Kirsehir Ahi Evran University Faculty of Medicine, Department of Neurology, Kirsehir, Turkey.
Kirsehir Ahi Evran University Faculty of Medicine, Department of Clinical Microbiology and Infectious Diseases, Kirsehir, Turkey.
Clin Neurol Neurosurg. 2022 Aug;219:107339. doi: 10.1016/j.clineuro.2022.107339. Epub 2022 Jun 14.
Headache is the most common COVID-19-related neurological symptom. We investigated the characteristics of COVID-19-related headache and their relationship with clinical severity in Kırşehir Province, Turkey.
This cross-sectional study prospectively enrolled 226 COVID-19-positive patients who developed headache during acute infection. Demographic data, headache characteristics, and infection symptoms were recorded. The clinical severity of COVID-19 was documented in each participant.
New-onset COVID-19-related headaches lasting 4 days were reported in 164 patients (72.5 %); these were mostly bilaterally or localized to the forehead (58.4 %), pulsating (42.5 %), moderate to severe intensity (30.1 %), with a partial response to paracetamol (23.5 %). The other 62 patients (27.4 %) reported headaches before COVID-19. Their COVID-related headaches were fiery type (p = 0.025), of very severe intensity (p = 0.008), had a holocranial distribution (p = 0.004), and were less response to paracetamol (p = 0.003); the headaches were significantly more frequent after COVID-19 than before COVID-19. Older age, high body mass index, and low education level were significantly higher in the severe group (all p < 0.001). Female sex (p = 0.019) and being a healthcare worker (p < 0.001) were significantly more frequent in mild cases.
Bilateral, prolonged, moderate to severe headaches that were analgesic resistant are more frequent in patients with COVID-19 infection. Further study should examine whether the headache characteristics distinguish COVID-19-related headaches from other types, particularly in asymptomatic subjects.
头痛是 COVID-19 相关的最常见神经症状。我们在土耳其克尔谢希尔省调查了 COVID-19 相关头痛的特征及其与临床严重程度的关系。
这项横断面研究前瞻性纳入了 226 名急性感染期间出现头痛的 COVID-19 阳性患者。记录了人口统计学数据、头痛特征和感染症状。每位参与者的 COVID-19 临床严重程度都有记录。
164 名患者（72.5%）报告了新发持续 4 天的 COVID-19 相关头痛；这些头痛大多是双侧或局限于额头（58.4%）、搏动性（42.5%）、中重度强度（30.1%），对扑热息痛有部分反应（23.5%）。另外 62 名患者（27.4%）在 COVID-19 之前报告了头痛。他们的 COVID 相关头痛为火热型（p=0.025），强度非常严重（p=0.008），全颅分布（p=0.004），对扑热息痛的反应较差（p=0.003）；COVID-19 后头痛的发生频率明显高于 COVID-19 前。严重组的年龄较大（p<0.001）、身体质量指数较高（p<0.001）、受教育程度较低（p<0.001）。轻度组中女性（p=0.019）和医务人员（p<0.001）的比例明显更高。
COVID-19 感染患者更常出现双侧、持续时间长、中重度、对镇痛药有抵抗性的头痛。进一步的研究应检查头痛特征是否能将 COVID-19 相关头痛与其他类型的头痛区分开来，特别是在无症状人群中。
