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与 COVID-19 相关的头痛:频率、特征以及与嗅觉丧失和味觉丧失的关联。

Headache associated with COVID-19: Frequency, characteristics and association with anosmia and ageusia.

机构信息

Hospital Universitario Oswaldo Cruz, Universidade de Pernambuco (UPE), Recife, Brazil; Division of Neuropsychiatry, Centro de Ciências Médicas, Universidade Federal de Pernambuco (UFPE), Recife, Brazil.

Hospital Universitario Oswaldo Cruz, Universidade de Pernambuco (UPE), Recife, Brazil; Faculdade de Ciências Médicas, Universidade de Pernambuco (UPE), Recife, Brazil.

出版信息

Cephalalgia. 2020 Nov;40(13):1443-1451. doi: 10.1177/0333102420966770.

Abstract

OBJECTIVES

To assess the frequency and characteristics of headache in patients with COVID-19 and whether there is an association between headache and anosmia and ageusia.

METHODS

This was a cross-sectional study. Consecutive patients admitted to hospital with COVID-19, confirmed by reverse transcription polymerase chain reaction (RT-PCR) technique, were assessed by neurologists.

RESULTS

Seventy-three patients were included in the study, 63% were male; the median age was 58 years (IQR: 47-66). Forty-seven patients (64.4%) reported headaches, which had most frequently begun on the first day of symptoms, were bilateral (94%), presenting severe intensity (53%) and a migraine phenotype (51%). Twelve patients (16.4%) presented with headache triggered by coughing. Eleven (15%) patients reported a continuous headache. Twenty-eight patients (38.4%) presented with anosmia and 29 (39.7%) with ageusia. Patients who reported hyposmia/anosmia and/or hypogeusia/ageusia experienced headache more frequently than those without these symptoms (OR: 5.39; 95% CI:1.66-17.45; logistic regression). Patients with anosmia and ageusia presented headache associated with phonophobia more often compared to those with headache without these complaints (Chi-square test;  < 0.05). Headache associated with COVID-19 presented a migraine phenotype more frequently in those experiencing previous migraine ( < 0.05).

CONCLUSION

Headaches associated with COVID-19 are frequent, are generally severe, diffuse, present a migraine phenotype and are associated with anosmia and ageusia.

摘要

目的

评估 COVID-19 患者头痛的频率和特征,以及头痛与嗅觉丧失和味觉丧失之间是否存在关联。

方法

这是一项横断面研究。连续入组因 COVID-19 住院、经逆转录聚合酶链反应(RT-PCR)技术确诊的患者,并由神经科医生进行评估。

结果

本研究共纳入 73 例患者,其中 63%为男性;中位年龄为 58 岁(IQR:47-66)。47 例(64.4%)患者报告有头痛,头痛最常始于症状出现的第 1 天,双侧性(94%),强度剧烈(53%),表现为偏头痛特征(51%)。12 例(16.4%)患者因咳嗽诱发头痛。11 例(15%)患者报告持续性头痛。28 例(38.4%)患者出现嗅觉丧失,29 例(39.7%)出现味觉丧失。报告嗅觉减退/丧失和/或味觉减退/丧失的患者比没有这些症状的患者更常出现头痛(OR:5.39;95%CI:1.66-17.45;logistic 回归)。有嗅觉丧失和味觉丧失的患者头痛伴畏声的发生率高于无这些症状的患者(卡方检验; < 0.05)。伴有 COVID-19 的头痛在既往有偏头痛的患者中更常出现偏头痛特征( < 0.05)。

结论

与 COVID-19 相关的头痛很常见,通常较为严重、弥漫、表现为偏头痛特征,且与嗅觉丧失和味觉丧失相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c641/7645592/03251086c8b6/10.1177_0333102420966770-fig1.jpg

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