Headache characteristics in COVID-19 pandemic-a survey study

Abstract

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.

Neurological manifestations of patients with mild-to-moderate COVID-19 attending a public hospital in Lima, Peru

“…For example, in a meta-analysis of 86 studies ( n = 14,275), the pooled prevalence of headache was much lower than that of our study (10.1%), with no significant difference in headache prevalence among severe/critically-ill vs. non-severe COVID-19 patents ( p = 0.78) [ 28 ]. Similar to the population in our study, one survey study from Turkey of patients with COVID-19 infection treated in an outpatient setting, found that new-onset headaches occurred in 33% of the population, and more common among those with COVID-19 compared to controls [ 29 ]. Our study has demonstrated a higher prevalence of headache than both of these studies, demonstrating the potential utility of headache as a clinical symptom of COVID-19 infection.…”

Triggers of Migraine during COVID-19 Pandemic Lockdown

“…Our result showed that stress was a common trigger for migraine in 24% which is similar to result of Uygun who reported that stress was triggers for headache in up to 30% of the participants [19]. Hearing or reading continuously about the COVID-19 from media can be stressful.…”

Neurological manifestations of patients with mild-to-moderate COVID-19 attending a public hospital in Lima, Peru

“…For example, in a meta-analysis of 86 studies (n=14,275), the pooled prevalence of headache was much lower than that of our study (10.1%), with no significant difference in headache prevalence among severe/critically-ill vs. non-severe COVID-19 patents (p=0.78) 28 . Similar to the population in our study, one survey study from Turkey of patients with COVID-19 infection treated in an outpatient setting, found that new-onset headaches occurred in 33% of the population, and more common among those with COVID-19 compared to controls 29 .…”