Factors associated with the presence of headache in hospitalized COVID-19 patients and impact on prognosis: a retrospective cohort study

• Published in: Journal of headache and pain Vol. 21; no. 1; pp. 94 - 10
• Main Authors: Trigo, Javier, García-Azorín, David, Planchuelo-Gómez, Álvaro, Martínez-Pías, Enrique, Talavera, Blanca, Hernández-Pérez, Isabel, Valle-Peñacoba, Gonzalo, Simón-Campo, Paula, de Lera, Mercedes, Chavarría-Miranda, Alba, López-Sanz, Cristina, Gutiérrez-Sánchez, María, Martínez-Velasco, Elena, Pedraza, María, Sierra, Álvaro, Gómez-Vicente, Beatriz, Arenillas, Juan Francisco, Guerrero, Ángel L.
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 29.07.2020; Springer Nature B.V; BMC
• Subjects: Aged; Aged, 80 and over; Anosmia; Betacoronavirus; C-reactive protein; Cohort analysis; Coronavirus Infections - complications; Coronavirus Infections - epidemiology; Coronavirus Infections - mortality; Coronaviruses; COVID-19; Female; Fever; Headache; Headache - epidemiology; Headache - etiology; Headache - mortality; Headache disorders, secondary; Headaches; Hospital Mortality; Hospitalization; Humans; Internal Medicine; Laboratories; Lymphopenia; Male; Medical prognosis; Medicine; Medicine & Public Health; Middle Aged; Mortality; Mortality, laboratory parameters; Multivariate analysis; Myalgia; Nervous system diseases; Neurology; Olfaction disorders; Pain Medicine; Pandemics; Patients; Pneumonia, Viral - complications; Pneumonia, Viral - epidemiology; Pneumonia, Viral - mortality; Prognosis; Research Article; Retrospective Studies; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Survival Rate; COVID-19; Headache disorders, secondary; Nervous system diseases; Mortality, laboratory parameters
• ISSN: 1129-2369; 1129-2377; 1129-2377
• DOI: 10.1186/s10194-020-01165-8

Introduction Headache is one of the most frequent neurologic manifestations in COVID-19. We aimed to analyze which symptoms and laboratory abnormalities were associated with the presence of headache and to evaluate if patients with headache had a higher adjusted in-hospital risk of mortality. Methods Retrospective cohort study. We included all consecutive patients admitted to the Hospital with confirmed SARS-CoV-2 infection between March 8th and April 11th, 2020. We collected demographic data, clinical variables and laboratory abnormalities. We used multivariate regression analysis. Results During the study period, 576 patients were included, aged 67.2 (SD: 14.7), and 250/576 (43.3%) being female. Presence of headache was described by 137 (23.7%) patients. The all-cause in-hospital mortality rate was 127/576 (20.0%). In the multivariate analysis, patients with headache had a lower risk of mortality (OR: 0.39, 95% CI: 0.17–0.88, p  = 0.007). After adjusting for multiple comparisons in a multivariate analysis, variables that were independently associated with a higher odds of having headache in COVID-19 patients were anosmia, myalgia, female sex and fever; variables that were associated with a lower odds of having headache were younger age, lower score on modified Rankin scale, and, regarding laboratory variables on admission, increased C-reactive protein, abnormal platelet values, lymphopenia and increased D-dimer. Conclusion Headache is a frequent symptom in COVID-19 patients and its presence is an independent predictor of lower risk of mortality in COVID-19 hospitalized patients.