Headache in long COVID as disabling condition: A clinical approach

Rodrigues, Arthur Nascimento; Dias, Ápio Ricardo Nazareth; Paranhos, Alna Carolina Mendes; Silva, Camilla Costa; Bastos, Thalita da Rocha; Brito, Bárbara Barros de; Silva, Nívia Monteiro da; Sousa, Emanuel de Jesus Soares de; Quaresma, Juarez Antônio Simões; Falcão, Luiz Fábio Magno

doi:10.3389/fneur.2023.1149294

Cited by 9 publications

(4 citation statements)

References 39 publications

(61 reference statements)

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“…Frequency of chronic headache range widely from ~8-40% among long COVID cases (46,(63)(64)(65). Individuals mildly affected by SARS-CoV-2 infections seemed more prone to post-COVID headaches (64,66), which were exacerbated with a prior history of migraines (63, 64).…”

Section: Discussionunclassified

The impact of COVID-19 on pulmonary, neurological, and cardiac outcomes: evidence from a Mendelian randomization study

Shenoy,

Udupa,

et al. 2023

Front. Public Health

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BackgroundLong COVID is a clinical entity characterized by persistent health problems or development of new diseases, without an alternative diagnosis, following SARS-CoV-2 infection that affects a significant proportion of individuals globally. It can manifest with a wide range of symptoms due to dysfunction of multiple organ systems including but not limited to cardiovascular, hematologic, neurological, gastrointestinal, and renal organs, revealed by observational studies. However, a causal association between the genetic predisposition to COVID-19 and many post-infective abnormalities in long COVID remain unclear.MethodsHere we employed Mendelian randomization (MR), a robust genetic epidemiological approach, to investigate the potential causal associations between genetic predisposition to COVID-19 and long COVID symptoms, namely pulmonary (pneumonia and airway infections including bronchitis, emphysema, asthma, and rhinitis), neurological (headache, depression, and Parkinson’s disease), cardiac (heart failure and chest pain) diseases, and chronic fatigue. Using two-sample MR, we leveraged genetic data from a large COVID-19 genome-wide association study and various disorder-specific datasets.ResultsThis analysis revealed that a genetic predisposition to COVID-19 was significantly causally linked to an increased risk of developing pneumonia, airway infections, headache, and heart failure. It also showed a strong positive correlation with chronic fatigue, a frequently observed symptom in long COVID patients. However, our findings on Parkinson’s disease, depression, and chest pain were inconclusive.ConclusionOverall, these findings provide valuable insights into the genetic underpinnings of long COVID and its diverse range of symptoms. Understanding these causal associations may aid in better management and treatment of long COVID patients, thereby alleviating the substantial burden it poses on global health and socioeconomic systems.

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Section: Discussionunclassified

The impact of COVID-19 on pulmonary, neurological, and cardiac outcomes: evidence from a Mendelian randomization study

Shenoy,

Udupa,

et al. 2023

Front. Public Health

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“…Neurological symptoms are frequently observed and the most common include headache, cognitive impairment, brain fog, fatigue syndrome and neuropsychiatric disorders like depression and sleep disturbances [ 54 – 56 ]. Other symptoms include cardiovascular, pulmonary/respiratory or musculoskeletal disorders [ 55 ]. The symptoms and course of long COVID vary depending on the viral variant that caused the infection [ 57 , 58 ].…”

Section: Environmental and Occupational Issues Based On The Example O...mentioning

confidence: 99%

Health equity, care access and quality in headache – part 1

Tana,

Raffaelli,

Souza

et al. 2024

J Headache Pain

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Current definitions of migraine that are based mainly on clinical characteristics do not account for other patient’s features such as those related to an impaired quality of life, due to loss of social life and productivity, and the differences related to the geographical distribution of the disease and cultural misconceptions which tend to underestimate migraine as a psychosocial rather than neurobiological disorder.Global differences definition, care access, and health equity for headache disorders, especially migraine are reported in this paper from a collaborative group of the editorial board members of the Journal of Headache and Pain. Other components that affect patients with migraine, in addition to the impact promoted by the migraine symptoms such as stigma and social determinants, are also reported.

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“…Headache has been identified as a common and significant issue in long COVID patients [104,105]. Duration of headaches in long COVID patients can be prolonged, impacting their quality of life [106]. It has been suggested that long COVID headaches may develop due to the activation of an existing headache condition or in patients with history of migraines [104].…”

Section: The Kynurenine Pathway Dysregulation and Its Implications Fo...mentioning

confidence: 99%

The roles of the kynurenine pathway in COVID-19 neuropathogenesis

Dehhaghi,

Heydari,

Panahi

et al. 2024

Infection

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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of the highly contagious respiratory disease Corona Virus Disease 2019 (COVID-19) that may lead to various neurological and psychological disorders that can be acute, lasting days to weeks or months and possibly longer. The latter is known as long-COVID or more recently post-acute sequelae of COVID (PASC). During acute COVID-19 infection, a strong inflammatory response, known as the cytokine storm, occurs in some patients. The levels of interferon‐γ (IFN‐γ), interferon-β (IFN-β), interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-α) are particularly increased. These cytokines are known to activate the enzyme indoleamine 2,3-dioxygenase 1 (IDO-1), catalysing the first step of tryptophan (Trp) catabolism through the kynurenine pathway (KP) leading to the production of several neurotoxic and immunosuppressive metabolites. There is already data showing elevation in KP metabolites both acutely and in PASC, especially regarding cognitive impairment. Thus, it is likely that KP involvement is significant in SARS-CoV-2 pathogenesis especially neurologically.

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Headache in long COVID as disabling condition: A clinical approach

Cited by 9 publications

References 39 publications

The impact of COVID-19 on pulmonary, neurological, and cardiac outcomes: evidence from a Mendelian randomization study

The impact of COVID-19 on pulmonary, neurological, and cardiac outcomes: evidence from a Mendelian randomization study

Health equity, care access and quality in headache – part 1

The roles of the kynurenine pathway in COVID-19 neuropathogenesis

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