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Prevalence and Risk Factors of Headache Associated with COVID-19

Duraníková et al., Journal of Clinical Medicine, doi:10.3390/jcm13175013
Aug 2024  
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Headache, persisting -70% Improvement Relative Risk Headache, during infection -45% Favipiravir  Duraníková et al.  LATE TREATMENT Is late treatment with favipiravir beneficial for COVID-19? Retrospective 295 patients in Slovakia (March 2020 - April 2021) Higher PASC with favipiravir (not stat. sig., p=0.24) c19early.org Duraníková et al., J. Clinical Medicine, Aug 2024 Favorsfavipiravir Favorscontrol 0 0.5 1 1.5 2+
Retrospective 295 hospitalized COVID-19 patients in Slovakia showing 35% prevalence of headache, of which 41% of patients had persistent headache 12-15 months after infection. Authors' analysis of long COVID headache is only for the subgroup of 102 patients. For evaluating treatments, the risk of long COVID headache among all patients may be more relevant. Authors hypothesize that headache may be related to persistent immune system activation with biohumoral response, trigeminal system activation in genetically predisposed individuals, or structural and functional brain changes.
Potential risks include the creation of dangerous variants, and mutagenicity, carcinogenicity, teratogenicity, and embryotoxicity1-5.
Study covers ivermectin, remdesivir, colchicine, and favipiravir.
headache, 70.2% higher, RR 1.70, p = 0.24, treatment 6 of 27 (22.2%), control 35 of 268 (13.1%), persisting headache.
headache, 45.0% higher, RR 1.45, p = 0.14, treatment 13 of 27 (48.1%), control 89 of 268 (33.2%), headache during infection.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Duraníková et al., 24 Aug 2024, retrospective, Slovakia, peer-reviewed, median age 58.0, 7 authors, study period March 2020 - April 2021. Contact: straka0105@gmail.com (corresponding author), olga.duranikova@gmail.com, simonah09@gmail.com, mmminar@gmail.com, veronika.bolekova@gmail.com, petersabaka@gmail.com, peter.valkovic@gmail.com.
This PaperFavipiravirAll
Prevalence and Risk Factors of Headache Associated with COVID-19
Oľga Duraníková, Simona Horváthová, Peter Sabaka, Michal Minár, Veronika Boleková, Igor Straka, Peter Valkovič
Journal of Clinical Medicine, doi:10.3390/jcm13175013
Background: Headache is a prevalent and disabling non-respiratory symptom of COVID-19, posing a persistent challenge in post-COVID syndrome. This study aimed to determine the prevalence, phenotypes, risk factors and biomarkers associated with COVID-related headaches. Methods: A retrospective analysis of 634 hospitalized COVID-19 patients was conducted, with 295 participants being followed up 12-15 months post-discharge via telephone call. Initial laboratory workups, including complete blood count and various biochemical parameters, were compared between headache and non-headache groups. Results: One-third of hospitalized patients experienced headaches, predominantly younger individuals (p < 0.001) and women (p = 0.002). Non-dominant headaches were characterized as dull (56.9%) and holocranial (26.5%), while dominant headaches were unilateral (31.3%) with photophobia (34.3%) and nausea (56.3%). Persistent headaches were unilateral (40%) and pulsating (38%) with phonophobia (74%). Decreased CD4 T cells independently predicted COVID-associated headaches, with elevated IL-6 levels noted in the dominant-headache group (p = 0.040). Remarkably, 50% of patients reported persistent headaches 12-15 months post-infection. Dexamethasone administration significantly reduced the likelihood of long-COVID headaches (52% vs. 73%, p = 0.029). Conclusions: Headache was present in one-third of patients with heterogenous phenotypes: tension headache in the non-dominant group, and migraine in the dominant and persistent headache groups. Persistent headache remains a challenge, with dexamethasone showing potential in reducing its incidence, emphasizing the need for tailored approaches in managing long-COVID headaches.
