About 1/5 patients with acute covid-19 may develop daily chronic headache

Recently, a study published in the journal cephalalgia showed that about one fifth of patients with headache in the acute phase of covid-19 will develop chronic daily headache. The greater the intensity of headache in the acute stage, the greater the possibility of persistent pain in the later stage.

The headache research team of the Spanish Society of Neurology (gecsen) carried out this study and evaluated the development of headache in more than 900 Spanish patients. Based on the research results, the research team emphasized the importance of timely evaluation of patients with acute covid-19 and subsequent persistent headache.

Headache is a common symptom of covid-19, but the long-term effects are still unknown. The aim of this study was to assess the long-term duration of headache symptoms in patients with acute phase of covid-19. The study was conducted from March 2020 to April 2020 and included 905 patients from six tertiary hospitals in Spain. All patients were followed up for 9 months. The median age was 51 years old, 66.5% were female, and 52.7% had a history of primary headache. 50.5% of the patients need hospitalization, and the rest are outpatient patients. The most common type of headache was the intensity of severity (50.6%) and total cranial pain (67.8%).

In 96.6% of patients for whom data were available, the median duration of headache was 14 days. Headache lasted for 1 month in 31.1%, 2 months in 21.5%, 3 months in 19%, 6 months in 16.8% and 9 months in 16.0%.

Dr davidgarc í aazor í n, a member of the Spanish Society of Neurology and one of the researchers of the study, said that the median duration of headache in patients with covid-19 was about 2 weeks, but about 20% of patients lasted longer. When headache still occurs at 2 months, it may become a daily pattern of chronic headache. Therefore, if the headache is not relieved, it is important to make full use of the opportunity window to give treatment within 6 to 12 weeks. To achieve this, the best choice is preventive treatment, so that patients will have better opportunities for rehabilitation.

Patients with headache lasting up to 9 months were older and mostly female. They are less likely to have pneumonia or experience tingling, photophobia or fear of sound. Studies have shown that when these patients engage in physical activities, the headache will worsen, but less often it will appear as throbbing headache.

Jaimerodr í guezvico, M.D., a headache expert at Jim é nezd í AZ hospital in Madrid, pointed out that according to his research, the most obvious feature after covid-19 infection is secondary, which is similar to tension headache. Generally speaking, the headache in patients with covid-19 usually lasts for 1~2 weeks, but there are also cases that last for months or even more than 1 year, and the headache continues every day. This case of persistent pain may be related to another pathological type, which may make the patient more likely to develop chronic pain

Garc í Azor í n pointed out that the history of headache may be one of the possible factors for the development of chronic headache after covid-19 infection. " The study also found that patients with persistent headache at 9 months often experienced migraine like pain. Infection is a common cause of acute and chronic headache. The persistence of headache after infection may be due to infection becoming chronic, as is the case with certain types of chronic meningitis, such as tuberculous meningitis. According to Garc í Azor í n, this may also be due to the persistence of a response and the activation of the immune system, or the deterioration of primary headache that occurs simultaneously with infection.

Some factors may help to understand how long a headache lasts. Univariate analysis of the study showed that age, women, headache intensity, photophobia / fear of sound, and decreased physical activity were associated with longer lasting headache. However, in multivariate analysis, only the intensity of acute headache was still statistically significant (hr=0.655; 95%ci: 0.582-0.737; p<0.001).

The study is evaluating different treatments that may improve the prognosis of patients. So far, the treatment scheme is mainly based on experience and major pain types. At present, most doctors treat headache after covid-19 infection according to the similarity between symptoms and primary headache.

 

Cindy