Post-COVID-19 neuropsychiatric manifestations among COVID-19 survivors suffering from migraine: a case–control study

Abstract

Background The burden of post-coronavirus disease (COVID)-19 symptoms has been increasing and is of great concern in patients with pre-existing chronic medical conditions.This study aimed to delineate the post-COVID-19 neuropsychiatric symptoms among migraine patients compared to the non-migraine control group. Methods Two groups, each of 204 COVID-19 survivors, were enrolled in the study after 3 months of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, one group fulfilling the episodic migraine criteria and the other serving as a matching control group. Subjects were evaluated through an in-person interview for post-COVID-19 neuropsychiatric symptoms, including detailed headache patterns and severity, using the visual analogue scale. Results The Frequency of headache during the acute phase of COVID-19 was more frequent in migraine patients (OR = 1.60, 95%CI = 1.04–2.45, P-value = 0.031). The reported significant post-COVID-19 neuropsychiatric symptoms in migraine patients compared to controls were fatigue (OR = 1.662, 95%CI = 1.064–2.596, P-value = 0.025), anosmia/hyposmia (OR = 2.06, 95%CI = 1.164- 3.645, P-value = 0.012), cacosmia (OR = 2.663, 95%CI = 1.145–6.195, P-value = 0.019), depression (OR = 2.259, 95%CI = 1.284- 3.975, P-value = 0.004), anxiety (OR = 3.267, 95%CI = 1.747- 6.108, P-value ≤ 0.001), insomnia (OR = 2.203, 95%CI = 1.298- 3.739, P-value = 0.003), and headache (OR = 3.148, 95%CI = 1.616–6.136, P-value = ≤ 0.001).While there was no statistically significant difference between migraine patients and controls regarding the post-COVID-19 functional status score (P-value = 0.102). The pattern of post-COVID-19 headache was reported as chronic headache transformation in 17.6% of the migraine group, with the median intensity rate being 5.5 and IQR (3–7). In the control group, 14% experienced chronic headache attributed to systemic viral infection with a median intensity rate of 2 and IQR (2–5), while 12% experienced a new daily persistent headache with a median intensity of 5 and IQR (1–6). Conclusion The study highlighted the importance of follow-up migraine patients upon recovery from COVID-19 infection, being more vulnerable to post-COVID-19 symptoms.

Headaches and facial pain attributed to SARS‐CoV‐2 infection and vaccination: a systematic review

“…Although studies are limited, vaccinated people report less headache than those unvaccinated [30]. Several studies describe headache being more frequent in women [19,23,31–33], at a younger age [19,34,35] and in patients with personal history of migraine [23,36,37]. Concerning ethnicity, Hispanic people seem to report headache more frequently [38], although more data are needed.…”

“…Association between headache and age is unclear, due to limited specific analysis [39]. Studies suggest that personal history of migraine [37,39] is not associated with persisting headache, but this finding is still controversial [36]. No conclusion can be obtained on headache prevalence during the phase after recovery from acute COVID-19 in relation to anxiety/depression, due to lack of data.…”

Headache in long COVID as disabling condition: A clinical approach

“…Meanwhile, patients with headache attributed to viral system infection reported a median of two points on the VAS, and patients with NDPH reported median VAS scores of five points Bold value indicates that these comparisons were statistically significant. (28). Although no data were found in the literature regarding the correlation between pain intensity and disability in long COVID, it is possible that patients with severe pain have a high degree of disability.…”

“…A case-controlled study developed in the Egypt on long COVID headache reported that patients with a previous diagnosis of migraine evaluated their actual pain with a median of 5.5 points on the VAS. Meanwhile, patients with headache attributed to viral system infection reported a median of two points on the VAS, and patients with NDPH reported median VAS scores of five points ( 28 ). Although no data were found in the literature regarding the correlation between pain intensity and disability in long COVID, it is possible that patients with severe pain have a high degree of disability.…”

Headache changes in individuals with migraine post-Covid-19: general characteristics of the acute phase and worsening of the migraine pattern

“…2 Neuropsychiatric symptoms are common comorbidities of migraine and, in our study, we found that people with a worsening migraine pattern post-COVID-19 were the most susceptible to depressive symptoms, both before and after the acute phase of COVID-19, and also demonstrated a higher frequency of mood swings during the acute phase of the infection. Magdy et al 17 observed that people with migraine, compared to the controls without migraine, had…”