The Anxiety and Pain of Fibromyalgia Patients during the COVID-19 Pandemic

  1. A. Y. Kharko
  2. K. J. Hansford
  3. P. L. Furlong
  4. S. D. Hall
  5. M. E. Roser

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Abstract

Background

Early research on the impact of the COVID-19 pandemic found persistent related anxiety in the general population. We hypothesised that this anxiety will be associated with increased pain in chronic pain patients diagnosed with fibromyalgia (FM).

Methods

To study this, we carried out a 10-day online survey with 58 female participants, diagnosed with FM and no other pain condition. We identified which aspects of the COVID-19 pandemic evoked anxiety. We then asked participants to provide daily ratings of both anxiety and pain on 101-point visual analogue scales (VAS). Key participant characteristics were included as mediators in a mixed-effects analysis, where the primary outcome was pain VAS.

Results

We found that participants were most often anxious about “impact on relationships”, “a family member contracting COVID-19” , and “financial hardships” , but on average rated “financial hardship”, “access to medication” , and “home loss/eviction” as evoking the strongest anxiety. Mixed-effects modelling showed that an increase in pain was significantly associated with an increase in anxiety, when taking into account individual variance and daily caffeine intake. Age and intake of some mild analgesics were also linked to stronger pain.

Conclusion

Our results extend the initial findings from the literature about the effects of COVID-19 pandemic on chronic pain sufferers. We found that not only is pandemic anxiety in FM patients present, but it is associated with amplified self-assessed chronic pain.

Significance

The long-term support of fibromyalgia patients is challenging for healthcare professionals due to the nature of the condition. The new normal introduced by the pandemic particularly hinders pain management, which is the leading request from this patient group. Our study demonstrates that mental health decline during the COVID-19 pandemic is directly related to the worsening of pain in fibromyalgia. Core stressors that evoke the strongest anxiety were identified thus providing guidance for where to focus patient support.

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  1. ScreenIT

    SciScore for 10.1101/2020.11.24.20188011: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Lastly, we identified several limitations of our study. The primary focus of our research was the experience of pain in the presence of COVID-19 anxiety. Pain, however, is only one of the cardinal FM symptoms. Sleep disturbances and fatigue are both most reported concerns for FM (Arnold et al., 2008), as well as both are acutely sensitive to stressors (Affleck et al., 1996). There has been a decline in the quality of sleep in the general population (Casagrande et al., 2020). If the regression is similar in FM, it may have profound consequences for pain (Affleck et al., 1996). Future investigations should therefore integrate daily evaluations of fatigue and sleep alongside of assessments of COVID-19 anxiety. Another constraint of our work was that the survey was carried out during the early phase of the pandemic, when anxiety was at its highest. Observing pain during time of relative normality as well as during reverting of lockdown would be advantageous for the understanding of long-term development of COVID-19 anxiety in the presence of chronic pain.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

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  2. Version published to 10.1101/2020.11.24.20188011v1 on medRxiv