Characteristics of headache attributed to COVID-19 infection and predictors of its frequency and intensity: A cross sectional study

• Published in: Cephalalgia Vol. 40; no. 13; pp. 1422 - 1431
• Main Authors: Magdy, Rehab, Hussein, Mona, Ragaie, Christine, Abdel-Hamid, Hoda M, Khallaf, Ahmed, Rizk, Hoda I, Dahshan, Ahmed
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.11.2020
• Subjects: Adult; Betacoronavirus; Coronavirus Infections - complications; COVID-19; Cross-Sectional Studies; Female; Headache - epidemiology; Headache - virology; Humans; Male; Pandemics; Pneumonia, Viral - complications; SARS-CoV-2; Special Section; VAS; fever; primary headache disorders; dehydration; COVID-19 related headache
• ISSN: 0333-1024; 1468-2982; 1468-2982
• DOI: 10.1177/0333102420965140

Objective To study the characteristics of headache attributed to COVID-19 infection and predictors of its severity. Methods A 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: The majority 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. Conclusion Healthcare 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.