Data-Driven Path Analytic Modeling to Understand Underlying Mechanisms in COVID-19 Survivors Suffering from Long-Term Post-COVID Pain: A Spanish Cohort Study
Abstract
:1. Introduction
2. Methods
2.1. Participants
2.2. Data Collection
2.3. Sensory-Related Variables
2.4. Psychological Variables
2.5. Cognitive Variables
2.6. Statistical Analysis
2.6.1. Packages
2.6.2. Missing Data Management
2.6.3. Bayesian Network (BN)
2.6.4. Structural Equation Modeling (SEM)
3. Results
4. Discussion
4.1. Emotional Aspects and Post-COVID Pain
4.2. Central Sensitization-Associated Symptoms and Post-COVID Pain
4.3. Sex and Post-COVID Pain
4.4. Clinical Application
4.5. Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | Mean (SD) |
---|---|
Age (years) | 57.3 (11.7) |
BMI (kg/m2) | 29.25 (5.2) |
Pain duration (months) | 18.8 (1.8) |
Pain intensity (NPRS, 0–10) | 5.6 (1.7) |
Anxiety (HADS-A, 0–21) | 5.2 (4.2) |
Depression (HADS-D, 0–21) | 4.9 (4.3) |
Sleep (PSQI, 0–21) | 8.0 (4.2) |
PainDETECT (−1 to 38) | 7.0 (6.2) |
S-LANSS (0–24) | 7.5 (8.5) |
CSI (0–100) | 33.9 (17.2) |
Catastrophizing (PCS, 0–52) | 12.3 (12.0) |
Fear (TSK-11, 0–44) | 24.0 (8.6) |
EQ-5D-5L (0–1) | 0.8 (0.2) |
DV | IV | Coef | SE | Pval | 2.5% | 97.5% | Type |
---|---|---|---|---|---|---|---|
Pain | BMI | 0.015 | 0.086 | 0.860 | −0.154 | 0.185 | Reg |
Pain | Dep | 0.241 | 0.075 | 0.001 | 0.095 | 0.387 | Reg |
Anx | Sex | 0.179 | 0.079 | 0.024 | 0.024 | 0.334 | Reg |
Dep | Anx | 0.745 | 0.064 | 0.000 | 0.620 | 0.869 | Reg |
Sleep | Dep | 0.298 | 0.071 | 0.000 | 0.158 | 0.438 | Reg |
Sleep | Fear | 0.201 | 0.080 | 0.012 | 0.045 | 0.357 | Reg |
PainDETECT | CSI | 0.406 | 0.071 | 0.000 | 0.267 | 0.545 | Reg |
S-LANSS | Sex | −0.150 | 0.052 | 0.004 | −0.251 | −0.049 | Reg |
S-LANSS | PainDETECT | 0.488 | 0.061 | 0.000 | 0.367 | 0.608 | Reg |
CSI | Sex | 0.319 | 0.063 | 0.000 | 0.196 | 0.441 | Reg |
CSI | Anx | 0.406 | 0.153 | 0.008 | 0.106 | 0.706 | Reg |
CSI | Dep | 0.119 | 0.146 | 0.415 | −0.167 | 0.405 | Reg |
Catastrop | Dep | 0.345 | 0.079 | 0.000 | 0.191 | 0.499 | Reg |
Catastrop | Fear | 0.494 | 0.066 | 0.000 | 0.364 | 0.624 | Reg |
Fear | CSI | 0.458 | 0.074 | 0.000 | 0.313 | 0.603 | Reg |
EQ-5D | Sleep | −0.305 | 0.071 | 0.000 | −0.443 | −0.167 | Reg |
Indirect effect 1 (Anx→Dep→CSI) | 0.089 | 0.105 | 0.397 | −0.116 | 0.294 | Med | |
Indirect effect 2 (Dep→CSI→Fear→Sleep) | 0.011 | 0.014 | 0.436 | −0.017 | 0.039 | Med | |
Indirect effect 3 (Sex→CSI→PainDETECT→S-LANSS) | 0.063 | 0.019 | 0.001 | 0.026 | 0.100 | Med | |
