The Impact of COVID-19 on Chronic Pain: Multidimensional Clustering Reveals Deep Insights into Spinal Cord Stimulation Patients

Abstract

The emergence of COVID-19 offered a unique opportunity to study chronic pain patients as they responded to sudden change in social environments, increased community stress, and reduced access to care. We report findings from n=70 Spinal Cord Stimulation (SCS) patients before and during initial pandemic stages resulting from advances in home monitoring and artificial intelligence that allowed novel patients insights despite pandemic-related disruptions. From the multi-dimensional array of frequently monitored signals—including mobility, sleep, voice, and psychological assessments—we found that while overall the patient cohort appeared unaffected by the pandemic onset, the individual patients were significantly different. Three patient responses were revealed, those with: worsened pain, reduced activities, or improved quality-of-life. Remarkably, none of the individual measures by themselves were significantly affected, and it was their synergy that exposed the effects elicited by the pandemic onset. Partial correlations illustrate linked dimensions by sub-cohort during the pandemic and those associations were different for each sub-cohort before COVID-19, suggesting that daily at-home tele-monitoring of chronic conditions may reveal novel patient types. This work highlights the opportunities in applying modern analytics techniques to comprehensive patient outcomes over long periods of time so that in the future clinicians can make more informed treatment decisions.