Headache Unit, Department of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Spain.
Headache. 2020 Sep;60(8):1664-1672. doi: 10.1111/head.13927. Epub 2020 Aug 18.
In this study, we aimed to evaluate the frequency of the main red flags in patients with headache who do have Covid-19.
Headache is one of the most frequent neurologic symptoms of Coronavirus disease 2019 (Covid-19). Diagnosis of secondary headache disorders is still based on the presence of red flags.
Cross-sectional study of hospitalized patients with confirmed Covid-19 disease. We interrogated every patient about the presence of headache and if so, a headache expert conducted a structured interview assessing the presence and type of the main red flags. We evaluated the presence of laboratory abnormalities on admission.
We screened 576 consecutive patients, 130/576 (22.6%) described headache, and 104 were included in the study. Mean age of patients was 56.7 (standard deviation: 11.2) and 66/104 (63.4%) were female. Red flags concerning prior medical history were present in 79/104 (76.0%) cases, and those related to the headache itself were observed in 99/104 (95.2%) patients. All patients 104/104 (100%) described systemic symptoms and 86/104 (82.7%) some neurologic symptoms. Laboratory results were abnormal in 98/104 (94.2%) cases. The most frequent red flags were fever, in 93/104 (89.4%) patients, cough, in 89/104 (85.6% cases), and increased C-reactive protein in 84/100 (84.0%) cases.
In patients with Covid-19 that described the headache red flags were present in most cases. There was not any universal red flag, being necessary the comprehensive evaluation of all of them.
本研究旨在评估患有新冠肺炎的头痛患者主要体征的出现频率。
头痛是 2019 年冠状病毒病（COVID-19）最常见的神经系统症状之一。继发性头痛疾病的诊断仍基于体征的存在。
对确诊为 COVID-19 住院患者进行横断面研究。我们询问每位患者是否存在头痛，如果有，由头痛专家进行结构化访谈，评估主要体征的存在和类型。我们评估入院时的实验室异常情况。
我们共筛查了 576 例连续患者，其中 130/576（22.6%）描述了头痛，104 例纳入了研究。患者的平均年龄为 56.7（标准差：11.2），其中 66/104（63.4%）为女性。79/104（76.0%）例有既往病史相关体征，99/104（95.2%）例有头痛相关体征。所有患者 104/104（100%）均有全身症状，86/104（82.7%）例有神经系统症状。98/104（94.2%）例实验室结果异常。最常见的体征是发热，93/104（89.4%）例，咳嗽，89/104（85.6%）例，C 反应蛋白升高 84/100（84.0%）例。
在描述头痛的 COVID-19 患者中，大多数患者存在体征。没有任何普遍的体征，需要对所有体征进行全面评估。
