Department of Neurology, Institute of Neurosciences, Hospital Clínico San Carlos, IdISSC, Universidad Complutense de Madrid, Madrid, Spain.
Department of Ophthalmology, Hospital Clínico San Carlos, IdISSC, Universidad Complutense de Madrid, Madrid, Spain.
Headache. 2020 Sep;60(8):1697-1704. doi: 10.1111/head.13902. Epub 2020 Jul 15.
Series of patients with SARS-CoV-2 infection report headache in 6%-15% of cases, although some data suggest that the actual frequency is higher, and that headache is not associated with fever. No study published to date has analyzed the characteristics of headache in these patients.
To analyze the characteristics of COVID-19 related headaches.
We conducted a survey of Spaniard healthcare professionals who have been infected by SARS-CoV-2 and presented headache during the course of the disease. The survey addressed respondents' medical history and headache characteristics, and we analyzed the association between both.
We analyzed the responses of a sample of 112 healthcare professionals. History of migraine was reported by 20/112 (17.9%) of respondents, history of tension-type headache by 8/112 (7.1%), and history of cluster headache was reported by a single respondent; 82/112(73.2%) of respondents had no history of headache. Headache presented independently of fever, around the third day after symptom onset. The previous history of migraine was associated with a higher frequency of pulsating headache (20% in patients with previous migraine vs 4.3% in those with no history of migraine, P = .013).
Headache is often holocranial, hemicranial, or occipital, pressing, and worsens with physical activity or head movements. Because the characteristics of the headache and the associated symptoms are heterogeneous in our survey, we suggest that several patterns with specific pathophysiological mechanisms may underlie the headache associated with COVID-19.
有一系列 SARS-CoV-2 感染患者报告称，头痛的发病率为 6%-15%，尽管一些数据表明实际发病率更高，而且头痛与发热无关。迄今为止，尚无研究分析过此类患者头痛的特征。
分析 COVID-19 相关头痛的特征。
我们对感染 SARS-CoV-2 并在病程中出现头痛的西班牙医护人员进行了一项调查。该调查涉及受访者的病史和头痛特征，并分析了两者之间的关联。
我们分析了 112 名医护人员的调查回复。20/112（17.9%）的受访者报告有偏头痛病史，8/112（7.1%）的受访者有紧张型头痛病史，1 名受访者有丛集性头痛病史；82/112（73.2%）的受访者无头痛病史。头痛独立于发热出现，通常在症状出现后第三天左右出现。偏头痛既往史与搏动性头痛的发生频率较高相关（有偏头痛既往史的患者为 20%，无偏头痛既往史的患者为 4.3%，P=0.013）。
头痛通常为全头痛、单侧头痛或枕部头痛，呈压迫性，且活动或头部运动后会加重。由于我们的调查中头痛的特征和相关症状存在异质性，我们建议 COVID-19 相关头痛可能由几种具有特定病理生理机制的模式引起。
