Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Çapa, Istanbul, Turkey.
Department of Neurology and Algology, Gazi University Faculty of Medicine, Besevler, 06510, Ankara, Turkey.
J Headache Pain. 2020 Oct 13;21(1):121. doi: 10.1186/s10194-020-01188-1.
Headache is the most common COVID-19-related neurological symptom. We aimed to reveal diagnostic clues of headache for COVID-19 infection and to investigate the course of primary headaches during the pandemic.
We developed a detailed web-based questionnaire screening the characteristics and course of headaches besides clinical COVID-19 features. The participants were grouped according to being diagnosed with COVID-19 infection or not, and having previous or new-onset headaches. The COVID-19 related headache features and their associations with other clinical features were investigated. A binary logistic regression model was performed to differentiate the characteristics of headache related to COVID-19.
A total of 3458 participants (2341 females;67.7%, 1495 healthcare workers;43.2%) with a mean age of 43.21 ± 11.2 years contributed to the survey. Among them, 262 participants had COVID-19 diagnosis and 126 (48.1%) were male. The rate of males in the group without COVID-19 was 31% (991 out of 3196 participants) showing significant gender difference between groups (p < 0.000). COVID-19 related headaches were more closely associated with anosmia/ageusia and gastrointestinal complaints (p < 0.000 and p < 0.000), and showed different characteristics like pulsating, pressing, and even stabbing quality. Logistic regression analyses showed that bilateral headache, duration over 72 h, analgesic resistance and having male gender were significant variables to differentiate COVID-19 positive patients from those without COVID-19 (p = 0.04 for long duration and p < 0.000 for others). A worsening of previous primary headaches due to the pandemic-related problems was not reported in the majority of patients.
Bilateral, long-lasting headaches, resistance to analgesics and having male gender were more frequent in people with COVID-19 in conjunction with anosmia/ageusia and gastrointestinal complaints. These features may be helpful for diagnosing the headache related to COVID-19 during the pandemic.
头痛是 COVID-19 相关的最常见神经系统症状。我们旨在揭示 COVID-19 感染相关头痛的诊断线索，并研究大流行期间原发性头痛的病程。
我们开发了一个详细的网络问卷，除了临床 COVID-19 特征外，还筛查头痛的特征和病程。参与者根据是否被诊断为 COVID-19 感染以及是否存在先前或新发头痛进行分组。研究了 COVID-19 相关头痛特征及其与其他临床特征的关联。采用二项逻辑回归模型区分与 COVID-19 相关的头痛特征。
共有 3458 名参与者（2341 名女性，占 67.7%；1495 名医护人员，占 43.2%）参与了调查，平均年龄为 43.21±11.2 岁。其中，262 名参与者被诊断为 COVID-19，126 名（48.1%）为男性。在没有 COVID-19 的组中，男性的比例为 31%（3196 名参与者中有 991 名），两组之间存在显著的性别差异（p<0.000）。COVID-19 相关头痛与嗅觉丧失/味觉丧失和胃肠道症状更密切相关（p<0.000 和 p<0.000），且表现出不同的特征，如搏动性、压迫性甚至刺痛性。逻辑回归分析显示，双侧头痛、持续时间超过 72 小时、对镇痛药的耐药性以及男性是将 COVID-19 阳性患者与非 COVID-19 患者区分开来的显著变量（持续时间长的 p=0.04，其他变量的 p<0.000）。在大多数患者中，由于大流行相关问题，先前的原发性头痛恶化的情况并未报告。
在伴有嗅觉丧失/味觉丧失和胃肠道症状的 COVID-19 患者中，双侧、持续时间长、对镇痛药耐药以及男性更常见。这些特征可能有助于在大流行期间诊断与 COVID-19 相关的头痛。
