Coronavirus Disease 2019 (COVID-19) from the point of view of Neurologists: Consideration of Neurological Findings and Symptoms during the Combat against a Pandemic

Acarlı, Ayşe Nur Özdağ; Samancı, Bedia; Eki̇zoğlu, Esme; Çakar, Arman; Şırın, Nermin Görkem; Gündüz, Tuncay; Parman, Yeşim; Baykan, Betül

doi:10.29399/npa.26148

Cited by 23 publications

(36 citation statements)

References 43 publications

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“…There are some studies and reviews highlighting that the most common neurological symptom is headache, often accompanied by high fever, moreover headache can occasionally be seen alone as the first sign of the disease [2,7]. A recent meta-analysis reported that the prevalence of headache was 10.9% with a high level of heterogeneity [8].…”

Section: Introductionmentioning

confidence: 99%

Headache characteristics in COVID-19 pandemic-a survey study

et al. 2020

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Background Headache is the most common COVID-19-related neurological symptom. We aimed to reveal diagnostic clues of headache for COVID-19 infection and to investigate the course of primary headaches during the pandemic. Methods We developed a detailed web-based questionnaire screening the characteristics and course of headaches besides clinical COVID-19 features. The participants were grouped according to being diagnosed with COVID-19 infection or not, and having previous or new-onset headaches. The COVID-19 related headache features and their associations with other clinical features were investigated. A binary logistic regression model was performed to differentiate the characteristics of headache related to COVID-19. Findings A total of 3458 participants (2341 females;67.7%, 1495 healthcare workers;43.2%) with a mean age of 43.21 ± 11.2 years contributed to the survey. Among them, 262 participants had COVID-19 diagnosis and 126 (48.1%) were male. The rate of males in the group without COVID-19 was 31% (991 out of 3196 participants) showing significant gender difference between groups (p < 0.000). COVID-19 related headaches were more closely associated with anosmia/ageusia and gastrointestinal complaints (p < 0.000 and p < 0.000), and showed different characteristics like pulsating, pressing, and even stabbing quality. Logistic regression analyses showed that bilateral headache, duration over 72 h, analgesic resistance and having male gender were significant variables to differentiate COVID-19 positive patients from those without COVID-19 (p = 0.04 for long duration and p < 0.000 for others). A worsening of previous primary headaches due to the pandemic-related problems was not reported in the majority of patients. Interpretation Bilateral, long-lasting headaches, resistance to analgesics and having male gender were more frequent in people with COVID-19 in conjunction with anosmia/ageusia and gastrointestinal complaints. These features may be helpful for diagnosing the headache related to COVID-19 during the pandemic.

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Section: Introductionmentioning

confidence: 99%

Headache characteristics in COVID-19 pandemic-a survey study

et al. 2020

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“…[3][4][5] To date, there are some studies and reviews highlighting that the most common neurological symptom is headache, often accompanied by high fever, whereas headache can occasionally be seen alone as the rst sign of the disease. 2,6 Therefore, detailed questioning of the presence of headaches in patients who admitted to the emergency and outpatient departments is still an important step in the prompt recognition of the infection in some patients.…”

