Duraníková Oľga, Horváthová Simona, Sabaka Peter, Minár Michal, Boleková Veronika, Straka Igor, Valkovič Peter
2nd Department of Neurology, Faculty of Medicine, Comenius University Bratislava, 813 72 Bratislava, Slovakia.
Department of Infectology and Geographical Medicine, Faculty of Medicine, Comenius University Bratislava, 813 72 Bratislava, Slovakia.
J Clin Med. 2024 Aug 24;13(17):5013. doi: 10.3390/jcm13175013.
Headache is a prevalent and disabling non-respiratory symptom of COVID-19, posing a persistent challenge in post-COVID syndrome. This study aimed to determine the prevalence, phenotypes, risk factors and biomarkers associated with COVID-related headaches. A retrospective analysis of 634 hospitalized COVID-19 patients was conducted, with 295 participants being followed up 12-15 months post-discharge via telephone call. Initial laboratory workups, including complete blood count and various biochemical parameters, were compared between headache and non-headache groups. One-third of hospitalized patients experienced headaches, predominantly younger individuals ( < 0.001) and women ( = 0.002). Non-dominant headaches were characterized as dull (56.9%) and holocranial (26.5%), while dominant headaches were unilateral (31.3%) with photophobia (34.3%) and nausea (56.3%). Persistent headaches were unilateral (40%) and pulsating (38%) with phonophobia (74%). Decreased CD4 T cells independently predicted COVID-associated headaches, with elevated IL-6 levels noted in the dominant-headache group ( = 0.040). Remarkably, 50% of patients reported persistent headaches 12-15 months post-infection. Dexamethasone administration significantly reduced the likelihood of long-COVID headaches (52% vs. 73%, = 0.029). Headache was present in one-third of patients with heterogenous phenotypes: tension headache in the non-dominant group, and migraine in the dominant and persistent headache groups. Persistent headache remains a challenge, with dexamethasone showing potential in reducing its incidence, emphasizing the need for tailored approaches in managing long-COVID headaches.
头痛是新冠病毒感染的一种常见且使人丧失能力的非呼吸道症状，在新冠后综合征中构成持续挑战。本研究旨在确定与新冠相关头痛的患病率、表型、风险因素和生物标志物。对634例住院的新冠病毒感染患者进行了回顾性分析，其中295名参与者在出院后12至15个月通过电话随访。对头痛组和非头痛组的初始实验室检查结果进行了比较，包括全血细胞计数和各种生化参数。三分之一的住院患者出现头痛，主要是年轻人（<0.001）和女性（=0.002）。非优势头痛的特点是钝痛（56.9%）和全头性头痛（26.5%），而优势头痛为单侧性（31.3%），伴有畏光（34.3%）和恶心（56.3%）。持续性头痛为单侧性（40%）和搏动性（38%），伴有恐音症（74%）。CD4 T细胞减少独立预测与新冠相关的头痛，优势头痛组白细胞介素-6水平升高（=0.040）。值得注意的是，50%的患者在感染后12至15个月报告有持续性头痛。使用地塞米松显著降低了长期新冠头痛的可能性（52%对73%，=0.029）。三分之一具有不同表型的患者出现头痛：非优势组为紧张性头痛，优势和持续性头痛组为偏头痛。持续性头痛仍然是一个挑战，地塞米松在降低其发病率方面显示出潜力，强调在管理长期新冠头痛方面需要采取针对性方法。
