examine important inflammatory markers in both the blood and the brain, to investigate the influence on long-COVID induced pain. Patients with long-COVID accessing Royal Berkshire Hospital will be approached as two cohorts (1) patients with chronic pain; (2) patients without pain. They will complete questionnaires including psychometric measures, comprehensive pain history, COVID diagnosis information, menstrual phase and contraception. Blood samples will be taken to measure peripheral inflammatory biomarkers, and participants will undergo fMRI scans to quantify the extent of neuroinflammation. To investigate whether there is an association between pain processing and the presence of chronic pain in Long Covid, patients will complete a sensory pain assessment using thermal stimulation in the CINN Pain Lab. Between-groups analysis aims to identify systemic inflammation mechanisms of long-COVID induced pain, informing pharmacological treatment.
REC name
North West - Preston Research Ethics Committee
REC reference
23/NW/0093
Date of REC Opinion
10 May 2023
REC opinion
Further Information Favourable Opinion