Headache and Covid-19: Etiopathogenetic Links, Diagnostic Features and Treatmetn Approaches

Abstract

COVID-19 is a human respiratory disease caused by the SARS-CoV-2 coronavirus. However, in most cases, COVID-19 is accompanied by neurological involvement, leading to persistent consequences. Even individuals, both adults and children, with mild forms of the disease may experience recurrent neurological and neuropsychiatric symptoms following the acute phase and beyond. Headache is one of the most common early symptoms of COVID-19. Beyond being a clinical condition, it significantly impacts the quality of life and poses an economic burden on society. Throughout the ongoing COVID-19 pandemic, headache has emerged as a serious neurological symptom associated with SARS-CoV-2 infection and is even considered among its cardinal symptoms. In this review, we highlight the latest research publications on headache as a symptom of post-COVID syndrome based on data published over the past 3 years. The purpose of this study is to enhance the management of patients with post-COVID headache by analyzing studies investigating the prevalence, pathogenesis, and phenotypic characteristics of headache following COVID-19. By identifying existing challenges and seeking optimal solutions, we aim to optimize the care and treatment of patients experiencing post-COVID headache. Among the pronounced features of SARS-CoV-2 infection there is the ability to cause exacerbation (increased intensity, frequency, duration of headache attacks) or chronic headache in patients with a history of primary headache. In addition, patients with COVID-19 and a history of primary headache may develop a qualitatively new headache during the acute phase of the disease.
 To date, there are no specific treatments, and most clinicians treat headache after COVID-19 based on the similarity of the clinical phenotype to other types of primary headache. Given the significant negative impact of headache in COVID-19, additional research is needed to make informed choices about optimal treatment methods. Thus, the problem of headache in patients who have experienced COVID 19 is an urgent medical and social challenge that requires relevant modern knowledge for its timely diagnosis and effective management.