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Chronic Pain Patients Are at Higher Risk for Coronavirus

Last updated: 02-18-2020

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Chronic Pain Patients Are at Higher Risk for Coronavirus

This article, in a slightly edited form, first appeared onPain News Network on February 15, 2020.

Tens of thousands of people have contracted the new coronavirus, now referred to as COVID-19. More than 30 million peoplehave been quarantined in the province of Zhejiang, China — which is more than 500 miles away from its epicenter in Wuhan, China — to prevent its spread. As I write this, 26 other countries have a confirmed diagnosis of the virus.

It is clear that COVID-19 qualifies as an epidemic; some experts predict it could become a pandemic. (The difference between an epidemic and pandemic is that a pandemic is a global spread of the virus, while an epidemic is contained in a particular region, such as China.)

The people with increased risk for experiencing severe symptoms, and possibly dying of COVID-19, are seniorsand those with chronic illness. Of course, people in chronic pain are part of this risk group. Lethality of COVID-19 has been reported at about two percent.

People with chronic pain may be more susceptible to viruses in general, because chronic pain can change the way our immune systems work. McGill University researchers found that “chronic pain changes the way DNA is marked, not only in the brain but also in T cells, a type of white blood cell essential for immunity.” Researchers were surprised by the number of genes affected by chronic pain, and hope their findings will lead them to new treatments.

According to the Centers for Disease Control and Prevention (CDC), symptoms of COVID-19 are similar to those of other viruses: fever, coughing, and shortness of breath. Symptoms may be mild or severe, and even deadly. Most troublingly, the virus causes respiratory difficulties, and antibiotics are worthless against all types of viral pneumonia. The virus can also lead to organ failure. The Guardianexplains that doctors can provide patients with “support for their lungs and other organs as well as fluids,” but their ability to recover “will depend on the strength of their immune system.”

One of the most effective methods to reduce illness and mortality from all viruses is to develop and use a vaccine. Developing new vaccines used to take at least a decade. However, thanks to recent medical advancements, it may be possible to develop a vaccine that can prevent COVID-19 in a matter of months.

World Health Organization (WHO) director-general Tedros Adhanom Ghebreyesus has called COVID-19 “a very grave threat.” However, Ghebreyesus stresses that while we wait for a vaccine to be developed, we are “not defenseless.” The CDCrecommends following the usual advice about protecting yourself from viruses: stay away from people who are sick; wash your hands and avoid touching your eyes, nose, or mouth with unwashed hands; and clean and disinfect objects you touch.

Since chronic pain seems to compromise the immune system, patients with chronic pain will have to rely on the best available advice to protect themselves from exposure to COVID-19. The potential of an infection is a serious issue that should not be dismissed, particularly for people with chronic pain.

Vaccines prevent an estimated two to three million deaths worldwide every year, according to WHO. They say, “Immunization saves millions of lives every year and is widely recognized as one of the world’s most successful and cost-effective health interventions.”

There are many risks associated with the new viruses, But, currently, one of the most significant threats to the spread of disease is social rather than medical. It is the dissemination of false information such as conspiracy theories by anti-vaxxers. Even intelligent people with otherwise good reputations, such as Robert Kennedy, Jr., are promulgating this nonsense through social media platforms and beyond to millions of people. These efforts must be discredited and stopped.

Also, the pharmaceutical industry is regarded more negatively than any other industry. They are even more villainized than the federal government which is hard to comprehend. There are well-publicized reasons why the public has a dim view of the pharmaceutical industry. Yet, paradoxically, they are the only industry that can prevent the deaths of an untold number of people worldwide during pandemics.  In this situation we need to cheer them on.

Immunization is important to stop the spread of viruses. But, first, the vaccines must be developed. Once they are available, people with chronic pain should be ready to discuss the potential benefits and risks of immunization with their physicians.

President Trump said the coronavirus may disappear by April. This is a dangerous statement. In the United States, most viruses wane in the summer, but not always and they usually reappear by fall. Dr. William Schaffner, medical director of the National Foundation for Infectious Diseases, points out that some respiratory viruses may exist year-round in other parts of the world. There is never a good time to disregard science. But if there were, the start of a possible new pandemic surely would not be it.

Lynn R. Webster, MD, is a vice president of scientific affairs for PRA Health Sciences and consults with the pharmaceutical industry. He is author of the award-winning book,“The Painful Truth,” and co-producer of the documentary,“It Hurts Until You Die.” Opinions expressed here are those of the author alone and do not reflect the views or policy of PRA Health Sciences.

You can find him on Twitter: @LynnRWebsterMD.


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