Case Series of Headache Characteristics in COVID‐19: Headache Can Be an Isolated Symptom

Abstract

Headache was reported in up to one‐third of the hospitalized patients; yet, the clinical characteristics of headache associated with coronavirus disease 2019 (COVID‐19) have not been defined. This observational case study included patients who were consulted to headache unit due to headache and had COVID‐19 illness. Headache features in 13 PCR‐confirmed COVID‐19 patients with mild symptoms were reported. Headache was the isolated symptom of the COVID‐19 in 3 patients and emerged as an early symptom during the disease course in all patients. Patients specified severe, rapid onset, unrelenting headache with migraine‐like features, as well as unusual sensory symptoms such as anosmia, and gastrointestinal symptoms such as diarrhea and loss of appetite and weight. Headache lasted up to 3 days in 70% of the patients and resolved in all patients within 2 weeks. Despite the fact that most of the patients were female and headache characteristics were suggestive of migraine, majority of patients were not suffering from primary headaches. It was concluded that headache could be an isolated symptom of COVID‐19, which might possibly be ignored in asymptomatic patients. Headaches associated with COVID‐19 included features resembling migraine and/or atypical symptoms including anosmia and diarrhea.

The scRNA-seq Expression Profiling of the Receptor ACE2 and the Cellular Protease TMPRSS2 Reveals Human Organs Susceptible to SARS-CoV-2 Infection

“…Therefore, epidemic prevention experts recommend paying attention to good personal hygiene and food handling practices. In addition, neurological symptoms such as headache, loss of sense of smell, amblyopia, weakness, and myalgia were described in some COVID-19 patients [ 5 , 74 , 75 ]. Our results show that the expression ratio of ACE2 in the cortex and substantia nigra of healthy people is higher than that in AT2 cells, which indicates that SARS-CoV-2 can also invade the nervous system.…”

Prevalence of Headache in Patients With Coronavirus Disease 2019 (COVID-19): A Systematic Review and Meta-Analysis of 14,275 Patients

“…Studies on the mechanism of CNS involvement in patients with COVID-19 have been carried out, and the main mechanism for damage was found to be inflammationcausing blood-brain barrier deterioration and inflammation of endothelial cells in vascular and cerebral tissues (34). These can explain the main migraine-like characteristics of some description in the literature (14)(15)(16). More should however be explained, possibly through larger studies on headache characteristics together with other parameters on inflammation, thrombophilic alteration, brain histology in autopsies, brain scan, and perfusion.…”

“…Presence of headache was linked to other central nervous system (CNS) manifestations in patients with COVID-19, suggesting that it is also a CNS-associated infectious disease (13). Headache in patients with COVID-19 does not seem to have any particular characteristics, as it is described as tension-type headache or migraine without aura (14)-the two most frequently observed types of headache (12), or a migraine-like headache type (15,16). As in previous reports on other coronaviruses, headache was an important symptom; we hypothesized the same for COVID-19 and intended to explore if it carries a prognostic value for early detection of the disease.…”

Acute and Post-Acute Neurological Complications of COVID-19

“…The Prevalence of headache was also reported to be as high as 70% in multicenter European study [ 58 ]. Additionally, headache was found to be an isolated symptom of COVID-19 in some cases [ 59 ]. A retrospective cohort study by Trigo and colleagues assessed the factors that are associated with the presence of headache in hospitalized COVID-19 patients and found that the frequency of headache was 23.7%.…”