Neuropathic Symptoms and Persistent Pain After Hospitalization for COVID-19: An 8-Month Longitudinal Follow-Up Study

Background: Persistent pain, neuropathic symptoms, dyspnea, and impaired quality of life are common components of post-COVID syndrome. However, the long-term trajectory of these symptoms and the factors associated with persistent pain remain incompletely understood. Methods: This longitudinal cohort study included 80 patients previously hospitalized with COVID-19. Participants were evaluated at approximately 1, 4, and 8 months after discharge. Pain severity was assessed using the Visual Analog Scale (VAS), neuropathic symptoms using the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scale, dyspnea using the modified Medical Research Council (mMRC) scale, functional limitation using the Post-CO9VID Functional Status (PCFS) scale, and health-related quality of life using the EQ-5D-5L and EQ-VAS scales. Functional performance was additionally assessed using the 30 s chair stand test and the Modified Borg Scale. Multivariable linear regression and logistic regression analyses were performed to identify predictors of reduced quality of life and persistent pain at 8 months. Results: A total of 80 patients were included in the study. Median VAS score decreased from 3.0 (0–6) at 1 month to 0 (0–0) at 4 months and 1 (0–1) at 8 months (p < 0.001). Median LANSS score decreased from 0 (0–2) at 1 month to 0 (0–0) at 4 and 8 months (p < 0.001), while the proportion of patients with LANSS ≥ 12 declined from 11.3% to 2.5%. EQ-5D index scores improved from 0.81 (0.72–0.91) to 0.93 (0.88–0.96) during follow-up (p < 0.001). Dyspnea severity, exertional symptoms, and functional limitation also improved significantly over time. Most of the clinical recovery occurred between the 1-month and 4-month evaluations, although smaller but significant improvements continued until 8 months for pain severity, functional performance, and quality-of-life measures. Older age, baseline dyspnea, anxiety, and higher baseline LANSS scores were independently associated with lower EQ-VAS scores at 8 months, whereas only higher baseline LANSS scores remained independently associated with persistent pain. Conclusions: Patients hospitalized with COVID-19 experience persistent pain, dyspnea, neuropathic symptoms, and reduced quality of life during follow-up, although most symptoms improve substantially over time. Early neuropathic symptom burden and baseline dyspnea may help identify patients at risk of poorer long-term recovery, although the associations should be interpreted cautiously.