Herpes Zoster and Postherpetic Neuralgia in an Elderly Patient with Critical COVID-19: A Case Report

• Main Authors: Cao X, Zhang X, Meng W, Zheng H
• Format: Article
• Language: English
• Published: Dove Medical Press 2020-09-01
• Series: Journal of Pain Research
• Subjects: sars-cov-2; covid-19; herpes zoster; postherpetic neuralgia; elderly patient
• Online Access: https://www.dovepress.com/herpes-zoster-and-postherpetic-neuralgia-in-an-elderly-patient-with-cr-peer-reviewed-article-JPR

Xueqin Cao,1 Xianwei Zhang,1 Weihua Meng,2 Hua Zheng1 1Department of Anesthesiology and Pain Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, People’s Republic of China; 2Division of Population Health and Genomics, School of Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee DD2 4BF, Scotland, UKCorrespondence: Hua ZhengDepartment of Anesthesiology and Pain Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, People’s Republic of ChinaTel [phone]Fax [phone]Email [e-mail]: Critical patients with COVID-19 are thought to be at high risk of developing chronic pain. However, the exact nature and mechanisms of COVID-19-related chronic pain remain largely unknown. Here, we describe clinical features, treatments and outcome of herpes zoster as well as postherpetic neuralgia in a 70-year-old woman with critical COVID-19. The patient had a history of type 2 diabetes and myasthenia gravis. She developed herpes zoster in the right 10 to 12 lumbar dermatomes in the recovery period of COVID-19. Intravenous (250 mg 3 times a day) and then oral (400 mg 5 times a day) acyclovir was used for antiviral therapy. Pregabalin (75 mg orally twice a day) and ibuprofen was used for analgesia. Her skin lesions resolved 21 days after the onset of rash. However, she continued to have persistent pain in the same dermatomal distribution. After the dosage of pregabalin was increased to 150 mg orally twice a day, her pain was partially relieved. During the telephone follow-up 4 months after herpes zoster eruption, the patient still complained intermittent pain in the right 10 to 12 lumbar dermatomes. Our case draws attention to postherpetic neuralgia in COVID-19 patients and provides a targeted suggestion for this kind of patients.Keywords: SARS-CoV-2, COVID-19, herpes zoster, postherpetic neuralgia, elderly patient