Gómez-Dabó Laura, Melgarejo-Martínez Laura, Caronna Edoardo, Pozo-Rosich Patricia
Neurology Department, Hospital Universitari Vall d'Hebron, Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
Headache Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
Curr Neurol Neurosci Rep. 2023 Oct;23(10):551-560. doi: 10.1007/s11910-023-01296-w. Epub 2023 Sep 4.
Headache is one of the most frequent symptoms of the acute and post-acute phase of COVID-19. Specific epidemiology, clinical features, risk factors, pathophysiology, and treatment have been reported in these two scenarios. With this narrative review of the literature, we aim to provide updated knowledge on headache in the COVID-19 setting and give clinicians a practical approach on this topic to guide them in their clinical practice.
Headache mechanisms in COVID-19 are still poorly understood. Strong evidence is also lacking on how to best treat and manage these patients, especially those with persistent and disabling headache after COVID-19. Data are also scarce on the characteristics of headache in COVID-19 caused by the new SARS-CoV-2 (Omicron) variants and how these may influence the acute and persistent symptoms of COVID-19. Patients with pre-existing primary headache disorders remain a particularly concerning population due to their biological predisposition in suffering from headaches and the potential risk of worsening in the setting of SARS-CoV-2 infection. Although there is an exponential growth of scientific evidence, studies are often controversial and focused on the first wave of the pandemic, making COVID-19 headache still a challenging matter for clinicians. New research is therefore needed.
头痛是新冠病毒病急性期和急性后期最常见的症状之一。已有关于这两种情况下头痛的具体流行病学、临床特征、危险因素、病理生理学及治疗方法的报道。通过对文献的叙述性综述，我们旨在提供新冠病毒病背景下头痛的最新知识，并为临床医生提供关于该主题的实用方法，以指导他们的临床实践。
新冠病毒病中头痛的机制仍未完全明确。在如何最佳治疗和管理这些患者方面，尤其是新冠病毒病后出现持续性和致残性头痛的患者，也缺乏有力证据。关于新的严重急性呼吸综合征冠状病毒2（奥密克戎）变异株引起的新冠病毒病头痛特征以及这些特征如何影响新冠病毒病急性和持续症状的数据也很稀少。患有既往原发性头痛疾病的患者仍然是一个特别值得关注的群体，因为他们有患头痛的生物学易感性以及在严重急性呼吸综合征冠状病毒2感染情况下病情恶化的潜在风险。尽管科学证据呈指数级增长，但研究往往存在争议且集中在疫情的第一波，这使得新冠病毒病头痛对临床医生来说仍然是一个具有挑战性的问题。因此需要开展新的研究。
