Previous clinical observations raised the possibility that COVID-19 vaccination might trigger a small-fibre neuropathy.Objectives:In this uncontrolled observational study, we aimed to identify small fibre damage in patients complaining of generalized sensory symptoms and pain after COVID-19 vaccination.Methods:We collected clinical data, including a questionnaire for assessing autonomic symptoms (Composite Autonomic Symptom Score-31), and investigated quantitative sensory testing (QST) and skin biopsy in 15 prospectively enrolled patients with generalized sensory symptoms and pain after COVID-19 vaccination. Nine patients complaining of orthostatic intolerance also underwent cardiovascular autonomic tests.Results:We found that all patients experienced widespread pain, and most of them (11 of 15) had a fibromyalgia syndrome. All patients had normal skin biopsy findings, and in the 9 patients with orthostatic intolerance, cardiovascular autonomic tests showed normal findings. Nevertheless, 5 patients had cold and warm detection abnormalities at the QST investigation.Conclusions:In our study, most patients complaining of generalized sensory symptoms and pain after COVID-19 vaccination had clinical and diagnostic test findings compatible with a fibromyalgia syndrome. Although the abnormal QST findings we found in 5 patients might be compatible with a small-fibre neuropathy, they should be cautiously interpreted given the psychophysical characteristics of this diagnostic test. Further larger controlled studies are needed to define precisely the association between small fibre damage and COVID-19 vaccination.

Pain associated with COVID-19 vaccination is unrelated to skin biopsy abnormalities / Di Stefano, G.; Falco, P.; Galosi, E.; De Stefano, G.; Di Pietro, G.; Leone, C.; Litewczuk, D.; Tramontana, L.; Strano, S.; Truini, A.. - In: PAIN REPORTS. - ISSN 2471-2531. - 8:5(2023). [10.1097/PR9.0000000000001089]

Pain associated with COVID-19 vaccination is unrelated to skin biopsy abnormalities

Di Stefano G.
Co-primo
Writing – Original Draft Preparation
;
Falco P.
Co-primo
Writing – Original Draft Preparation
;
Galosi E.
Membro del Collaboration Group
;
De Stefano G.
Membro del Collaboration Group
;
Di Pietro G.
Membro del Collaboration Group
;
Leone C.
Membro del Collaboration Group
;
Litewczuk D.
Membro del Collaboration Group
;
Tramontana L.
Methodology
;
Strano S.
Membro del Collaboration Group
;
Truini A.
Writing – Review & Editing
2023

Abstract

Previous clinical observations raised the possibility that COVID-19 vaccination might trigger a small-fibre neuropathy.Objectives:In this uncontrolled observational study, we aimed to identify small fibre damage in patients complaining of generalized sensory symptoms and pain after COVID-19 vaccination.Methods:We collected clinical data, including a questionnaire for assessing autonomic symptoms (Composite Autonomic Symptom Score-31), and investigated quantitative sensory testing (QST) and skin biopsy in 15 prospectively enrolled patients with generalized sensory symptoms and pain after COVID-19 vaccination. Nine patients complaining of orthostatic intolerance also underwent cardiovascular autonomic tests.Results:We found that all patients experienced widespread pain, and most of them (11 of 15) had a fibromyalgia syndrome. All patients had normal skin biopsy findings, and in the 9 patients with orthostatic intolerance, cardiovascular autonomic tests showed normal findings. Nevertheless, 5 patients had cold and warm detection abnormalities at the QST investigation.Conclusions:In our study, most patients complaining of generalized sensory symptoms and pain after COVID-19 vaccination had clinical and diagnostic test findings compatible with a fibromyalgia syndrome. Although the abnormal QST findings we found in 5 patients might be compatible with a small-fibre neuropathy, they should be cautiously interpreted given the psychophysical characteristics of this diagnostic test. Further larger controlled studies are needed to define precisely the association between small fibre damage and COVID-19 vaccination.
2023
small-fibre neuropathy; COVID-19 vaccination; skin biopsy; quantitative sensory testing; fibromyalgia
01 Pubblicazione su rivista::01a Articolo in rivista
Pain associated with COVID-19 vaccination is unrelated to skin biopsy abnormalities / Di Stefano, G.; Falco, P.; Galosi, E.; De Stefano, G.; Di Pietro, G.; Leone, C.; Litewczuk, D.; Tramontana, L.; Strano, S.; Truini, A.. - In: PAIN REPORTS. - ISSN 2471-2531. - 8:5(2023). [10.1097/PR9.0000000000001089]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1689588
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