Abstract
ObjectiveTo study the characteristics of headache attributed to COVID-19 infection and predictors of its severity.MethodsA cross-sectional study involved 172 individuals who had headache due to COVID-19 infection. A detailed analysis of such headache was done through a face-to-face interview. Patients with any other form of secondary headache were excluded. Labs, including lymphocytic count, C-reactive protein, D-dimer and ferritin and chest imaging, were made available.Results: Themajority of our patients had a diffuse headache (52.9%). It was pressing in 40.7%, with median intensity of 7 (assessed by visual analogue scale) and median frequency of 7 days/week. Patients with preexisting primary headache (52.9%) had significantly more frequent COVID-19 related headache than those without (47.1%) (p = 0.001). Dehydrated patients (64.5%) had more frequent COVID-19 related headache than those who were not dehydrated (35.5%) (p = 0.029). Patients with fever (69.8%) had significantly higher frequency and intensity of COVID-19 related headache compared to those without fever (30.2%) (p = 0.003, 0.012). Patients with comorbidities (19.8%) had significantly higher frequency and intensity of headache than those without comorbidities (80.2%) (p = 0.006, 0.003). After multiple linear regression, primary headache disorders, dehydration and comorbidities were considered predictors of frequency of COVID-19 related headache. Meanwhile, fever and dehydration were predictors of pain intensity.ConclusionHealthcare providers of COVID-19 patients need to be aware of frequency and intensity predictors of COVID-19 related headache: Primary headache disorders, fever, dehydration, and comorbidities.
Highlights
Coronavirus disease 2019 (COVID-19) is an escalating crisis all over the world caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1]
The study population included 172 patients who had headache attributed to COVID-19 infection, with median age of 33 and interquartile range (IQR) 27.3– 42 years
Post hoc pairwise comparisons of the Kruskal-Wallis test showed that such frequency was significantly higher in patients with migraine and tension-type headache (TTH) compared to patients without pre-existing primary headache, (p < 0.001 and p 1⁄4 0.011), respectively
Summary
Coronavirus disease 2019 (COVID-19) is an escalating crisis all over the world caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1]. It was first identified in December 2019 in Wuhan, China [2]. Fever, malaise, muscle and joint pains, dyspnea, cough, and loss of smell and taste [5,6]. Less common symptoms include abdominal pain, nausea, vomiting and diarrhea [7]. The time from exposure to onset of symptoms ranges from 5–14 days [8]. While the majority of cases have mild symptoms, some cases may progress
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