Investigating the Effects of COVID-19 Quarantine in Migraine: An Observational Cross-Sectional Study from the Italian National Headache Registry (RICe)

Abstract

BACKGROUND: Previous studies during SARS and Ebola pandemics have shown that quarantine is associated with several negative psychological effects, such as post-traumatic stress symptoms, confusion and anger. These conditions may affect the course of many diseases, including migraine. Although it is possible that the quarantine measures for the current COVID-19 pandemic affect migraine burden, no information is currently available on this issue. AIM: In this study, we aimed to: 1) explore the possible changes in migraine frequency, severity, and days with acute medication intake during quarantine period; 2) evaluate possible differences in migraine outcomes in consideration of lifestyle changes, emotions, pandemic diffusion, and COVID-19 infection. METHODS : We interviewed patients who were included in the observational Italian Headache Registry (Registro Italiano Cefalee, RICE), retrospectively collecting information on main headache features, lifestyles factors, emotions, individual infection status, and perception of COVID-19 for two months before (pre-quarantine) and after the beginning of the quarantine (quarantine). Inclusion criteria were: age > 18, diagnosis of migraine without aura, migraine with aura and chronic migraine, last in-person visit more than 3 months preceding the beginning of quarantine. RESULTS: A total of 433 migraine subjects agreed to be interviewed. We found an overall reduction in headache frequency and intensity during the quarantine, compared to pre-quarantine. There was a correlation between improvement and number of days of stay-at-home. When results were stratified for geographic area, we found a tendency towards worsening of headache frequency in northern Italy. Disgust regarding viral infection corresponded to a minor improvement in migraine.CONCLUSIONSMigraine patients showed resilient behavior toward pandemic distress. Disgust regarding the contagion whereas potentially favoring defensive behavior, could potentially worsen migraine.

A Review on Headaches Due to COVID-19 Infection

“…There is some evidence highlighting that headache is the most common neurological manifestation, which can occasionally be seen alone as the first sign of the disease (5)(6)(7)(8). Apart from the headaches associated with covid-19 infection, an increased number of headaches among the general population and those with a previous history of headaches could be referred to the lifestyle changes in the covid-19 era (9)(10)(11)(12). The other cause of headache at present is vaccination against covid- 19 (13-15).…”

Data_Sheet_1.DOCX

“…The study was promoted by the Italian Society for Headache Study (SISC). This manuscript has been released as a preprint at Research square: https://www.researchsquare.com/ article/rs-62932/v1, https://www.researchsquare.com/article/rs-39228/v1 (32).…”