Impact of the COVID-19 pandemic on migraine in Japan: a multicentre cross-sectional study

Keisuke Suzuki,Hisaka Igarashi,Takao Takeshima,Mamoru Shibata,Toshimasa Yamamoto,Daisuke Danno,Shoji Kikui,Shiho Suzuki,Noboru Imai,Eiichiro Nagata,Hisanori Kowa,Koichi Hirata,Yasuo Haruyama,Yasuo Ito,Madoka Okamura,Muneto Tatsumoto,Takashi Mitsufuji,Tomohiko Shiina

doi:10.1186/s10194-021-01263-1

Abstract

ObjectivesTo assess the impacts of social situation changes due to the coronavirus disease 2019 (COVID-19) pandemic on headache-related disability and other symptoms in patients with migraine in Japan.MethodsWe conducted a multicentre, cross-sectional study including 659 outpatients with migraine diagnosed by headache specialists. The participants were asked about the impacts of the first wave of the COVID-19 pandemic on headache-related disability, headache days, headache intensity, stress, physical activity, hospital access and their work and home lives. For headache-related disability, the total Migraine Disability Assessment (MIDAS) score and part A and B scores were analysed. Multivariate stepwise linear regression analysis was performed to identify the clinical predictors of changes in the total MIDAS score before and during the COVID-19 pandemic. Logistic regression analysis was performed to determine the factors related to new-onset headache during the COVID-19 pandemic.ResultsFinally, 606 migraine patients (73 M/533 F; age, 45.2 ± 12.0 years) were included in the study, excluding those with incomplete data. Increased stress, substantial concern about COVID-19 and negative impacts of the first wave of the COVID-19 pandemic on daily life were reported in 56.8 %, 55.1 and 45.0 % of the participants, respectively. The total MIDAS and A and B scores did not significantly change after the first wave of the COVID-19 pandemic. New-onset headache, which was observed in 95 patients (15.7 %), was associated with younger age and worsened mood and sleep in the logistic regression analysis. The multivariate stepwise linear regression analysis of changes in the total MIDAS score before and during the first wave of COVID-19 pandemic identified worsened sleep, increased acute medication use, increased stress, medication shortages, comorbidities, the absence of an aura and new-onset headache were determinants of an increased total MIDAS score during the first wave of the COVID-19 pandemic.ConclusionsIn this multicentre study, clinical factors relevant to headache-related disability, such as new-onset headache, stress and sleep disturbances, were identified, highlighting the importance of symptom management in migraine patients during the first wave of the COVID-19 pandemic.

Highlights

The spread of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a global pandemic since its emergence in Wuhan, China, in December 2019 [1]
Great concerns about COVID-19 and negative impacts of COVID-19 pandemic on daily life were reported in 56.8 %, 55.1 and 45.0 % of the participants, respectively (Table 2)
A stepwise linear regression analysis of changes in the total Migraine Disability Assessment (MIDAS) score identified sleep disturbances, increased acute medication use, increased stress, medication shortage, the presence of comorbidities, the absence of aura and new-onset headache as determinants of an increased total MIDAS score during the COVID-19 pandemic (Table 4). In this multicentre study, we studied the effects of social distancing during the first wave of the COVID-19 pandemic on headache-related disability, daily life and other various clinical symptoms using clinical information, headache diaries, and questionnaires at multiple headache centres

Summary

Introduction

The spread of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a global pandemic since its emergence in Wuhan, China, in December 2019 [1]. The Ministry of Health, Labour and Welfare of Japan declared that people should avoid three Cs during the COVID-19 pandemic: (1) closed spaces with poor ventilation; (2) crowded places with many people nearby; and (3) close-contact situations, such as close-range conversations. These recommendations reflect the fact that the risk of cluster occurrence is high when the three Cs overlap [2]. Lifestyles and social situations changed dramatically after activities were restricted to maintain social distancing Due to this situation, some medical institutions, including our hospitals, introduced telemedicine to prevent the spread of infection

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