{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T10:18:20Z","timestamp":1787739500888,"version":"build-2784847793"},"reference-count":37,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nurs. Rep.","Nursing Reports"],"abstract":"<jats:p>Objective: To identify the clinical manifestations associated with pain in nursing students in emerging adulthood with Long COVID (LC). Methods: A cross-sectional, descriptive, and analytical study was conducted. The universe comprised 1508 students from a Faculty of Nursing in the State of Mexico. The sample size of 307 participants was calculated using Cochran\u2019s formula (1977) with 95% confidence and a 5% margin of error, with correction for finite populations; participants were invited through an open call and selected non-probabilistically according to inclusion criteria and willingness to participate. Instrument: A questionnaire on post-SARS-CoV-2 health conditions was used, with reliability assessed in a pilot test through internal consistency measures, obtaining a Cronbach\u2019s Alpha = 0.86 and KR-20 = 0.87. It was administered between the third and fourth week following the three-month mark after COVID-19 onset. Descriptive analysis, Fisher\u2019s exact test, and a binary logistic regression model were used, with pain as the dependent variable (1 = yes, 0 = no); statistical significance was set at p &lt; 0.05, with a 95% CI. Results: 40.4% of students reported pain\u2014(46.6%) males and (39.0%) females\u2014with a significant association between age group and pain (p &lt; 0.001). A total of 198 painful clinical manifestations were reported: headache (48.0%), chest oppression (26.8%), and myalgias (23.2%). The model showed that taste alteration (p &lt; 0.001) and decreased vision (p &lt; 0.001) were associated with a lower likelihood of pain, while gastrointestinal alterations (p = 0.025) and fatigue (p = 0.048) were associated with a higher likelihood of pain. Conclusions: Pain in students with LC is associated with clinical manifestations, mainly gastrointestinal alterations, and fatigue.<\/jats:p>","DOI":"10.3390\/nursrep16090302","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T09:05:46Z","timestamp":1787735146000},"page":"302","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Manifestations Associated with Pain in Nursing Students in Emerging Adulthood with Long COVID"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7241-5502","authenticated-orcid":false,"given":"Marisol","family":"Ignacio Albino","sequence":"first","affiliation":[{"name":"Faculty of Dentistry, Autonomous University of the State of Mexico, Toluca 50180, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4388-7775","authenticated-orcid":false,"given":"Yolanda","family":"Hern\u00e1ndez Ortega","sequence":"additional","affiliation":[{"name":"Faculty of Nursing and Obstetrics, Autonomous University of the State of Mexico, Toluca 50180, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8241-8694","authenticated-orcid":false,"given":"Lorena","family":"Chaparro D\u00edaz","sequence":"additional","affiliation":[{"name":"Departamento de Enfermer\u00eda, Facultad de Enfermer\u00eda, Universidad Nacional de Colombia, Sede Bogot\u00e1, Bogot\u00e1 111321, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6410-3362","authenticated-orcid":false,"given":"Mar\u00eda de Lourdes","family":"Rico Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Faculty of Nursing and Obstetrics, Autonomous University of the State of Mexico, Toluca 50180, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1531-0373","authenticated-orcid":false,"given":"Patricia","family":"Cruz Bello","sequence":"additional","affiliation":[{"name":"Faculty of Nursing and Obstetrics, Autonomous University of the State of Mexico, Toluca 50180, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0291-8882","authenticated-orcid":false,"given":"Zuleyma","family":"Gonz\u00e1lez Miguel","sequence":"additional","affiliation":[{"name":"Faculty of Nursing and Obstetrics, Autonomous University of the State of Mexico, Toluca 50180, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1999-5541","authenticated-orcid":false,"given":"Nicolas","family":"Santiago Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Ixtapaluca Regional High-Speciality Hospital, Mexican Social Security Institute for Wellbeing (IMSS-BIENESTAR), Mexico-Puebla Federal Highway, Km 34.5, Ixtapaluca 56530, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1820-1965","authenticated-orcid":false,"given":"Mar\u00eda Gicela","family":"P\u00e9rez Hernandez","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, University of Colima, Colima 28040, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3847-109X","authenticated-orcid":false,"given":"\u00c1ngel Eduardo","family":"B\u00e1rcenas Garc\u00eda","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Autonomous University of the State of Mexico, Toluca 50180, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8422-0665","authenticated-orcid":false,"given":"Mar\u00eda de Lourdes","family":"Garc\u00eda Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Faculty of Nursing and Obstetrics, Autonomous University of the State of Mexico, Toluca 50180, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2026, August 08). COVID-19 Epidemiological Update\u201415 July 2024, Available online: https:\/\/www.who.int\/publications\/m\/item\/covid-19-epidemiological-update-edition-169."