Indirect effect 4 (Dep→CSI→Fear→Catastrop) | 0.027 | 0.034 | 0.426 | −0.039 | 0.093 | Med | |
Pain | Pain | 0.942 | 0.036 | 0.000 | 0.871 | 1.013 | vCov |
Anx | Anx | 0.968 | 0.028 | 0.000 | 0.912 | 1.024 | vCov |
Dep | Dep | 0.445 | 0.095 | 0.000 | 0.260 | 0.631 | vCov |
Sleep | Sleep | 0.845 | 0.051 | 0.000 | 0.746 | 0.945 | vCov |
PainDETECT | PainDETECT | 0.835 | 0.058 | 0.000 | 0.722 | 0.948 | vCov |
S-LANSS | S-LANSS | 0.764 | 0.054 | 0.000 | 0.658 | 0.870 | vCov |
CSI | CSI | 0.591 | 0.056 | 0.000 | 0.481 | 0.701 | vCov |
Catastrop | Catastrop | 0.565 | 0.055 | 0.000 | 0.457 | 0.672 | vCov |
Fear | Fear | 0.790 | 0.068 | 0.000 | 0.657 | 0.923 | vCov |
EQ-5D | EQ-5D | 0.907 | 0.043 | 0.000 | 0.823 | 0.991 | vCov |
Pain | S-LANSS | −0.051 | 0.081 | 0.524 | −0.210 | 0.107 | vCov |
Pain | Catastrop | −0.145 | 0.071 | 0.042 | −0.285 | −0.005 | vCov |
Pain | EQ-5D | 0.047 | 0.078 | 0.544 | −0.105 | 0.199 | vCov |
S-LANSS | Catastrop | −0.001 | 0.058 | 0.991 | −0.115 | 0.113 | vCov |
S-LANSS | EQ-5D | 0.064 | 0.069 | 0.349 | −0.070 | 0.199 | vCov |
Catastrop | EQ-5D | −0.085 | 0.088 | 0.332 | −0.258 | 0.087 | vCov |
BMI | BMI | 1.000 | 0.000 | 1.000 | 1.000 | vCov | |
BMI | Sex | 0.073 | 0.000 | 0.073 | 0.073 | vCov | |
Sex | Sex | 1.000 | 0.000 | 1.000 | 1.000 | vCov |
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Fernández-de-las-Peñas, C.; Liew, B.X.W.; Herrero-Montes, M.; del-Valle-Loarte, P.; Rodríguez-Rosado, R.; Ferrer-Pargada, D.; Neblett, R.; Paras-Bravo, P. Data-Driven Path Analytic Modeling to Understand Underlying Mechanisms in COVID-19 Survivors Suffering from Long-Term Post-COVID Pain: A Spanish Cohort Study. Pathogens 2022, 11, 1336. https://doi.org/10.3390/pathogens11111336
Fernández-de-las-Peñas C, Liew BXW, Herrero-Montes M, del-Valle-Loarte P, Rodríguez-Rosado R, Ferrer-Pargada D, Neblett R, Paras-Bravo P. Data-Driven Path Analytic Modeling to Understand Underlying Mechanisms in COVID-19 Survivors Suffering from Long-Term Post-COVID Pain: A Spanish Cohort Study. Pathogens. 2022; 11(11):1336. https://doi.org/10.3390/pathogens11111336
Chicago/Turabian StyleFernández-de-las-Peñas, César, Bernard X. W. Liew, Manuel Herrero-Montes, Pablo del-Valle-Loarte, Rafael Rodríguez-Rosado, Diego Ferrer-Pargada, Randy Neblett, and Paula Paras-Bravo. 2022. "Data-Driven Path Analytic Modeling to Understand Underlying Mechanisms in COVID-19 Survivors Suffering from Long-Term Post-COVID Pain: A Spanish Cohort Study" Pathogens 11, no. 11: 1336. https://doi.org/10.3390/pathogens11111336