Chronic headache after Covid-19

Headache is a common symptom of Covid-19, but its long-term progression is still unknown. To evaluate the duration of headache duration in these symptomatic patients during the acute phase of the disease, members of the Headache Study of the Spanish Neurological Society (GECSEN) conducted a follow-up study throughout the course of the disease. 9 months in 905 patients.

The average age of the participants was 51 years old. Of these, 66.5% were women and more than half (52.7%) had a history of primary headache. About half of the patients were hospitalized (50.5%); The rest are treated on an outpatient basis. The researchers found that headache intensity during the acute phase was related to the duration of headache duration.

Persistent headache

In 96.6% of cases where data were available, the mean duration of headache was 14 days. Headache persisted for 1 month in 31.1% of patients, 2 months in 21.5%, 3 months in 19% of patients, 6 months in 16.8%, and 9 months in 16% of patients.

David García Azorín, MD, PhD, member of the Spanish Neurological Society, study co-author, told Medscape Spanish EditionThe average duration of a Covid-19 headache is about 2 weeks. However, nearly 20% of patients experience the condition longer than that. Even headaches are more likely to be chronic daily.

“If the headache does not improve, the patient must make the most of the opportunity and treat it for 6 to 12 weeks. To do this, the best option is to carry out preventive treatment to give the patient a chance. better recovery,” he said.

The study participants had headaches that lasted 9 months and were mostly women. They are less likely to have pneumonia or to have pain, photophobia or phobias. They say the headache gets worse when participating in physical activities.

Secondary tension headache

According to case studies by Jaime Rodríguez Vico, MD, head of the Headache Unit at the Jiménez Díaz Foundation Hospital in Madrid, the most striking features of headaches secondary to Covid-19 share similarities with pain. head due to stress.

He said: “Post-Covid-19 headaches usually last for 1 to 2 weeks, but there are cases that last several months and even more than a year with persistent daily headaches. These cases can be associated related to the pathology that makes them more likely to become chronic”.

Migraine

García Azorín points out that, for people who already have primary headaches, their condition worsens after infection with SARS-CoV-2. However, many people distinguish infectious headaches from their regular headaches because, after an infection, their headaches are mostly chronic. “Having a history of headaches is one of the factors that can increase the likelihood of a Covid-19 headache becoming chronic,” he notes.

The same study also showed that patients with persistent headaches at 9 months had migraine-like pain.

Infections are common causes of acute and chronic headaches. A persistent headache after an infection may be because the infection becomes chronic, as occurs in some types of chronic meningitis, such as tuberculous meningitis. García Azorín adds, it can also be due to the existence of a certain response and activation of the immune system…

Univariate analysis of the study showed that age, female sex, headache intensity, pressure-like quality, presence of photophobia/phobia, and worse when physical activity were associated associated with more persistent headaches. But in multivariate analysis, only headache intensity during the acute phase was statistically significant.

To date, most doctors treat post-Covid-19 headaches on the basis that symptoms are similar to those of other primary headaches. Patricia Pozo Rosich, MD, PhD, one of the study’s co-authors, said: “Given the impact of headache on patients’ quality of life, there is an urgent need for controlled studies of their possible and effective treatments”.

“We believe that if these patients get their symptoms properly addressed in the first place, they can avoid many of the problems that arise in the condition becoming chronic,” she asserts.

Equanimity (according to Medscape)