Long-term examination of pain and health-related outcomes in people with fibromyalgia before, during, and after COVID-19.

Introduction: Since the outbreak of COVID-19, many studies have investigated long-term consequences associated to the pandemic. Undoubtedly, restrictions and changes in everyday life during that time have had a broad impact on mental health and well-being, particularly in vulnerable populations, such as chronic pain patients. Objectives: The aim of this study was to examine longitudinal progression of pain-related outcomes in patients with fibromyalgia (FM). Methods: Using a repeated measures design with comparative data acquired before (T1) and during the pandemic (T2), as well as data from a recent survey (T3), this study investigated long-term development of pain symptoms and well-being in FM (N = 75) throughout and beyond the pandemic. For this purpose, longitudinal changes of clinical parameters, such as pain severity, disability, and depressive mood, as well as self-perceived changes of pain, anxiety, depression, and physical activity were assessed. Results: Patients displayed significant self-perceived worsening of pain compared with both preceding survey periods. However, these self-perceived changes were not reflected in longitudinal increases of pain values. Pain-related interference, perceived helplessness, and social activity levels were significant predictors of pain severity at T3, when using only T3 determinants as predictors. On the other hand, with regard to the prepandemic and pandemic period, past pain levels (T1, T2) and affective distress experienced at T2 were significant predictors of T3 pain. Conclusions: These findings emphasize the importance of psychosocial factors for the long-term progression of pain symptoms. In addition, our data suggest remarkable long-term stability of pain symptoms, despite repeated evidence for a self-perceived worsening of pain.