Determinants of Quality of Life in Long-COVID Patients with New-Onset Chronic Pain

J Pain. 2025 Aug 14:105531. doi: 10.1016/j.jpain.2025.105531. Online ahead of print.

ABSTRACT

Chronic pain is highly prevalent in Long-COVID syndrome and significantly impacts quality of life (QoL). Given the complexity of long-COVID, a comprehensive approach is necessary to understand how the interactions of psychosocial, pain and functional factors may influence patients’ well-being. This study aimed to explore key factors associated with QoL in long-COVID patients with new-onset chronic pain, and to multidimensionally characterize this population. A case-control design was used, recruiting 163 Long-COVID patients (49.04±8.23 years, 80% females) and 151 controls (48.86±8.28 years, 78% females). Socio-demographic, psychosocial, pain-related and functional outcomes were measured. QoL, assessed by the EQ-5D, was considered the main outcome. Anxiety was negatively associated with QoL (β=-0.012,95%CI:[-0.015, -0.008],p<0.001), while aerobic capacity showed a positive association (β=0.001,95%CI:[0.001,0.002],p<0.001). Employment status (β=0.175,95%CI:[0.091,0.260],p<0.001), pain intensity (β=-0.003,95%CI:[-0.005,-0.001],p=0.004) and symptom complexity (β=-0.32,95%CI:[-0.51,-0.13],p<0.001) were also significant associated factors. The strongest factor associated with being a case was higher levels of symptoms complexity (OR=1.09;95%CI:[1.05, 1.15];p<0.001) followed by higher levels of depression (OR=1.13; 95%CI:[1.04,1.22];p=0.002). Long-COVID patients reported poorer self-perceived QoL and had significantly lower overall QoL, as well as worse outcomes in functional, pain-related and psychosocial variables when compared to control subjects (p<0.001). Clinicians should pay attention to anxiety levels, aerobic capacity, work status and pain intensity early in the course of the disease to try to minimize the loss of QoL in this population. These findings may also assist clinicians in profiling their patients and guiding them toward an early and target ed intervention that addresses the associated factors, ultimately improving functionality and QoL of patients. PERSPECTIVE: This study identifies key clinical and psychosocial factors linked to new-onset chronic pain and reduced quality of life in long-COVID. Understanding these insights may help clinicians implement early, targeted, and interdisciplinary interventions to improve patient functionality and long-term outcomes.

PMID:40818641 | DOI:10.1016/j.jpain.2025.105531