Background Neurological symptoms are frequent among patients with COVID-19. Little is known regarding the repercussions of neurological symptoms for patients and how these symptoms are related to one another. Objectives To determine whether there is an association between the neurological symptoms in patients with COVID-19, and to characterize the headache. Method This was a cross-sectional study. All hospital inpatients and health workers at the Hospital Universitario Oswaldo Cruz with a PCR-confirmed COVID-19 infection between March and June 2020 were considered for the study and were interviewed by telephone at least 2-months after the acute phase of the disease. These patients were identified by the hospital epidemiological surveillance department. A semi-structured questionnaire was used containing sociodemographic and clinical data and the ID-Migraine. Results A total of 288 patients was interviewed; 53.1% were male; with a median age of 49.9 (41.5–60.5) years; 91.7% presented some neurological symptom; 22.2% reported some neurological symptom as the symptom that troubled them most during COVID-19. Neurological symptoms were: ageusia (69.8%), headache (69.1%), anosmia (67%), myalgia (44.4%), drowsiness (37.2%), agitation (20.8%); mental confusion (14.9%), syncope (4.9%) and epileptic seizures (2.8%). Females, those who presented with fever, sore throat, anosmia/ageusia and myalgia also presented significantly more with headache (logistic regression). The most frequent headache phenotype was a non-migraine phenotype, was of severe intensity and differed from previous headaches. This persisted for more than 30 days in 18% and for more than 90 days in 10% of patients. Thirteen percent of those with anosmia and 11% with ageusia continued with these complaints after more than 90 days of the acute phase of the disease. Aged over 50 years, agitation and epileptic seizures were significantly associated with mental confusion (logistic regression). Conclusion Headache is frequent in COVID-19, is associated with other symptoms such as fever, sore throat, anosmia, ageusia, and myalgia, and may persist beyond the acute phase of the disease.
IntroduçãoEstima-se que a frequência de cefaleia em pacientes com COVID-19 em torno de 12%. No entanto, pouco se sabe sobre as características destas cefaleias. Temos como objetivos estimar a frequência das cefaleias apresentadas por pacientes com COVID-19 e estudar suas características.MétodoTrata-se de um estudo transversal. Pacientes atendidos no Hospital Universitário Oswaldo Cruz de março de 2020 a junho de 2020 com diagnóstico de COVID-19 (RT-PCR positivo) foram incluídos. Os pacientes foram identificados a partir do registro no Setor de Vigilância Epidemiológica do hospital e foram entrevistados por telefone sobre da presença e características das cefaleias. As entrevistas foram feitas por médicos e estudante de medicina treinados. Foram utilizados questionário semi-estruturado e o migraine-ID. Esta pesquisa foi aprovada pelo pala CONEP (CAAE: 30479220.8.0000.5192; Número do Parecer 4.082.904.ResultadosForam entrevistadas 183 pessoas, 100/183 (55%) eram mulheres, idade média de 48,6 ± 14,3 anos, 137/183 (74,9%) tiveram cefaleias associadas à COVID-19, em 23/183 (13%) a cefaleia foi o sintoma que mais incomodou. As mulheres tiveram mais cefaleia do que os homens (83% vs 65%; qui-quadrado; p< 0,05). Não houve diferença em relação à idade (47 ± 13 vs 53 ± 16 anos; Mann-Whitney; p: 0,054). Em 74/137 (54%) esta cefaleia tinha um padrão não migranoso; em 74/137 (54%) a cefaleia foi incapacitante; em 49/137 (35,8%) foi associada à náuseas e em 62/137 (45,3%), à fotofobia. A duração média da cefaleia foi de 9 ± 9 dias. Em 56/183 (31%) das pessoas, a cefaleia foi o primeiro sintoma da COVID-19. Sessenta e nove pessoas com cefaleia associada à COVID-19 tinham cefaleia prévia, desses, 52/69 (75,4%) avaliaram que a cefaleia da COVID-19 como diferente da cefaleia anterior.ConclusõesA cefaleia é um sintoma frequente e importante em pessoas com COVID-19. Esta cefaleia em geral tem padrão não migranoso e é diferente das cefaleias anteriores.
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