Headache : A striking prodromal and persistent symptom, predictive of COVID-19 clinical evolution

Edoardo Caronna, Alejandro Ballvé, Arnau Llaurado, Víctor J.. Gallardo, Diana María Ariton, Sofia Lallana, Samuel López Maza, Marta Olivé Gadea, Laura Quibus, Juan Luis Restrepo, Marc Rodrigo-Gisbert, Andreu Vilaseca, Manuel Hernandez Gonzalez, Monica Martinez Gallo, Alicia Alpuente, Marta Torres-Ferrús, Ricard Pujol Borrell, José Álvarez Sabín, Patricia Pozo-Rosich

Research output: Contribution to journalArticleResearchpeer-review

152 Citations (Scopus)

Abstract

To define headache characteristics and evolution in relation to COVID-19 and its inflammatory response. This is a prospective study, comparing clinical data and inflammatory biomarkers of COVID-19 patients with and without headache, recruited at the Emergency Room. We compared baseline with 6-week follow-up to evaluate disease evolution. Of 130 patients, 74.6% (97/130) had headache. In all, 24.7% (24/97) of patients had severe pain with migraine-like features. Patients with headache had more anosmia/ageusia (54.6% vs. 18.2%; p < 0.0001). Clinical duration of COVID-19 was shorter in the headache group (23.9 ± 11.6 vs. 31.2 ± 12.0 days; p = 0.028). In the headache group, IL-6 levels were lower at the ER (22.9 (57.5) vs. 57.0 (78.6) pg/mL; p = 0.036) and more stable during hospitalisation. After 6 weeks, of 74 followed-up patients with headache, 37.8% (28/74) had ongoing headache. Of these, 50% (14/28) had no previous headache history. Headache was the prodromal symptom of COVID-19 in 21.4% (6/28) of patients with persistent headache (p = 0.010). Headache associated with COVID-19 is a frequent symptom, predictive of a shorter COVID-19 clinical course. Disabling headache can persist after COVID-19 resolution. Pathophysiologically, its migraine-like features may reflect an activation of the trigeminovascular system by inflammation or direct involvement of SARS-CoV-2, a hypothesis supported by concomitant anosmia.
Original languageEnglish
Pages (from-to)1410-1421
Number of pages12
JournalCephalalgia
Volume40
DOIs
Publication statusPublished - 2020

Keywords

  • Headache
  • COVID-19
  • SARS-CoV-2
  • Prognosis
  • Loss of smell

Fingerprint

Dive into the research topics of 'Headache : A striking prodromal and persistent symptom, predictive of COVID-19 clinical evolution'. Together they form a unique fingerprint.

Cite this