Deep Phenotyping of Headache in Hospitalized COVID-19 Patients via Principal Component Analysis

Planchuelo‐Gómez, Álvaro; Trigo, Javier; Luis‐García, Rodrigo de; Guerrero, Ángel L; Porta‐Etessam, Jesús; García‐Azorín, David

doi:10.3389/fneur.2020.583870

Cited by 33 publications

(35 citation statements)

References 38 publications

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“…In agreement with this hypothesis, Planchuelo-Gómez et al. described two different COVID-19 related phenotypes of headache, i.e., tension-type like and migraine-like headache ( 28 ). We found that the presence of headache as a symptom in the acute phase was more prevalent in patients with pre-existing migraine, which may have important clinical implications for clinical examination.…”

Section: Discussionmentioning

confidence: 70%

The presence of headache at onset in SARS-CoV-2 infection is associated with long-term post-COVID headache and fatigue: A case-control study

Fernández‐de‐las‐Peñas

Gómez‐Mayordomo

Cuadrado

et al. 2021

Cephalalgia

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Objective To investigate the association of headache during the acute phase of SARS-CoV-2 infection with long-term post-COVID headache and other post-COVID symptoms in hospitalised survivors. Methods A case-control study including patients hospitalised during the first wave of the pandemic in Spain was conducted. Patients reporting headache as a symptom during the acute phase and age- and sex-matched patients without headache during the acute phase participated. Hospitalisation and clinical data were collected from medical records. Patients were scheduled for a telephone interview 7 months after hospital discharge. Participants were asked about a list of post-COVID symptoms and were also invited to report any additional symptom they might have. Anxiety/depressive symptoms and sleep quality were assessed with the Hospital Anxiety and Depression Scale and the Pittsburgh Sleep Quality Index. Results Overall, 205 patients reporting headache and 410 patients without headache at hospitalisation were assessed 7.3 months (Standard Deviation 0.6) after hospital discharge. Patients with headache at onset presented a higher number of post-COVID symptoms (Incident Rate Ratio: 1.16, 95% CI: 1.03–1.30). Headache at onset was associated with a previous history of migraine (Odd Ratio: 2.90, 95% Confidence Interval: 1.41–5.98) and with the development of persistent tension-type like headache as a new post-COVID symptom (Odd Ratio: 2.65, 95% CI: 1.66–4.24). Fatigue as a long-term symptom was also more prevalent in patients with headache at onset (Odd Ratio: 1.55, 95% CI: 1.07–2.24). No between-group differences in the prevalence of anxiety/depressive symptoms or sleep quality were seen. Conclusion Headache in the acute phase of SARS-CoV-2 infection was associated with higher prevalence of headache and fatigue as long-term post-COVID symptoms. Monitoring headache during the acute phase could help to identify patients at risk of developing long-term post-COVID symptoms, including post-COVID headache.

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Section: Discussionmentioning

confidence: 70%

The presence of headache at onset in SARS-CoV-2 infection is associated with long-term post-COVID headache and fatigue: A case-control study

Fernández‐de‐las‐Peñas

Gómez‐Mayordomo

Cuadrado

et al. 2021

Cephalalgia

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“…Migraine is a disabling neurological disease which can be also vulnerable to a negative impact by the COVID-19 outbreak (Szperka et al, 2020). Current data on this topic is heterogeneous, since Al-Hashel and Ismail (2020) reported that 60% of patients suffering from migraine experienced an increase in their frequency of attacks during the worldwide lockdown of March-April 2020, whereas Uygun et al (2020b) and Parodi et al (2020) did not find a significant worsening of previous primary headaches due to the pandemic. Schankin and Straube (2012) observed that patients with pre-existing primary headaches are more prone to develop other secondary headaches.…”

Section: Introductionmentioning

confidence: 99%

Previous History of Migraine Is Associated With Fatigue, but Not Headache, as Long-Term Post-COVID Symptom After Severe Acute Respiratory SARS-CoV-2 Infection: A Case-Control Study

Fernández‐de‐las‐Peñas

Gómez‐Mayordomo

García‐Azorín

et al. 2021

Front. Hum. Neurosci.

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ObjectiveTo investigate the association of pre-existing migraine in patients hospitalised and who recovered from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with the presence of post-coronavirus disease (COVID) symptoms.BackgroundNo study has investigated the role of migraine as a risk factor for development of post-COVID symptoms.MethodsA case-control study including individuals hospitalised during the first wave of the pandemic (from February 20 to May 31, 2020) was conducted. Patients with confirmed previous diagnosis of migraine were considered cases. Two age- and sex-matched individuals without a history of headache per case were also recruited as controls. Hospitalisation/clinical data were collected from hospital medical records. Patients were scheduled for a telephone interview. A list of post-COVID symptoms was systematically evaluated, but participants were invited to freely report any symptom. The Hospital Anxiety and Depression Scale and the Pittsburgh Sleep Quality Index were used to assess anxiety/depressive symptoms and sleep quality. Multivariable conditional logistic regression models were constructed.ResultsOverall, 57 patients with confirmed diagnosis of migraine and 144 non-migraine controls who had recovered from COVID-19 were assessed at 7.3 months (SD 0.6) after hospital discharge. The number of post-COVID symptoms in the migraine group was significantly greater (OR 1.70, 95% CI 1.29–2.25, P < 0.001) than in the non-migraine group. Fatigue was significantly more prevalent (OR 2.89, 95% CI 1.32–6.32, P = 0.008) in the migraine group. However, no between-groups difference in the prevalence of headache as a post-COVID symptom was detected.ConclusionPatients with a history of migraine who recovered from COVID-19 exhibited more long-term fatigue as post-COVID sequelae than those without migraine. Some of the pathophysiological changes associated with migraine could predispose to the occurrence of post-COVID symptoms.

