Department of Neurology, Beni-Suef University, Beni-Suef, Egypt.
Department of Anaesthesia, Surgical ICU and Pain management, Beni-Suef University, Beni-Suef, Egypt.
Pain Med. 2021 Sep 8;22(9):2092-2099. doi: 10.1093/pm/pnab020.
Headache is considered one of the most frequent neurological manifestations of coronavirus disease 2019 (COVID-19). This work aimed to identify the relative frequency of COVID-19-related headache and to clarify the impact of clinical, laboratory findings of COVID-19 infection on headache occurrence and its response to analgesics.
Cross-sectional study.
Recovered COVID-19 patients.
In total, 782 patients with a confirmed diagnosis of COVID-19 infection.
Clinical, laboratory, and imaging data were obtained from the hospital medical records. Regarding patients who developed COVID-19 related headache, a trained neurologist performed an analysis of headache and its response to analgesics.
The relative frequency of COVID-19 related headache among our sample was 55.1% with 95% confidence interval (CI) (.516-.586) for the estimated population prevalence. Female gender, malignancy, primary headache, fever, dehydration, lower levels of hemoglobin and platelets and higher levels of neutrophil/lymphocyte ratio (NLR) and CRP were significantly associated with COVID-19 related headache. Multivariate analysis revealed that female gender, fever, dehydration, primary headache, high NLR, and decreased platelet count were independent predictors of headache occurrence. By evaluating headache response to analgesics, old age, diabetes, hypertension, primary headache, severe COVID-19, steroid intake, higher CRP and ferritin and lower hemoglobin levels were associated with poor response to analgesics. Multivariate analysis revealed that primary headache, steroids intake, moderate and severe COVID-19 were independent predictors of non-response to analgesics.
Headache occurs in 55.1% of patients with COVID-19. Female gender, fever, dehydration, primary headache, high NLR, and decreased platelet count are considered independent predictors of COVID-19 related headache.
头痛被认为是 2019 年冠状病毒病（COVID-19）最常见的神经学表现之一。本研究旨在确定 COVID-19 相关头痛的相对频率，并阐明 COVID-19 感染的临床和实验室发现对头痛发生及其对镇痛药反应的影响。
横断面研究。
康复的 COVID-19 患者。
共纳入 782 例确诊 COVID-19 感染的患者。
从医院病历中获取临床、实验室和影像学数据。对于出现 COVID-19 相关头痛的患者，由一名经过培训的神经科医生对头痛及其对镇痛药的反应进行分析。
在我们的样本中，COVID-19 相关头痛的相对频率为 55.1%，估计人群患病率的 95%置信区间（CI）为（0.516-0.586）。女性、恶性肿瘤、原发性头痛、发热、脱水、较低的血红蛋白和血小板水平以及较高的中性粒细胞/淋巴细胞比值（NLR）和 C 反应蛋白（CRP）与 COVID-19 相关头痛显著相关。多变量分析显示，女性、发热、脱水、原发性头痛、高 NLR 和血小板计数减少是头痛发生的独立预测因素。通过评估头痛对镇痛药的反应，发现年龄较大、糖尿病、高血压、原发性头痛、严重 COVID-19、类固醇摄入、较高的 CRP 和铁蛋白以及较低的血红蛋白水平与对镇痛药反应不佳相关。多变量分析显示，原发性头痛、类固醇摄入、中度和重度 COVID-19 是对镇痛药无反应的独立预测因素。
COVID-19 患者中 55.1%出现头痛。女性、发热、脱水、原发性头痛、高 NLR 和血小板计数减少被认为是 COVID-19 相关头痛的独立预测因素。