Author Contributions: O.D.: conceptualization, data curation, investigation, project administration, formal analysis, writing-original draft; S.H.: conceptualization, data curation, investigation, formal analysis, writing-review and editing, P.S.: conceptualization, methodology, writing-review and editing, M.M.: conceptualization, methodology, writing-review and editing, supervision, V.B.: methodology, writing-review and editing, I.S.: conceptualization, methodology, writing-review and editing, supervision, P.V.: writing-review and editing, supervision. All authors have read and agreed to the published version of the manuscript. Informed Consent Statement: Participants were fully informed about the purpose of the study and potential risks of participation. Written informed consent was obtained from all participants before the enrolment and verbal informed consent during telephone survey. Conflicts of Interest: The authors declare no conflicts of interest.
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Methods: A retrospective analysis of 634 hospitalized COVID-19 patients was ' 'conducted, with 295 participants being followed up 12–15 months post-discharge via telephone ' 'call. Initial laboratory workups, including complete blood count and various biochemical ' 'parameters, were compared between headache and non-headache groups. Results: One-third of ' 'hospitalized patients experienced headaches, predominantly younger individuals (p &lt; 0.001) ' 'and women (p = 0.002). Non-dominant headaches were characterized as dull (56.9%) and ' 'holocranial (26.5%), while dominant headaches were unilateral (31.3%) with photophobia ' '(34.3%) and nausea (56.3%). Persistent headaches were unilateral (40%) and pulsating (38%) ' 'with phonophobia (74%). Decreased CD4 T cells independently predicted COVID-associated ' 'headaches, with elevated IL-6 levels noted in the dominant-headache group (p = 0.040). ' 'Remarkably, 50% of patients reported persistent headaches 12–15 months post-infection. ' 'Dexamethasone administration significantly reduced the likelihood of long-COVID headaches ' '(52% vs. 73%, p = 0.029). Conclusions: Headache was present in one-third of patients with ' 'heterogenous phenotypes: tension headache in the non-dominant group, and migraine in the ' 'dominant and persistent headache groups. Persistent headache remains a challenge, with ' 'dexamethasone showing potential in reducing its incidence, emphasizing the need for tailored ' 'approaches in managing long-COVID headaches.</jats:p>', 'DOI': '10.3390/jcm13175013', 'type': 'journal-article', 'created': {'date-parts': [[2024, 8, 26]], 'date-time': '2024-08-26T07:32:01Z', 'timestamp': 1724657521000}, 'page': '5013', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'Prevalence and Risk Factors of Headache Associated with COVID-19', 'prefix': '10.3390', 'volume': '13', 'author': [ { 'given': 'Oľga', 'family': 'Duraníková', 'sequence': 'first', 'affiliation': [ { 'name': '2nd Department of Neurology, Faculty of Medicine, Comenius ' 'University Bratislava, 813 72 Bratislava, Slovakia'}]}, { 'given': 'Simona', 'family': 'Horváthová', 'sequence': 'additional', 'affiliation': [ { 'name': '2nd Department of Neurology, Faculty of Medicine, Comenius ' 'University Bratislava, 813 72 Bratislava, Slovakia'}]}, { 'ORCID': 'http://orcid.org/0000-0001-9337-8843', 'authenticated-orcid': False, 'given': 'Peter', 'family': 'Sabaka', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Infectology and Geographical Medicine, Faculty of ' 'Medicine, Comenius University Bratislava, 813 72 Bratislava, ' 'Slovakia'}]}, { 'ORCID': 'http://orcid.org/0000-0002-0812-2366', 'authenticated-orcid': False, 