Objectives Headache is considered one of the most frequent neurological manifestations of COVID-19. This work aimed to identify the relative frequency of COVID-19 related headache and to clarify the impact of clinical, laboratory findings of COVID-19 infection on headache occurrence and its response to analgesics. Design Cross-sectional study Setting Recovered COVID-19 patients Subjects 782 patients with a confirmed diagnosis of COVID-19 infection. Methods Clinical, laboratory and imaging data were obtained from the hospital medical records. Regarding patients who developed COVID-19 related headache, a trained neurologist performed an analysis of headache and its response to analgesics. Results The relative frequency of COVID-19 related headache among our sample was 55.1% with 95% CI (0.516–0.586) for the estimated population prevalence. Female gender, malignancy, primary headache, fever, dehydration, lower levels of hemoglobin and platelets and higher levels of neutrophil/lymphocyte ratio (NLR) and CRP were significantly associated with COVID-19 related headache. Multivariate analysis revealed that female gender, fever, dehydration, primary headache, high NLR, and decreased platelet count were independent predictors of headache occurrence. By evaluating headache response to analgesics, old age, diabetes, hypertension, primary headache, severe COVID-19, steroid intake, higher CRP and ferritin and lower hemoglobin levels were associated with poor response to analgesics. Multivariate analysis revealed that primary headache, steroids intake, moderate and severe COVID-19 were independent predictors of non-response to analgesics. Discussion Headache occurs in 55.1% of patients with COVID-19. Female gender, fever, dehydration, primary headache, high NLR, and decreased platelet count are considered independent predictors of COVID-19 related headache.

Objectives To assess risk factors for persistent neuropathic pain in subjects recovered from COVID-19 and to study the serum level of neurofilament light chain (NFL) in those patients. Design Case-control study Setting Persistent post COVID-19 pain Subjects 45 patients with post COVID-19 pain and another 45 age and sex-matched healthcare workers who recovered from COVID-19 without pain. Methods The included participants were subjected to medical history taking, screening for depressive disorders, comprehensive neurological examination, and pain evaluation using the Douleur Neuropathique en 4 questions (DN4). All patients who had a score at least 4/10 on DN4 were included. The serum NFL level was measured for both groups at the time of patients’ enrollment. Results The frequency of depression, moderate and severe COVID-19 cases, disease duration and serum ferritin were significantly higher in the cases with post COVID-19 pain than controls. Binary logistic regression revealed that depression, azithromycin use, moderate and severe COVID-19 increased the odds of post COVID-19 pain by 4.462, 5.444, 4.901, & 6.276 times, respectively. Cases with post COVID-19 pain had significantly higher NFL (11.34 ± 9.7, 95%CI: 8.42 – 14.25) than control group (7.64 ± 5.40, 95%CI: 6.02–9.27), (P-value= 0.029). Patients with allodynia had significantly higher NFL (14.96 ± 12.41, 95%CI: 8.58—21.35) compared to those without (9.14 ± 6.99, 95%CI: 6.43—11.85) (P-value= 0.05). Discussion Depression, azithromycin, moderate and severe COVID-19 are independent predictors of persistent post COVID-19 pain. Serum NFL may serve as a potential biomarker for persistent neuropathic pain after COVID-19.

Health care workers (HCWs) are at high risk of exposure to hepatitis B virus (HBV) and hepatitis C virus (HCV) transmission due to injuries and frequency of exposure. We aimed to assess HBV/HCV seroprevalence among nurses and housekeepers in Beni-Suef University Hospital, and to identify possible risk factors.A cross sectional study was conducted from March to July 2016 using a self-administered questionnaire. A blood sample was withdrawn from each participant and tested for hepatitis B surface antigen (HBsAg) and HCV antibodies. Enzyme-linked immunosorbent assay (ELISA) seropositivity to HCV was confirmed by polymerase chain reaction (PCR).The study involved 175/255 participants with a response rate of 68.5%. Nurses constituted 76% and 24% were housekeepers. Overall prevalence of HCV seropositivity was 4.6%, detected by ELISA. Confirmatory PCR testing revealed positivity in 75% (6/8) of these. Cut injuries were a risk factor for HCV positivity (OR 4.388, 95% CI 0.859 -22.4, P= 0.05). Previous training and use of gloves was a protective factor (OR 0.135, 95% CI .016-1.118, P= 0.03 and OR 0.241, 95% CI 0.055-1.04, P= 0.04 respectively). None of the participants was found to be HBV seropositive. Practices and behaviours posing risk for HCWs included needle stick injury (NSI) and cut injuries. Focus on improving safety training programs to HCWs and provision of infection prevention equipment is needed. In addition regular reporting, follow up and assessment of occupational exposures should be in place.

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