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Pain and Fatigue Perceptions of Patients with Systemic Autoimmune Myopathies before and during the COVID-19 Pandemic Period

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Open Journal of Rheumatology and Autoimmune Diseases 2022年第4期12卷 83-98页

作者： Rafael Giovani Missé Isabela bruna Pires Borges bruna lindoso correia Lorenza Rosa Silvério da Silva Marlise Sítima Mendes Simões Alexandre Moura dos Santos Samuel Katsuyuki Shinjo Division of Rheumatology Faculdade de Medicina FMUSP Universidade de Sao Paulo Brazil

Objective: To assess general pain and fatigue and their association with the disease status of patients with systemic autoimmune myopathies (SAMs), in terms of the impact of the COVID-19 pandemic on these parameters. Methods: This is a cross-sectional and prospective cohort study that included 72 patients with SAMs who were matched by age and gender with 67 healthy individuals. The patients engaged in an interview via a validity survey to measure disease status, and assess a visual analog scale (VAS) for pain and fatigue in two periods: before (phase I) and during (phase II) of the Brazilian COVID-19 pandemic. For cross-sectional analysis, patients’ data from phase I were compared to healthy individuals’ information, whereas for prospective analysis, data of the patients who were assessed in phase II were compared to the same patients’ data from phase I. Results: The patients had significantly more pain perception, comparable fatigue perception and fatigue severity, when compared to the healthy individuals. During the COVID-19 pandemic period, the disease activity, pain and fatigue perceptions, and fatigue severity remained unchanged. Despite this, the pain and fatigue perceptions correlated significantly with patients’ VAS, the patient health outcome, and fatigue severity. In addition, the pain perception correlated to creatine phosphokinase, whereas fatigue perceptions correlated to physicians' VAS. Conclusions: The study showed that patients with SAMs have significantly increased pain perceptions compared to healthy individuals. During the COVID-19 pandemic period, the pain and fatigue perceptions remained unchanged in patients with SAMs but they correlated to several disease status parameters.

关键词： COVID-19 Pandemic Fatigue Inflammatory Myopathies Myositis Physical Activity

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Transcranial direct current electrical stimulation in combination with aerobic exercise:A pilot study in post-COVID-19 systemic autoimmune rheumatic patients

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World Journal of Rheumatology 2023年第1期11卷 1-12页

作者： Rafael Giovani Missé Alexandre Moura dos Santos Isabela bruna Pires Borges Marlise Sítima Mendes Simões Lorenza Rosa Silvério bruna lindoso correia Ana Wook Sook Kim Aline Marques Caetano Sandra Gofinet Pasoto Carla Gonçalves Schahin Saad Diogo Souza Domiciano Clarice Tanaka Julia Maria D’Andrea Greve Abrahão Fontes Baptista Samuel Katsuyuki Shinjo Division of Rheumatology Hospital das Clinicas HCFMUSPFaculdade de MedicinaUniversidade de Sao PauloSao PauloBrazil Departamento de Fisioterapia Fonoaudiologia e Terapia OcupacionalHospital das Clínicas HCFMUSPFaculdade de MedicinaUniversidade de Sao PauloNúcleo de Assistência e Pesquisa em NeuromodulaçãoSao PauloBrazil Laboratório de Estudos do Movimento Instituto de Ortopedia e TraumatologiaHospital das Clinicas HCFMUSPFaculdade de MedicinaUniversidade de Sao PauloSao PauloBrazil

BACKGROUND Systemic autoimmune rheumatic diseases(SARDs)are a group of diseases with multiorgan involvement and a high prevalence of chronic pain and fatigue.Patients with SARDs and post-coronavirus disease 2019(COVID-19)syndrome experience aggravation of symptoms.In this context,it is essential to establish strategies to reduce chronic pain and fatigue and improve quality of life.AIM To assess the efficacy of transcranial direct current stimulation(tDCS)for the treatment of fatigue and pain-associated post-COVID-19 syndrome in patients with SARDs.METHODS This study included nine patients with different types of SARDs.All patients had reverse transcription-polymerase chain reaction(RT-PCR)test confirmed COVID-19 as well as significant,persistent fatigue and pain that began to worsen after infection.Anodal tDCS was administered in five daily sessions(2mA,20 min).Concomitantly,patients were involved in aerobic exercise program.All participants were evaluated using specific questionnaires and strength assessment by handgrip and physical function by timed-up-and-go test and sit-to-stand test at baseline(within one week before tDCS protocol),and one week after tDCS protocol.During all procedures,the patients’treatments remained unchanged.RESULTS The sample comprised eight women and one man with a mean age of 48.7±9.6 years.After the tDCS protocol,pain and fatigue significantly improved on the visual analog scale(P<0.05).The physical function also improved 9.5±2.7 vs 6.8±0.8(P=0.001)for timed-up-go-test and 10.3±3.7 vs 15.1±4.0(P=0.037)for sit-to-stand test.None of the patients experienced any adverse events.CONCLUSION The present study showed that tDCS in combination with aerobic exercise was effective in improving physical function,and reducing fatigue/pain in SARDs patients with post-COVID-19 syndrome.

关键词： Autoimmune diseases COVID-19 Fatigue Neuromodulation Physical function Rheumatic diseases Pain

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