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“…O fenótipo migranoso está associado a pior curso clínico da COVID-19 e dores mais intensas, e relaciona-se com alguns marcadores laboratoriais hematológicos e inflamatórios, como linfopenia e hiperfferitinemia; também observou-se nesse fenótipo redução da taxa de filtração glomerular e maior associação com diabetes. O fenótipo tipo tensional está relacionada a menores níveis de pró calcitonina e proteína c reativa, ambas potenciais biomarcadores de gravidade da infecção pelo SARS-CoV-2 quando presentes em altos níveis [15].…”

Section: Discussionunclassified

“…A cefaleia deve ser considerada um sintoma importante no curso clínico da COVID-19, tendo em conta que é um sintoma comum e incapacitante e frequentemente permanece como sequela após a doença [15]. No nosso estudo, a cefaleia foi a sequela pós fase aguda/subaguda mais comum dentre os pacientes que apresentaram resultado positivo para COVID-19, 36,4% dos nossos pacientes apresentou cefaleia recorrente após a fase aguda/subaguda.…”

Section: Discussionunclassified

Perfil da cefaleia em pacientes com covid-19 atendidos em programa de teleorientação em 2020 / Profile of headache in patients with covid-19 served in a teleorientation program in 2020

Salomão¹,

Ciríaco²,

Lima³

et al. 2021

Braz. J. Hea. Rev.

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Introdução: Manifestações neurológicas já foram relacionadas a Covid-19 e são divididas em três categorias: sistema nervoso central (tontura, cefaleia, doença cerebrovascular, convulsão e alteração de consciência), sistema nervoso periférico (anosmia, ageusia, deficiência visual, dor neuropática, síndrome de Guillain-Barré e variantes) e lesão muscular esquelética. A presença, em especial, de cefaleia varia de 2,8% a 71,1% [1], a análise desse sintoma pode contribuir para identificação precoce de casos da doença e para maior entendimento da apresentação clínica do SARS-Cov-2. Objetivos: O objetivo do estudo foi analisar o perfil epidemiológico da cefaleia em pacientes com suspeita clínica ou diagnosticados com Covid-19 através de RT-PCR e/ou sorologia, que fizeram uso do serviço de teleorientação do Projeto de Extensão Orienta Covid ES HUCAM-UFES no período de Junho a Agosto de 2020. Metodologia: Estudo individualizado, de caráter observacional e corte transversal, construído a partir de um banco de dados contendo informações de pacientes com suspeita clínica ou diagnosticados com Covid-19, atendidos pelo serviço de teleorientação, a partir do qual, foram coletadas as características da cefaleia, sintomas neurológicos associados, sequelas pós fase aguda, e a presença de outras comorbidades, relacionando-as com idade, sexo e procedência dos pacientes. Resultados: Foram realizados 88 atendimentos telefônicos, porém, apenas 69 deles apresentavam informações clínicas suficientes para a análise. A maioria dos pacientes atendidos eram mulheres (68,1%), com mediana de idade de 52 anos, a faixa etária similar com outros estudos [2], entretanto, a literatura relaciona o sexo masculino como maioria de casos atendidos. O quadro de cefaleia foi observado em 52,2% dos casos, na maioria das vezes contínua (36,6%), bilateral (44,4%), de moderada intensidade (30,5%), em aperto ou latejante (ambas 14%), a dor bilateral atendendo aos critérios de cefaleia tensional foi um achado comum nesse estudo, estando em consonância com apresentações vistas em outras publicações [3], diversos estudos apontam a cefaleia como sintoma presente em cerca de 15% dos casos [4]. Dos pacientes que apresentaram resultado positivo para COVID-19, 66,7% deles apresentaram alguma sequela pós fase aguda/subaguda da doença, dentre elas: anosmia e ageusia persistentes, esquecimento, doença renal crônica, poliartralgia, alopécia, enxaqueca recorrente e parestesia de membros inferiores. Conclusão: Reconhecer sintomas cardinais da COVID-19 é imprescindível para o aprimoramento do sistema de triagem de casos suspeitos, melhorando a assistência em especial de quadros atípicos da doença. Sendo a cefaleia um sintoma comum na infecção por SARS-Cov-2, a caracterização clínica deve ser bem estabelecida a fim de nortear o atendimento médico visando uma abordagem ágil para diagnóstico. Além disso, a vigilância neurológica deve ser rigorosa para o reconhecimento de complicações agudas e sequelas pós fase aguda.

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Deep Phenotyping of Headache in Hospitalized COVID-19 Patients via Principal Component Analysis

Cited by 33 publications

References 38 publications

The presence of headache at onset in SARS-CoV-2 infection is associated with long-term post-COVID headache and fatigue: A case-control study

The presence of headache at onset in SARS-CoV-2 infection is associated with long-term post-COVID headache and fatigue: A case-control study

Previous History of Migraine Is Associated With Fatigue, but Not Headache, as Long-Term Post-COVID Symptom After Severe Acute Respiratory SARS-CoV-2 Infection: A Case-Control Study

Perfil da cefaleia em pacientes com covid-19 atendidos em programa de teleorientação em 2020 / Profile of headache in patients with covid-19 served in a teleorientation program in 2020

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