},{"key":"ref_2","first-page":"100996","article-title":"Impact of COVID-19 on total excess mortality and geographic disparities in Europe, 2020\u20132023: A spatio-temporal analysis","volume":"44","author":"Pizzato","year":"2024","journal-title":"Lancet Reg. Health\u2013Eur."},{"key":"ref_3","unstructured":"(2026, July 30). Direcci\u00f3n de Vigilancia Epidemiol\u00f3gica de Enfermedades Transmisibles. Informe Semanal. Available online: https:\/\/www.gob.mx\/cms\/uploads\/attachment\/file\/1088895\/Informesemanal_ERV_SE26_2026_06.07.2026_.pdf."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/j.healun.2020.03.012","article-title":"COVID-19 illness in native and immunosuppressed states: A clinical\u2013therapeutic staging proposal","volume":"39","author":"Siddiqi","year":"2020","journal-title":"J. Heart Lung Transpl."},{"key":"ref_5","first-page":"22","article-title":"Long COVID-19 syndrome as a fourth phase of SARS-CoV-2 infection","volume":"30","author":"Staffolani","year":"2022","journal-title":"Infez. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s10020-024-00986-6","article-title":"Chronic inflammation in post-acute sequelae of COVID-19 modulates gut microbiome: A review of literature on COVID-19 sequelae and gut dysbiosis","volume":"31","author":"Iqbal","year":"2025","journal-title":"Mol. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1038\/s41591-021-01283-z","article-title":"Post-acute COVID-19 syndrome","volume":"27","author":"Nalbandian","year":"2021","journal-title":"Nat. Med."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Fern\u00e1ndez-de-las-Pe\u00f1as, C., Nijs, J., Neblett, R., Polli, A., Moens, M., Goudman, L., Shekhar Patil, M., Knaggs, R.D., Pickering, G., and Arendt-Nielsen, L. (2022). Phenotyping Post-COVID Pain as a Nociceptive, Neuropathic, or Nociplastic Pain Condition. Biomedicines, 10.","DOI":"10.3390\/biomedicines10102562"},{"key":"ref_9","unstructured":"National Academies of Sciences, Engineering, and Medicine (2024). Defining Long COVID: A State of Chronic and Systemic Disease with Profound Consequences, National Academies Press."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1976","DOI":"10.1097\/j.pain.0000000000001939","article-title":"The revised International Association for the Study of Pain definition of pain: Concepts, challenges, and compromises","volume":"161","author":"Raja","year":"2020","journal-title":"Pain"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2082","DOI":"10.1016\/S0140-6736(21)00393-7","article-title":"Chronic pain: An update on burden, best practices, and new advances","volume":"397","author":"Cohen","year":"2021","journal-title":"Lancet"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1410","DOI":"10.1177\/0333102420965157","article-title":"Headache: A striking prodromal and persistent symptom, predictive of COVID-19 clinical evolution","volume":"40","author":"Caronna","year":"2020","journal-title":"Cephalalgia"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"S31","DOI":"10.1016\/j.neurop.2021.10.003","article-title":"Persistent headache after COVID-19: Pathophysiology, clinic and treatment","volume":"1","author":"Membrilla","year":"2021","journal-title":"Neurol. Perspect."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1177\/03331024211068074","article-title":"Post-COVID-19 persistent headache: A multicentric 9-months follow-up study of 905 patients","volume":"42","author":"Membrilla","year":"2022","journal-title":"Cephalalgia"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"20542704241274292","DOI":"10.1177\/20542704241274292","article-title":"Long COVID symptoms and demographic associations: A retrospective case series study using healthcare application data","volume":"15","author":"Sunkersing","year":"2024","journal-title":"JRSM Open"},{"key":"ref_16","first-page":"314","article-title":"Cutaneous manifestations in patients with COVID-19: Clinical characteristics and postulated pathophysiological mechanisms","volume":"112","year":"2021","journal-title":"Actas Dermo-Sifiliogr."},{"key":"ref_17","first-page":"102460","article-title":"Post-traumatic stress and quality of life of post-COVID-19 patients in primary care","volume":"54","year":"2022","journal-title":"Aten. Primaria"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.reuma.2015.05.007","article-title":"Gender differences in chronic fatigue syndrome","volume":"12","author":"Faro","year":"2016","journal-title":"Reumatol. Clin."