Covid could cause a strange phenomenon regarding pain for cancer patients says new study

COVID-19: All of us will 'have our day' with virus says expert

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A surprising phenomenon has been observed regarding pain, particularly among cancer patients. Physicians from the Geneva University Hospitals (HUG) have found some patients with cancer-related pain have experienced a significant decrease in pain perception. In fact, some patients have had a complete disappearance of pain perception during the acute phase of infection.

Other researchers are confirming this hypothesis declaring an absence of the perception of shortness of breath in a large proportion of patients with severe COVID-19 infection.

It’s been suggested that infection with the virus could induce atypical symptoms with a nervous system dysfunction being a possible cause.

In the study, led by Dr Lisa Hentsch, senior resident at the Division of Palliative Medicine, and Dr Matteo Coen, senior resident at the Division of Internal Medicine were joined by experts in internal medicine and palliative, neurology, radiology and pathology and discovered a significant reduction in pain among three oncological patients suffering with severe Covid.

In the study, the patients, three men aged 67 to 84 years old, were followed by the outpatient consultation of palliative care for severe oncological pain, refractory to opioid treatment.

Patients were hospitalised at the HUG due to COVID-19; all patients observed a decrease or even a disappearance of their pain soon after infection.

The recovery from COVID-19 was also associated with a gradual return of pain in one of the patients.

Previously, a Canadian researcher found that the virus that causes COVID-19 can hijack a pain receptor on a person’s cells, using it to get into the cell, but also blocking its ability to signal pain.

It was believed that the virus blocks the discomfort people would normally feel early in an infection, keeping them unaware that they’re sick and spreading the disease.

Pain researcher and professor of pharmacology at the University of Arizona, Professor Rajesh Khanna further studied this unusual attribute.

Professor Khanna and his colleagues began a series of experiments to explore this theory finding a possible link between a Covid infection, neuropilin and pain. 

Neuropilin acts as a receptor on the surface of cells.

Khanna said it was similar to a “pocket” for receiving a chemical signal from elsewhere in the body.

The particular signal that neuropilin was designed to receive is a molecule called VEGF.

“VEGF is a protein that normally would bind to neuropilin, and this is what would trigger pain signalling.

“What we discovered was that instead of VEGF binding on this pocket on neuropilin, you had the spike protein of the virus occupying the same pocket,” said Khanna.

“And when that pocket was occupied by the virus, pain signalling stopped.”

To verify this insight, the team did a series of tests on laboratory rats.

They found that rats given the coronavirus spike protein didn’t experience acute pain when dosed with VEGF — the spike protein dampened the expected pain response.

They also found that mice experiencing chronic pain had that pain relieved when they were given the spike protein.

“It was a truly wonderful and very weird discovery because it’s very counterintuitive,” said Khanna.

“Why would a virus provide pain relief? But then if you think back and really look at it, it’s a pretty ingenious way of doing this for the virus to succeed.”
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