Division of Neuropsychiatry, Centro de Ciências Médicas, Universidade Federal de Pernambuco (UFPE), Recife, Brazil.
Hospital Universitario Oswaldo Cruz, Universidade de Pernambuco, Recife, Brazil.
Headache. 2022 Jun;62(6):650-656. doi: 10.1111/head.14319. Epub 2022 May 11.
To review data regarding the epidemiology, pathophysiology, characteristics, and management of COVID-19-associated headache. The persistence of headache after the acute phase of COVID-19 was also reviewed.
Headache is a frequent symptom of COVID-19, and understanding its management is important for health-care professionals involved in treating the disease.
This is a narrative review. A literature review was conducted in the PubMed database with the following terms: "headache" and "COVID-19." All articles written in English that were considered relevant were included.
Half of the patients who have COVID-19 present with headache, which occurs more frequently in younger patients; in those with previous primary headache or with previous migraine; and in those who have concomitantly presented with anosmia, ageusia, and myalgia. The headache usually begins early in the symptomatic phase, is bilateral, moderate to severe, and has a similar pattern to tension-type headache. All studies found the migraine pattern and the tension-type headache pattern to be frequent patterns. The possible pathophysiological mechanisms include direct viral injury, the inflammatory process, hypoxemia, coagulopathy, and endothelial involvement. Common analgesics and nonsteroidal anti-inflammatory drugs are the most commonly used drugs for headache in the acute phase of COVID-19. The headache may persist beyond the acute phase, and in such cases, there is an improvement over time. However, not all patients' headaches improve. It seems to be a greater proportion of patients whose headache improves in the first 3 months after the acute phase of the disease than after this period. COVID-19 may trigger new daily persistent headache.
Headache is a clinically significant symptom of COVID-19. Although its characteristics in the acute phase of the disease are already well known, there is a need for studies on its management and persistence.
综述与 COVID-19 相关头痛的流行病学、病理生理学、特征和管理相关的数据。同时还回顾了 COVID-19 急性后期头痛的持续存在情况。
头痛是 COVID-19 的常见症状，了解其管理对于参与治疗该疾病的医疗保健专业人员非常重要。
这是一篇叙述性综述。在 PubMed 数据库中使用“头痛”和“COVID-19”这两个术语进行了文献回顾。纳入所有被认为相关的、用英文撰写的文章。
有一半的 COVID-19 患者出现头痛，头痛在年轻患者中更为常见；在既往有原发性头痛或既往偏头痛的患者中；在同时出现嗅觉丧失、味觉丧失和肌痛的患者中。头痛通常在症状早期开始，呈双侧性，中度至重度，与紧张型头痛模式相似。所有研究均发现偏头痛模式和紧张型头痛模式是常见模式。可能的病理生理学机制包括直接病毒损伤、炎症过程、低氧血症、凝血异常和内皮受累。在 COVID-19 急性发作期间，常用的头痛药物是普通镇痛药和非甾体抗炎药。头痛可能会在急性期后持续存在，在这种情况下，头痛会随着时间的推移而改善。然而，并非所有患者的头痛都能得到改善。在疾病急性后期 3 个月内头痛改善的患者似乎比在此之后改善的患者比例更大。COVID-19 可能引发新的每日持续性头痛。
头痛是 COVID-19 的一个具有临床意义的症状。虽然 COVID-19 急性后期头痛的特征已经很清楚，但仍需要对其管理和持续性进行研究。