'given': 'Michal', 'family': 'Minár', 'sequence': 'additional', 'affiliation': [ { 'name': '2nd Department of Neurology, Faculty of Medicine, Comenius ' 'University Bratislava, 813 72 Bratislava, Slovakia'}]}, { 'ORCID': 'http://orcid.org/0000-0003-2076-1096', 'authenticated-orcid': False, 'given': 'Veronika', 'family': 'Boleková', 'sequence': 'additional', 'affiliation': [ { 'name': '2nd Department of Neurology, Faculty of Medicine, Comenius ' 'University Bratislava, 813 72 Bratislava, Slovakia'}, { 'name': 'Faculty of Psychology, Institute of Clinical Psychology, ' 'Pan-European University, 821 02 Bratislava, Slovakia'}]}, { 'ORCID': 'http://orcid.org/0000-0003-1134-7029', 'authenticated-orcid': False, 'given': 'Igor', 'family': 'Straka', 'sequence': 'additional', 'affiliation': [ { 'name': '2nd Department of Neurology, Faculty of Medicine, Comenius ' 'University Bratislava, 813 72 Bratislava, Slovakia'}]}, { 'ORCID': 'http://orcid.org/0000-0001-7837-8781', 'authenticated-orcid': False, 'given': 'Peter', 'family': 'Valkovič', 'sequence': 'additional', 'affiliation': [ { 'name': '2nd Department of Neurology, Faculty of Medicine, Comenius ' 'University Bratislava, 813 72 Bratislava, Slovakia'}, { 'name': 'Institute of Normal and Pathological Physiology, Centre of ' 'Experimental Medicine, Slovak Academy of Sciences, 813 71 ' 'Bratislava, Slovakia'}]}], 'member': '1968', 'published-online': {'date-parts': [[2024, 8, 24]]}, 'reference': [ { 'key': 'ref_1', 'doi-asserted-by': 'crossref', 'first-page': '73', 'DOI': '10.1007/s11916-021-00987-8', 'article-title': 'Headache as a Symptom of COVID-19: Narrative Review of 1-Year Research', 'volume': '25', 'author': 'Caronna', 'year': '2021', 'journal-title': 'Curr. Pain. Headache Rep.'}, { 'key': 'ref_2', 'doi-asserted-by': 'crossref', 'first-page': '358', 'DOI': '10.1016/j.tins.2022.02.006', 'article-title': 'The Neuroinvasiveness, Neurotropism, and Neurovirulence of SARS-CoV-2', 'volume': '45', 'author': 'Bauer', 'year': '2022', 'journal-title': 'Trends Neurosci.'}, { 'key': 'ref_3', 'doi-asserted-by': 'crossref', 'first-page': '51', 'DOI': '10.1186/s10194-021-01268-w', 'article-title': 'Cytokine and Interleukin Profile in Patients with Headache and ' 'COVID-19: A Pilot, CASE-Control, Study on 104 Patients', 'volume': '22', 'author': 'Trigo', 'year': '2021', 'journal-title': 'J. Headache Pain'}, { 'key': 'ref_4', 'doi-asserted-by': 'crossref', 'first-page': '3426', 'DOI': '10.1111/ene.14718', 'article-title': 'Headache during SARS-CoV-2 Infection as an Early Symptom Associated ' 'with a More Benign Course of Disease: A Case–Control Study', 'volume': '28', 'author': 'Fanjul', 'year': '2021', 'journal-title': 'Eur. J. 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Sci., 13.', 'DOI': '10.3390/app13137443'}], 'container-title': 'Journal of Clinical Medicine', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://www.mdpi.com/2077-0383/13/17/5013/pdf', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2024, 8, 26]], 'date-time': '2024-08-26T08:43:42Z', 'timestamp': 1724661822000}, 'score': 1, 'resource': {'primary': {'URL': 'https://www.mdpi.com/2077-0383/13/17/5013'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2024, 8, 24]]}, 'references-count': 28, 'journal-issue': {'issue': '17', 'published-online': {'date-parts': [[2024, 9]]}}, 'alternative-id': ['jcm13175013'], 'URL': 'http://dx.doi.org/10.3390/jcm13175013', 'relation': {}, 'ISSN': ['2077-0383'], 'subject': [], 'container-title-short': 'JCM', 'published': {'date-parts': [[2024, 8, 24]]}}
Late treatment
is less effective
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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