COVID-19 and SARS-CoV-2 Vaccines: A Cameo Role for Headache

Martelletti, Paolo

doi:10.3390/ijerph20053914

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…Curation of large-scale electronic health record documented frequencies of AEs are much lower than their solicited frequencies reported in clinical trials (e.g., BioNTech/ Pfizer 1%; Moderna 1.1%). In addition, headache was recorded frequently as an AE in the placebo arms of randomized clinical trials for SARS-CoV-2 vaccines indicating a nocebo response [89,90].…”

Section: Commentmentioning

confidence: 99%

Headaches and facial pain attributed to SARS‐CoV‐2 infection and vaccination: a systematic review

Mitsikostas,

Caronna,

De Tommaso

et al. 2024

Euro J of Neurology

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Background and purposeThe aim was to provide insights to the characteristics of headache in the context of COVID‐19 on behalf of the Headache Scientific Panel and the Neuro‐COVID‐19 Task Force of the European Academy of Neurology (EAN) and the European Headache Federation (EHF).MethodsFollowing the Delphi method the Task Force identified six relevant questions and then conducted a systematic literature review to provide evidence‐based answers and suggest specific diagnostic criteria.ResultsNo data for facial pain were identified in the literature search. (1) Headache incidence during acute COVID‐19 varies considerably, with higher prevalence rates in prospective compared to retrospective studies (28.9%–74.6% vs. 6.5%–34.0%). (2) Acute COVID‐19 headache is usually bilateral or holocranial and often moderate to severe with throbbing pain quality lasting 2–14 days after first signs of COVID‐19; photo‐phonophobia, nausea, anosmia and ageusia are common associated features; persistent headache shares similar clinical characteristics. (3) Acute COVID‐19 headache is presumably caused by immune‐mediated mechanisms that activate the trigeminovascular system. (4) Headache occurs in 13.3%–76.9% following SARS‐CoV‐2 vaccination and occurs more often amongst women with a pre‐existing primary headache; the risk of developing headache is higher with the adenoviral‐vector‐type vaccines than with other preparations. (5) Headache related to SARS‐CoV‐2 vaccination is mostly bilateral, and throbbing, pressing, jolting or stabbing. (6) No studies have been conducted investigating the underlying mechanism of headache attributed to SARS‐CoV‐2 vaccines.ConclusionThe results of this joint EAN/EHF initiative provide a framework for a better understanding of headache in the context of SARS‐CoV‐2 infection and vaccination.

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Section: Commentmentioning

confidence: 99%

Headaches and facial pain attributed to SARS‐CoV‐2 infection and vaccination: a systematic review

Mitsikostas,

Caronna,

De Tommaso

et al. 2024

Euro J of Neurology

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“…Although post-vaccination headache in the acute setting is now well-recognized, little is known about the long-term course of these headaches. Whether these headaches subside over time or persist as part of long-COVID symptoms are some of the unclear points that require clarification [ 9 ]. Currently, only a few papers have reported on the long-term course of COVID-19 vaccination-related headaches, with a focus on headache characteristics.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 vaccination-related headache showed two different clusters in the long-term course: a prospective multicenter follow-up study (COVA-Head Study)

Atalar,

Acarlı,

Baykan

et al. 2023

J Headache Pain

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Background Although acute headache following COVID-19 vaccination is widely acknowledged, the long-term progression of these headaches remains poorly understood. Our objective was to identify various phenotypes of prolonged or worsened headaches associated with COVID-19 vaccination and document any changes in these phenotypes over an extended period. Additionally, we aimed to document the diverse headache presentations among patients with pre-existing primary headaches. Methods A multinational, prospective observational study was conducted to investigate prolonged or worsened headaches associated with COVID-19 vaccination. Questionnaires assessing COVID-19 vaccination-related headaches at three time points (initial visit, 3rd month follow-up, and 6th month follow-up) were developed for the study. Headache specialists/clinicians evaluated patients using these questionnaires in a prospective manner. Repeated K-means cluster analysis was performed to identify patient profiles with prolonged or worsened headaches related to COVID-19 vaccination. Results Among the 174 patients included in the study, there was a female-to-male ratio of 128 (73.6%) to 46 (26.4%). The mean age of the patient group was 45.2 ± 13.3 years, and 107 patients (61.5%) had a pre-existing history of primary headaches. Through the analysis, two major clusters were identified based on headache characteristics at each visit. During the first visit (n = 174), Cluster 1 primarily comprised patients with a history of primary headaches, frontal localization of pain, throbbing pain type, more severe headaches accompanied by symptoms such as nausea, phonophobia, photophobia, and osmophobia, and worsened by physical activity. In contrast, Cluster 2 consisted of patients with longer headache durations (over one month) and a stabbing/pressing quality of pain. Patients in Cluster 1 had a higher prevalence of migraine as the pre-existing primary headache disorder compared to Cluster 2 (90.48% vs. 68.18%, respectively; p = 0.005). Conclusion The identification of two distinct phenotypes of prolonged or worsened headaches related to COVID-19 vaccination can provide valuable clinical insights. Having an awareness of the potential worsening of headaches following COVID-19 vaccination, particularly in patients with a primary headache disorder such as migraine, can help clinicians and headache experts anticipate and adjust their treatment strategies accordingly. This knowledge can aid in preplanning treatment modifications and optimize patient care.

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COVID-19 and SARS-CoV-2 Vaccines: A Cameo Role for Headache

Cited by 2 publications

References 17 publications

Headaches and facial pain attributed to SARS‐CoV‐2 infection and vaccination: a systematic review

Headaches and facial pain attributed to SARS‐CoV‐2 infection and vaccination: a systematic review

COVID-19 vaccination-related headache showed two different clusters in the long-term course: a prospective multicenter follow-up study (COVA-Head Study)

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