Center of Excellence On Headache, Geriatrics and COVID-19 Clinic, SS Annunziata Hospital of Chieti, 66100, Chieti, Italy.
Internal Medicine and Emergency Medicine, Sant' Andrea Hospital, Sapienza University, Rome, Italy.
J Headache Pain. 2022 Aug 1;23(1):93. doi: 10.1186/s10194-022-01450-8.
Headache is among the most frequent symptoms persisting or newly developing after coronavirus disease 2019 (COVID-19) as part of the so-called long COVID syndrome. The knowledge on long COVID headache is still limited, however growing evidence is defining the features of this novel condition, in particular regarding clinical characteristics, some pathophysiological mechanisms and first treatment recommendations. Long COVID headache can present in the form of worsening of a preexisting primary headache, or, more specifically, in the form of a new (intermittent or daily) headache starting during the acute infection or after a delay. It often presents together with other long COVID symptoms, most frequently with hyposmia. It can manifest with a migrainous or, more frequently, with a tension-type-like phenotype. Persistent activation of the immune system and trigeminovascular activation are thought to play a role. As there are virtually no treatment studies, treatment currently is largely guided by the existing guidelines for primary headaches with the corresponding phenotype. The present report, a collaborative work of the international group of the Junior Editorial Board of The Journal of Headache and Pain aims to summarize the most recent evidence about long COVID headache and suggests approaches to the diagnosis and treatment of this disorder.
头痛是 COVID-19 后持续或新出现的最常见症状之一，属于所谓的长新冠综合征。然而，关于长新冠头痛的知识仍然有限，越来越多的证据正在定义这种新病症的特征，特别是关于临床特征、一些病理生理机制和初步治疗建议。长新冠头痛可以表现为原有原发性头痛加重，或者更具体地说，表现为急性感染期间或延迟后开始的新发（间歇性或每日）头痛。它通常与其他长新冠症状一起出现，最常见的是嗅觉减退。它可以表现为偏头痛样，更常见的是紧张型头痛样。免疫系统的持续激活和三叉血管激活被认为发挥了作用。由于几乎没有治疗研究，目前的治疗主要是根据原发性头痛的现有指南进行，同时考虑相应的头痛表型。本报告是头痛和疼痛杂志青年编辑委员会国际小组的合作工作，旨在总结长新冠头痛的最新证据，并提出诊断和治疗这种疾病的方法。
