Small fibre neuropathy frequently underlies the painful long-COVID syndrome, 2024, Falco et al.

Small fibre neuropathy frequently underlies the painful long-COVID syndrome
Falco, Pietro;Litewczuk, Daniel;Di Stefano, Giulia;Galosi, Eleonora;Leone, Caterina;De Stefano, Gianfranco;Di Pietro, Giuseppe;Tramontana, Lorenzo;Ciardi, Maria Rosa;Pasculli, Patrizia;Zingaropoli, Maria Antonella;Arendt-Nielsen, Lars;Truini, Andrea

Approximately 10% to 20% of individuals with previous SARS-CoV-2 infection may develop long-COVID syndrome, characterized by various physical and mental health issues, including pain. Previous studies suggested an association between small fibre neuropathy and pain in long-COVID cases.

In this case–control study, our aim was to identify small fibre neuropathy in patients experiencing painful long-COVID syndrome. Clinical data, quantitative sensory testing, and skin biopsies were collected from 26 selected patients with painful long-COVID syndrome. We also examined 100 individuals with past COVID-19 infection, selecting 33 patients with painless long-COVID syndrome, characterized mainly by symptoms such as brain fog and fatigue, and 30 asymptomatic post–COVID-19 controls. Demographic and clinical variables were compared among these groups.

Among the 26 patients with painful long-COVID syndrome, 12 had skin biopsy and/or quantitative sensory testing abnormalities compatible with small fibre neuropathy. Demographic and clinical data did not differ across patients with small fibre neuropathy, patients with painless long-COVID syndrome, and asymptomatic post–COVID-19 controls.

This case–control study showed that approximately 50% of patients experiencing painful long-COVID syndrome had small fibre neuropathy. However, in our patient cohort, this specific post–COVID-19 complication was unrelated to demographic and COVID-19 clinical variables. Approximately half of our sample of patients with painful long-COVID symptoms met diagnostic criteria for small fibre neuropathy.

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I'm wondering if it'd be worth testing for this. I don't even know if it's worth doing, if it'd change anything. If I can even get it tested. If it's even a thing that they test around here.

I'm leaning towards... no. I may get a reference to a new (from last year) clinic dedicated to chronic illness, maybe they do that there. If I get an appointment before the end of the decade.