Choi Soyoun, Hong Yooha, Kang Mi-Kyoung, Song Tae-Jin, Cho Soo-Jin
Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Korea.
Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea.
J Korean Med Sci. 2025 Jun 30;40(25):e127. doi: 10.3346/jkms.2025.40.e127.
The coronavirus disease 2019 (COVID-19) pandemic has underscored the need for effective treatment for post-infectious complications, including headaches. Owing to the variable nature of post-COVID headaches, identifying effective therapies through clinical trials is challenging and the burden on patients is often severe. This study aimed to summarize the presentation of post-COVID headache in clinical practice and evaluate its response to treatment with calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs).
In this retrospective cohort study, medical records obtained between March 2022 and May 2024 from two centers were analyzed. The study included nine patients with new-onset or significantly worsening or altered patterns of previous headaches lasting more than one month after COVID-19 infection who subsequently received CGRP mAbs. Demographics, headache frequency and severity, medication use, and quality of life were assessed before and after CGRP mAb treatment.
All patients were female (median age, 48 years), and 88.9% had headaches for more than three months despite conventional preventive therapies. Headache Impact Test-6 (HIT-6) scores were greater than 60 in all patients, and the headaches were unilateral (66.7%) and pulsating (22.2%). After CGRP mAb treatment, the monthly headache days, headache severity scores, and monthly medication days decreased significantly (median with interquartile range: 25 [15-28] to 5 [4-10], = 0.012; 8 [7-9] to 3 [2-4], = 0.011; 16 [15-20] to 5 [4-10], = 0.017). The HIT-6 (65 [60-68] to 48 [48-60], = 0.017) and Patient Health Questionnaire-9 scores (14 [5-15] to 10 [4-12], = 0.028) also decreased significantly after treatment.
CGRP mAbs may be considered a potential treatment option for persistent headaches following COVID-19, especially the long-COVID headaches. Their use may contribute to an improved burden of headache and quality of life and may help alleviate the psychological symptoms associated with persistent headaches.
2019年冠状病毒病（COVID-19）大流行凸显了对包括头痛在内的感染后并发症进行有效治疗的必要性。由于新冠后头痛的性质多变，通过临床试验确定有效疗法具有挑战性，且患者负担往往很重。本研究旨在总结新冠后头痛在临床实践中的表现，并评估其对降钙素基因相关肽（CGRP）单克隆抗体（mAbs）治疗的反应。
在这项回顾性队列研究中，分析了2022年3月至2024年5月期间从两个中心获取的医疗记录。该研究纳入了9例在COVID-19感染后出现新发或既往头痛模式显著恶化或改变且持续超过1个月的患者，这些患者随后接受了CGRP mAbs治疗。在CGRP mAb治疗前后评估了人口统计学、头痛频率和严重程度、药物使用情况以及生活质量。
所有患者均为女性（中位年龄48岁），尽管接受了常规预防性治疗，但88.9%的患者头痛持续超过3个月。所有患者的头痛影响测试-6（HIT-6）评分均大于60，头痛为单侧性（66.7%）且呈搏动性（22.2%）。CGRP mAb治疗后，每月头痛天数、头痛严重程度评分和每月用药天数均显著减少（中位数及四分位间距：25[15 - 28]降至5[4 - 10]，P = 0.012；8[7 - 9]降至3[2 - 4]，P = 0.011；16[15 - 20]降至5[4 - 10]，P = 0.017）。治疗后HIT-6（65[60 - 68]降至48[48 - 60]，P = 0.017）和患者健康问卷-9评分（14[5 - 15]降至10[4 - 12]，P = 0.028）也显著降低。
CGRP mAbs可被视为COVID-19后持续性头痛，尤其是长期新冠头痛的一种潜在治疗选择。其使用可能有助于减轻头痛负担和改善生活质量，并可能有助于缓解与持续性头痛相关的心理症状。
