{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:33:00Z","timestamp":1777944780784,"version":"3.51.4"},"reference-count":37,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mol Pain"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:p>\n                    Post-COVID syndrome (PCS) may manifest as chronic pain and fibromyalgia-like symptoms, but the specific risk factors contributing to these outcomes remain poorly understood. We conducted a prospective cohort study using data from the ongoing \u201cPost-Acute Sequelae of SARS-CoV-2 Infection (PASC)\u201d study to identify predictors of chronic pain and fibromyalgia-related phenotypes among previously hospitalized COVID-19 patients. Participants were adults (\n                    <jats:italic>n<\/jats:italic>\n                    = 756, mean age 55, 47% female) hospitalized between March and August 2020 at the University of S\u00e3o Paulo Medical School. Clinical and demographic data from hospitalization, along with psychological, functional, and cognitive assessments at 3\u201311 months post-discharge (phase 1), were used to predict chronic pain, chronic widespread pain (CWP), fibromyalgia-like symptoms (FLS), and probable fibromyalgia (FM) at a 2\u20133 year follow-up (phase 2). Multivariate logistic regression analyses revealed that higher anxiety\/depression severity (OR 1.35; 95% CI 1.09\u20131.69;\n                    <jats:italic>p<\/jats:italic>\n                    = 0.008) and reduced left handgrip strength (OR 0.95; 95% CI 0.92\u20130.98;\n                    <jats:italic>p<\/jats:italic>\n                    &lt; 0.001) at phase 1 significantly predicted chronic pain at phase 2. For fibromyalgia-related phenotypes, greater left-side pain, insomnia severity, and weaker left handgrip strength were consistently associated with increased risk across all outcomes (CWP, FLS, FM), with statistically significant odds ratios ranging from 1.07 to 1.44. These findings highlight key modifiable risk factors \u2013 particularly psychological distress, sleep disruption, and muscle weakness \u2013 that may contribute to the development of chronic pain and fibromyalgia symptoms following COVID-19 hospitalization. Early identification and targeted intervention on these domains could improve long-term outcomes in PCS populations.\n                  <\/jats:p>","DOI":"10.1177\/17448069251369069","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T11:27:46Z","timestamp":1754652466000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk factors associated with chronic pain and fibromyalgia-like symptoms post-COVID hospitalization"],"prefix":"10.1177","volume":"21","author":[{"given":"Linamara Rizzo","family":"Battistella","sequence":"first","affiliation":[{"name":"Faculdade de Medicina, Instituto de Medicina F\u00edsica e Reabilita\u00e7\u00e3o, Hospital das Cl\u00ednicas HCFMUSP, Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Imamura","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina, Instituto de Medicina F\u00edsica e Reabilita\u00e7\u00e3o, Hospital das Cl\u00ednicas HCFMUSP, Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinyi Christine","family":"Zhang","sequence":"additional","affiliation":[{"name":"Harvard College, Cambridge, MA, USA"},{"name":"Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7166-2816","authenticated-orcid":false,"given":"Kevin","family":"Pacheco-Barrios","sequence":"additional","affiliation":[{"name":"Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA"},{"name":"Vicerrectorado de Investigaci\u00f3n, Unidad de Investigaci\u00f3n para la Generaci\u00f3n y S\u00edntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felipe","family":"Fregni","sequence":"additional","affiliation":[{"name":"Vicerrectorado de Investigaci\u00f3n, Unidad de Investigaci\u00f3n para la Generaci\u00f3n y S\u00edntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,8,8]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arcmed.2021.03.010"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2023.12.004"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-36995-4"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid3003.231194"},{"issue":"6","key":"e_1_3_3_6_2","first-page":"571","article-title":"Post-COVID patients with new-onset chronic pain two years after infection: clinical and psychosocial profile","volume":"24","author":"Calvache-Mateo A","year":"2023","unstructured":"Calvache-Mateo A, Navas-Otero A, Heredia-Ciur\u00f3 A, Mat\u00edn-N\u00fa\u00f1ez J, Torres-S\u00e1nchez I, L\u00f3pez-L\u00f3pez L, Valenza MC. Post-COVID patients with new-onset chronic pain two years after infection: clinical and psychosocial profile. Pain Manag Nurs 2023; 24(6): 571\u2013579.","journal-title":"Pain Manag Nurs"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000002564"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000002291"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11195569"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2021-001735"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1515\/sjpain-2020-0072"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-022-06279-9"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.5606\/tftrd.2024.13828"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.3390\/pathophysiology29010003"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.5114\/reum\/163094"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10787-023-01160-w"},{"issue":"7","key":"e_1_3_3_17_2","article-title":"A cross-sectional study of fibromyalgia and Post-acute COVID-19 Syndrome (PACS): could there be a relationship?","volume":"15","author":"Akel A","year":"2023","unstructured":"Akel A, Almanasyeh B, Abo Kobaa A, Aljabali A, Al-Abadleh A, Alkhalaileh A, Alwardat AR, Sarhan MY, Abu-Jeyyab M. A cross-sectional study of fibromyalgia and Post-acute COVID-19 Syndrome (PACS): could there be a relationship? Cureus 2023; 15(7): e42663.","journal-title":"Cureus"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0281593"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2023.08.011"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjane.2023.08.001"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0296700"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0287554"},{"issue":"3","key":"e_1_3_3_23_2","article-title":"Investigating the fluctuating nature of post-COVID pain symptoms in previously hospitalized COVID-19 survivors: the LONG-COVID-EXP multicenter study","volume":"9","author":"Fern\u00e1ndez-de-las-Pe\u00f1as C","year":"2024","unstructured":"Fern\u00e1ndez-de-las-Pe\u00f1as C, Pellicer-Valero OJ, Mart\u00edn-Guerrero JD, Hern\u00e1ndez-Barrera V, Arendt-Nielsen L. Investigating the fluctuating nature of post-COVID pain symptoms in previously hospitalized COVID-19 survivors: the LONG-COVID-EXP multicenter study. 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The natural history of chronic pain in the community: a better prognosis than in the clinic? J Rheumatol 1996; 23(9): 1617\u20131620.","journal-title":"J Rheumatol"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-016-0873-6"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2022.110745"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-64059-8"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-058489"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1080\/00325481.2019.1663705"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2015.56"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph182010770"}],"container-title":["Molecular Pain"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17448069251369069","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17448069251369069","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17448069251369069","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T08:20:43Z","timestamp":1777710043000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17448069251369069"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,8]]},"references-count":37,"alternative-id":["10.1177\/17448069251369069"],"URL":"https:\/\/doi.org\/10.1177\/17448069251369069","relation":{},"ISSN":["1744-8069","1744-8069"],"issn-type":[{"value":"1744-8069","type":"print"},{"value":"1744-8069","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,8]]},"article-number":"17448069251369069"}}