Post-COVID-19 persistent headache: A multicentric 9-months follow-up study of 905 patients

Abstract

Background Headache is a frequent symptoms of coronavirus disease 2019 (COVID-19). Its long-term evolution remains unknown. We aim to evaluate the long-term duration of headache in patients that presented headache during the acute phase of COVID-19. Methods This is a post-hoc multicenter ambisective study including patients from six different third-level hospitals between 1 March and 27 April 2020. Patients completed 9 months of neurological follow-up. Results We included 905 patients. Their median age was 51 (IQR 45–65), 66.5% were female, and 52.7% had a prior history of primary headache. The median duration of headache was 14 (6–39) days; however, the headache persisted after 3 months in 19.0% (95% CI: 16.5–21.8%) and after 9 months in 16.0% (95% confidence interval: 13.7–18.7%). Headache intensity during the acute phase was associated with a more prolonged duration of headache (Hazard ratio 0.655; 95% confidence interval: 0.582–0.737). Conclusion The median duration of headache was 2 weeks, but in approximately a fifth of patients it became persistent and followed a chronic daily pattern.

COVID-19-related headache and innate immune response — a narrative review

“…Headache is a common symptom of post-COVID-19 syndrome included in some diagnostic guidelines [84]. A study assessing data from 905 subjects with COVID-19-related headache showed that 31.1% of patients still had headache after one month, 16.8% after three months, and 16% after nine months [2]. These numbers were slightly lower in a recent meta-analysis: 47.1% during the acute phase, 10.6% at [2].…”

“…In published studies, headache has often appeared as the most prevalent neurological complaint related to different aspects of the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It has been named as a symptom of COVID-19 [1] or its direct and indirect sequelae [2]. Moreover, headache has been identified as a prognostic factor [3], as well as an adverse reaction to therapeutic interventions and preventive strategies [4].…”

COVID-19 2022 update: transition of the pandemic to the endemic phase

“…Approximately 25% of patients who developed COVID-19 experienced neurological disorders of various degrees in the months following diagnosis [ 46 ]. The most common and mild symptoms include headache [ 47 ], disturbances in perception of taste and smell [ 48 – 50 ], “brain fog” and memory disorders [ 51 ]. Among the major complications, however, those mostly described were the presence of diffuse brain damage of inflammatory [ 52 ] or acute metabolic origins (toxic-metabolic encephalopathies) [ 53 ], Guillain-Barré syndrome [ 54 , 55 ], Miller-Fisher syndrome [ 56 ], ischemic vasculitis [ 57 ], dysautonomic dysfunctions [ 55 , 58 , 59 ] and seizures.…”

Cardio-Pulmonary Dysfunction Evaluation in Patients with Persistent Post-COVID-19 Headache

“…Once the acute infection is resolved, headache is also a common post-COVID-19 symptom [ 5 ]. The proportion of patients with headaches during the acute phase that report persistence over time is estimated to be around 25% after three months and 16% after nine months [ 6 , 7 , 8 ]. It has also been observed that the headaches tend to have a migraine phenotype [ 9 ].…”

“…The WHO recently proposed a clinical-case definition for the post-COVID-19 condition, setting 3 months as the usual time from the onset of COVID-19, acknowledging that symptoms may fluctuate or relapse over time [ 12 ]. A recent study observed that when headache persists beyond 2 months after the acute phase of the disease, it adopts a chronic pattern [ 8 ]. We recently reported an impaired ventilatory efficiency among patients with long-COVID dyspnea, with 14.3% of the global population presenting long-lasting headache [ 13 ].…”