Section: Introductionmentioning

confidence: 99%

The Emergence of a New Form of Headache in COVID-19 Pandemic Era

Uygun¹,

Ertaş²,

Eki̇zoğlu³

et al. 2020

Preprint

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BackgroundHeadache is the most common COVID-19-related neurological symptom. But, diagnostic clues of headache for COVID-19 infection are not well known. MethodsWe developed a detailed web-based questionnaire screening the characteristics and course of headaches besides clinical COVID-19 features. The participants were grouped according to being diagnosed with COVID-19 infection or not, and having previous or new-onset headaches. The COVID-19 related headache features and their associations with other clinical features were investigated. A binary logistic regression model was performed to differentiate the characteristics of headache related to COVID-19. Findings 3458 participants (2341 females;67.7%, 1495 healthcare workers;43.2%) with a mean age of 43.21±11.2 years experiencing headache during pandemic contributed to the survey. Among them, 262 participants had COVID-19 and 126(48.1%) were male. The rate of males in the group without COVID-19 was 31% (991 out of 3196 participants) showing significant gender difference between groups (p<0.000). COVID-19 related headaches were more closely associated with anosmia/ageusia and gastrointestinal complaints (RR=3.7 and RR=1.33, respectively), showed different characteristics like pulsating, pressing, and even stabbing quality. Logistic regression analyses showed that bilateral headache, duration over 72 hours, analgesic resistance and having male gender were significant variables to differentiate COVID-19 positive patients from those without COVID-19 (p<0.000 for all variables). A worsening of previous primary headaches due to the pandemic-related problems was not the rule in majority of patients.Interpretation Bilateral, long-lasting headaches, resistance to analgesics and having male gender were more frequent in people with COVID-19 in conjunction with the anosmia/ageusia and gastrointestinal complaints. These features may be helpful for COVID-19 diagnosis in the clinical evaluation of headache patients during the pandemic.Funding: This study was funded by Scientific Research Projects Coordination Unit of Istanbul University with a project number of GAP-36802.

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“…It is reported that a variety of symptoms and syndromes such as headache, dizziness, confusion, ataxia, epilepsy, ischemic stroke, neuropathic pain, and myopathy are common especially in more severe coronavirus disease-2019 (COVID-19) patients. 1,2 SARS-CoV-2 may cause headache symptoms through direct or indirect mechanisms 3 and could be a new member of neuroinvasive viruses due to the complex nature of the inflammation. 1 Surprisingly, the risk factors and comorbid disorders of COVID-19 are somewhat different from other respiratory viral illnesses.…”

Section: Introductionmentioning

confidence: 99%

Are Migraine Patients at Increased Risk for Symptomatic Coronavirus Disease 2019 Due to Shared Comorbidities?

et al. 2020

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The coronavirus disease 2019 (COVID-19) pandemic has rapidly transformed the whole world and forced us to look through comorbid diseases and risk factors from a different perspective. COVID-19 shows some inherent risk factors like cardiovascular comorbidities independent from age, gender, and geographic location. One of the most peculiar features of the COVID-19 pandemic is that severe acute respiratory syndrome coronavirus 2 respiratory infections disproportionately impact patients with hypertension, diabetes, and other cardiovascular comorbidities rather than those with allergic respiratory diseases and immunecompromised conditions. Migraine is a complex neuro-vasculo-inflammatory disorder that is also packed frequently with certain medical conditions including vascular disorders, hypertension, allergic diseases such as asthma and systemic inflammatory disorders. Accordingly, 2 different questions arise during the pandemic: (1) Do share comorbidities of cardiovascular diseases and hypertension increase the risk of symptomatic COVID-19 for migraine patients? (2) Do comorbid allergic and atopic diseases, including asthma act as opposite influencers alongside with female gender? This paper focuses on the coexistence of comorbidities of COVID-19, in comparison with migraine, based on a wide clinical dataset and available reports. Discussed mechanisms include potential strategic roles of angiotensin-converting enzyme 2, angiotensin-II, and nucleotide oligomerization domain-like receptor family, pyrin domain containing 3 inflammasome, playing remarkable parts in the pathogenesis of COVID-19 and migraine. There are also some clues about the importance of endothelial and pericyte dysfunction and neuroinflammation in COVID-19 infection, related to complications and survival of the patients. The large epidemiological studies as well as basic research, focusing on migraine patients with COVID-19 will clarify these vital questions during the upcoming periods.

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Coronavirus Disease 2019 (COVID-19) from the point of view of Neurologists: Consideration of Neurological Findings and Symptoms during the Combat against a Pandemic

Cited by 23 publications

References 43 publications

Headache characteristics in COVID-19 pandemic-a survey study

Headache characteristics in COVID-19 pandemic-a survey study

The Emergence of a New Form of Headache in COVID-19 Pandemic Era

Are Migraine Patients at Increased Risk for Symptomatic Coronavirus Disease 2019 Due to Shared Comorbidities?

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