Headaches associated with acute SARS-CoV-2 infection: A prospective cross-sectional study

Abstract

Objectives: The prevalence and characteristics of COVID-19-related headaches are not known in Indian patients. We aim to determine the prevalence and characteristics of headache in COVID-19-infected individuals and make a comparison with those without headaches. Methods: This prospective cross-sectional observational study was conducted from 1 October to 31 October 2020. Data were collected using a detailed questionnaire. We compared the data of those with and without headaches to identify the differences between the groups. Results: During the study period of 1 month, among 225 COVID-19-infected patients, 33.8% patients had headaches. The mean age of patients with headache was 48.89 ± 15.19 years. In all, 53.9% were females. In 65.8%, headache occurred at the onset of viral illness; 44.7% described the headache as dull aching; 39.5% had bifrontal headache; and 32.9% had holocranial headache. In total, 78.9% had complete resolution of headache within 5 days. A comparison between those with and without headaches showed that those with headaches were more younger (48.89 ± 15.19 vs 54.61 ± 14.57 years, p = 0.007) and of female gender (41/76(53.9%) vs 41/149 (27.5%), p = 0.001). Primary headache disorders were more common in the headache group. Levels of inflammatory markers such as leukocyte count (7234.17 ± 3054.96 vs 8773.35 ± 5103.65, p = 0.017), erythrocyte sedimentation rate (39.28 ± 23.29 vs 50.41 ± 27.61, p = 0.02) and ferritin (381.06 ± 485.2 vs 657.10 ± 863.80, p = 0.014) were lower in those with headaches. Conclusions: Headaches are a common and early symptom of acute SARS-CoV-2 infection more frequently seen in young females and in those with a history of primary headache disorders. The lower level of inflammatory markers in those with headaches suggests that these headaches are probably due to the local spread of virus through the trigeminal nerve endings, resulting in activation of the trigeminovascular system.

Patterns of COVID-19-related headache: A cross-sectional study

“…In an observational study, Porta-Etessam et al revealed that the COVID-19 headache is mostly holocranial, pressing, and exacerbated with activity [23] . Souza et al reported that patients mostly described the headache as dull aching, bifrontal, mild to moderate intensity with complete resolution within 5 days [24] . In line with the literature, our subjects with new-onset headache described their pain as lasting for 4 days, and mostly bilaterally or localized in the forehead, pulsating type, moderate to severe intensity, with a partial response to analgesics.…”

“…However, there have also been some differences among studies of COVID-19-related headache. Some have reported male dominance [22] , [28] others have reported female dominance [23] , [24] . Most of our subjects were female, which may be attributed to the high enrollment of healthcare workers in this study, with most being female nurses.…”

“…Porta-Etessam et al described the headaches as mostly holocranial, pressing, and exacerbated by activity [23] . Souza et al reported they were dull aching, bifrontal, mild to moderate intensity, with complete resolution within a few days [24] . Therefore, we investigated the characteristics or COVID-19-related headache, and their relationship with clinical severity in the early phase in Kırşehir Province, also known as Central Anatolia.…”

Neuro-Ophthalmic Implications of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Related Infection and Vaccination

“…In addition to classical migraine headaches as defined by the International Headache Society (ichd-3.org), there are a plethora of visual symptoms related to migraine that can be acephalic 58 . Both SARS-CoV-2 infection and vaccination may worsen preexisting migraine 59,60 . The features of vestibular migraine are discussed next.…”

A comparison study of headache characteristics and headache-associated quality-of-life of COVID-19 and non-COVID-19 patients

“…The pandemic of the coronavirus disease 2019 (COVID- 19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has infected more 587 million people and resulted in over 6 million deaths as of 15 August 2022 [1]. Headache, along with shortness of Original Article breath and coughing are among the early symptoms of SARS-CoV-2 infection [2] and the most common neurological complaint in COVID-19 patients [3,4]. The prevalence of headache ranges from 14 to 60% in COVID-19 patients [3][4][5][6][7].…”