Straburzyński Marcin, Waliszewska-Prosół Marta
Department of Family Medicine and Infectious Diseases, University of Warmia and Mazury, Olsztyn, Poland.
Department of Neurology, Wroclaw Medical University, Wroclaw, Poland.
Neurol Neurochir Pol. 2024;58(6):593-599. doi: 10.5603/pjnns.103063. Epub 2024 Dec 9.
This study aimed to compare headache and facial pain prevalence and headache phenotype among people with common upper respiratory tract infections (URTIs).
Headache is a common symptom in viral URTI, but its phenotyping has so far been limited to coronavirus disease 2019 (COVID-19) and influenza. Additionally, the prevalence of facial pain in URTIs has only rarely been discussed in scientific publications.
Patients with acute URTI symptoms were evaluated for headache phenotype using a semi-structured questionnaire. Antigen swab tests were performed in all participants.
The analysis included 276 URTI/APVRS (acute post-viral rhinosinusitis) episodes in 223 patients (136 women, 60.1%) aged 18-73 [mean 41.3 / median (25th, 75th) 40 / standard deviation 15.1]. Participants were diagnosed with: COVID-19 - 107/276 (38.8%); 'common cold' - 103/276 (37.3%); influenza - 36/276 (13.0%); or APVRS - 30/276 (10.9%). Headache was present in 183/276 (66.3%) and URTIs and facial pain in 107/276 (38.8%). Predictors of headache in URTIs included sinonasal symptoms (odds ratio (OR) 10.70, p < 0.001) and fever (OR 2.9, p = 0.004). Headache more often (p = 0.030) had a migraine-like phenotype in COVID-19 (27.4% (20/73) vs. 9.1% (10/110) and tension-type headache (TTH)-like phenotype in 'common cold' (75.4%, 49/64 vs. 61.3%, 73/119). Previous COVID-19 immunisation (vaccination or infection) was associated (p = 0.004) with a lower prevalence of migraine-like headache [6.3% (1/16) vs. 32.8% (19/58)].
Headache and facial pain are prevalent during URTIs, and are associated with general and sinonasal immune response rather than virus type. Headache phenotype may depend on the causative microorganism, but it can evolve in response to previous immunisation. Our study supports vaccination against COVID-19, as people with prior immunisation are probably less likely to experience migraine-like headache.
本研究旨在比较常见上呼吸道感染（URTI）患者的头痛和面部疼痛患病率以及头痛表型。
头痛是病毒性URTI的常见症状，但迄今为止其表型分析仅限于2019冠状病毒病（COVID-19）和流感。此外，科学出版物中很少讨论URTI患者面部疼痛的患病率。
使用半结构化问卷对有急性URTI症状的患者进行头痛表型评估。对所有参与者进行抗原拭子检测。
分析纳入了223例年龄在18 - 73岁[平均41.3岁/中位数（第25、75百分位数）40岁/标准差15.1]的患者（136名女性，占60.1%）的276次URTI/急性病毒性鼻-鼻窦炎（APVRS）发作。参与者被诊断为：COVID-19 - 107/276（38.8%）；“普通感冒” - 103/276（37.3%）；流感 - 36/276（13.0%）；或APVRS - 30/276（10.9%）。183/276（66.3%）存在头痛，107/276（38.8%）存在URTI和面部疼痛。URTI中头痛的预测因素包括鼻窦症状（比值比（OR）10.70，p < 0.001）和发热（OR 2.9，p = 0.004）。头痛在COVID-19中更常表现为偏头痛样表型（27.4%（20/73）对9.1%（10/110）），在“普通感冒”中更常表现为紧张型头痛（TTH）样表型（75.4%，49/64对61.3%，73/119）（p = 0.030）。既往COVID-19免疫接种（疫苗接种或感染）与较低的偏头痛样头痛患病率相关（p = 0.004）[6.3%（1/16）对32.8%（19/58）]。
头痛和面部疼痛在URTI期间很常见，并且与全身和鼻窦免疫反应相关，而非病毒类型。头痛表型可能取决于致病微生物，但可因既往免疫接种而发生变化。我们的研究支持COVID-19疫苗接种，因为既往免疫接种的人可能较少经历偏头痛样头痛。