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"611.e9","DOI":"10.1016\/j.cmi.2021.11.002","article-title":"Female gender is associated with long COVID syndrome: A prospective cohort study","volume":"28","author":"Bai","year":"2022","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"993","DOI":"10.15585\/mmwr.mm7131a3","article-title":"Post-COVID-19 Symptoms and Conditions Among Children and Adolescents\u2014United States, March 1, 2020\u2013January 31, 2022","volume":"71","author":"Kompaniyets","year":"2022","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/S2215-0366(14)00080-7","article-title":"The new life stage of emerging adulthood at ages 18\u201329 years: Implications for mental health","volume":"1","author":"Arnett","year":"2014","journal-title":"Lancet Psychiatry"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e12962","DOI":"10.1111\/obr.12962","article-title":"Changes in physical activity, diet, and body weight across the education and employment transitions of early adulthood: A systematic review and meta-analysis","volume":"21","author":"Winpenny","year":"2020","journal-title":"Obes. Rev."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Li, D., Zou, L., Zhang, Z., Zhang, P., Zhang, J., Fu, W., Mao, J., and Cao, S. (2021). The Psychological Effect of COVID-19 on Home-Quarantined Nursing Students in China. Front. Psychiatry, 12.","DOI":"10.3389\/fpsyt.2021.652296"},{"key":"ref_24","first-page":"136","article-title":"Evaluation of clinical condition and quality of life following coronavirus infection","volume":"11","author":"Lovera","year":"2022","journal-title":"Rev. Argent. Med."},{"key":"ref_25","first-page":"1","article-title":"Techniques and instruments for data collection that support scientific research in times of pandemic","volume":"8","year":"2022","journal-title":"Dominio Cienc."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e2455430","DOI":"10.1001\/jamanetworkopen.2024.55430","article-title":"Sex Differences in Long COVID","volume":"8","author":"Shah","year":"2025","journal-title":"JAMA Netw. Open"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"4109","DOI":"10.1007\/s10072-024-07620-7","article-title":"Beyond the acute: Pain in long COVID survivors at 1.5 years","volume":"45","author":"Gullu","year":"2024","journal-title":"Neurol. Sci."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e235763","DOI":"10.1001\/jamanetworkopen.2023.5763","article-title":"Prevalence and Characteristics Associated with Post\u2013COVID-19 Condition Among Nonhospitalized Adolescents and Young Adults","volume":"6","author":"Selvakumar","year":"2023","journal-title":"JAMA Netw. Open"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1016\/j.it.2024.10.004","article-title":"The immune\u2013endocrine interplay in sex differential responses to viral infection and COVID-19","volume":"45","year":"2024","journal-title":"Trends Immunol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1038\/s41591-021-01292-y","article-title":"Attributes and predictors of long COVID","volume":"27","author":"Sudre","year":"2021","journal-title":"Nat. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"101019","DOI":"10.1016\/j.eclinm.2021.101019","article-title":"Characterizing long COVID in an international cohort: 7 months of symptoms and their impact","volume":"38","author":"Davis","year":"2021","journal-title":"EClinicalMedicine"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1038\/s41586-021-03553-9","article-title":"High-dimensional characterization of post-acute sequelae of COVID-19","volume":"594","author":"Xie","year":"2021","journal-title":"Nature"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"6427","DOI":"10.1038\/s41467-022-29521-z","article-title":"Persistent COVID-19 symptoms in a community study of 606,434 people in England","volume":"13","author":"Whitaker","year":"2022","journal-title":"Nat. Commun."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Mohammed, I., Podhala, S., Zamir, F., Shiyam, S., Salameh, A.R., Salahuddin, Z., Salameh, H., Kim, C., Sinan, Z., and Kim, J. (2024). Gastrointestinal Sequelae of COVID-19: Investigating Post-Infection Complications\u2014A Systematic Review. Viruses, 16.","DOI":"10.3390\/v16101516"},{"key":"ref_35","first-page":"S28","article-title":"Long COVID, audiovestibular symptoms and persistent chemosensory dysfunction: A systematic review of the current evidence","volume":"42","author":"Colacurcio","year":"2022","journal-title":"Acta Otorhinolaryngol. Ital."},{"key":"ref_36","first-page":"565596","article-title":"Ocular symptoms in long COVID: A cross-sectional study","volume":"20","author":"Kaleem","year":"2026","journal-title":"Clin. Ophthalmol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies","volume":"370","author":"Altman","year":"2007","journal-title":"Lancet"}],"container-title":["Nursing Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2039-4403\/16\/9\/302\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T09:25:22Z","timestamp":1787736322000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-4403\/16\/9\/302"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,26]]},"references-count":37,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["nursrep16090302"],"URL":"https:\/\/doi.org\/10.3390\/nursrep16090302","relation":{},"ISSN":["2039-4403"],"issn-type":[{"value":"2039-4403","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,26]]}}}