Neurology, GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India.
Community Medicine, All India Institute of Medical Sciences, New Delhi, India.
Acta Neurol Scand. 2021 Dec;144(6):706-716. doi: 10.1111/ane.13525. Epub 2021 Aug 30.
To assess the impact of lockdown during the COVID-19 pandemic on migraine patients in India on disease activity, healthcare accessibility, and quality of life (QoL).
MATERIALS & METHODS: This internet-based survey study using a structured questionnaire was conducted from 27th April to 31st July 2020. Previous physician-diagnosed migraine patients or those fulfilling any two of three clinical features (limitation of activities for >1 day, associated nausea or vomiting, and photophobia or phonophobia) were diagnosed as migraine patients. QoL was captured using a Likert scale and determinants of poor QoL were identified by logistic regression.
A total of 4078 persons completed the full survey out of which 984 (24.1%) had migraine (mean age 35.3 ±11.2). Compared to pre-lockdown, 51.3% of migraineurs reported worsening of their headaches in terms of increased attack frequency (95.6%), increased headache days (95%), increased attack duration (89.9%) and increased headache severity (88.1%). The worsening was attributed to anxiety due to the pandemic (79.7%), inability or difficulty to access healthcare (48.4%) and migraine medicines (48.9%), and financial worries (60.9%). 26.8% of migraineurs reported poor QoL compared to 7.37% of non-migraineurs [p<0.0001]. Migraine affected QoL in 61.4% of migraineurs. The predictors of poor QoL on logistic regression included worsening migraine during the lockdown (AOR 4.150; CI 2.704- 6.369) and difficulty accessing migraine medicines (AOR 4.549; CI 3.041- 6.805). Employment as an essential COVID-19 worker (AOR 0.623; CI 0.409- 0.950) protected against poor QoL.
COVID-19 pandemic-related lockdown greatly impacted migraine patients in India which significantly reduced their QoL.
评估 COVID-19 大流行期间印度封锁对偏头痛患者疾病活动、医疗保健可及性和生活质量(QoL)的影响。
这是一项基于互联网的调查研究,使用结构化问卷,于 2020 年 4 月 27 日至 7 月 31 日进行。既往有医生诊断的偏头痛患者或符合以下三项临床特征中的两项的患者(活动受限超过 1 天、伴有恶心或呕吐、畏光或畏声)被诊断为偏头痛患者。使用李克特量表评估 QoL,并通过逻辑回归确定 QoL 差的决定因素。
共有 4078 人完成了完整的调查,其中 984 人(24.1%)患有偏头痛(平均年龄 35.3±11.2 岁)。与封锁前相比,51.3%的偏头痛患者报告头痛恶化,表现为发作频率增加(95.6%)、头痛天数增加(95%)、发作持续时间延长(89.9%)和头痛严重程度增加(88.1%)。这种恶化归因于对大流行的焦虑(79.7%)、无法或难以获得医疗保健(48.4%)和偏头痛药物(48.9%)以及财务担忧(60.9%)。与非偏头痛患者(7.37%)相比,26.8%的偏头痛患者报告 QoL 差(p<0.0001)。偏头痛影响了 61.4%的偏头痛患者的 QoL。逻辑回归分析显示,封锁期间偏头痛恶化(优势比 4.150;95%置信区间 2.704-6.369)和难以获得偏头痛药物(优势比 4.549;95%置信区间 3.041-6.805)是 QoL 差的预测因素。作为 COVID-19 相关的必要工作人员(优势比 0.623;95%置信区间 0.409-0.950)可预防 QoL 差。
与 COVID-19 大流行相关的封锁对印度的偏头痛患者产生了重大影响,大大降低了他们的 QoL。