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Published on: June 2, 2014
Are Migraine Patients at Increased Risk for Symptomatic Coronavirus Disease 2019 Due to Shared Comorbidities?
Hayrunnisa Bolay1, Aynur Özge2, Derya Uludüz3
1Department of Neurology and Algology, Medical Faculty, Gazi University, Ankara, Turkey.
Insights
Migraine patients with cardiovascular conditions like hypertension may face higher symptomatic COVID-19 risk. Conversely, allergic diseases and female gender might offer protection, warranting further investigation into these complex interactions.
Area of Science:
- Neurology
- Infectious Diseases
- Cardiology
Background:
- The COVID-19 pandemic highlighted the role of comorbidities in disease severity.
- Migraine shares several comorbidities with severe COVID-19, including hypertension and vascular disorders.
- Understanding these overlaps is crucial for managing patient risk.
Purpose of the Study:
- To investigate if shared comorbidities between migraine and COVID-19 increase symptomatic COVID-19 risk in migraine patients.
- To explore the potential protective role of allergic diseases and female gender against severe COVID-19 in this population.
Main Methods:
- Comparative analysis of clinical datasets and available reports on COVID-19 and migraine comorbidities.
- Review of proposed pathogenetic mechanisms involving the renin-angiotensin system and inflammasomes.
Main Results:
- COVID-19 disproportionately affects patients with hypertension and cardiovascular comorbidities.
- Migraine patients with hypertension and cardiovascular disease may be at increased risk for symptomatic COVID-19.
- Allergic and atopic diseases, along with female gender, may act as protective factors.
Conclusions:
- Shared comorbidities like hypertension and cardiovascular disease may elevate COVID-19 risk in migraineurs.
- Allergic conditions and female sex might confer a protective effect against severe COVID-19.
- Further research into neuroinflammation, endothelial dysfunction, and specific molecular pathways is needed to clarify these relationships.
Abstract:
The coronavirus disease 2019 (COVID-19) pandemic has rapidly transformed the whole world and forced us to look through comorbid diseases and risk factors from a different perspective. COVID-19 shows some inherent risk factors like cardiovascular comorbidities independent from age, gender, and geographic location. One of the most peculiar features of the COVID-19 pandemic is that severe acute respiratory syndrome coronavirus 2 respiratory infections disproportionately impact patients with hypertension, diabetes, and other cardiovascular comorbidities rather than those with allergic respiratory diseases and immune-compromised conditions. Migraine is a complex neuro-vasculo-inflammatory disorder that is also packed frequently with certain medical conditions including vascular disorders, hypertension, allergic diseases such as asthma and systemic inflammatory disorders. Accordingly, 2 different questions arise during the pandemic: (1) Do share comorbidities of cardiovascular diseases and hypertension increase the risk of symptomatic COVID-19 for migraine patients? (2) Do comorbid allergic and atopic diseases, including asthma act as opposite influencers alongside with female gender? This paper focuses on the co-existence of comorbidities of COVID-19, in comparison with migraine, based on a wide clinical dataset and available reports. Discussed mechanisms include potential strategic roles of angiotensin-converting enzyme 2, angiotensin-II, and nucleotide oligomerization domain-like receptor family, pyrin domain containing 3 inflammasome, playing remarkable parts in the pathogenesis of COVID-19 and migraine. There are also some clues about the importance of endothelial and pericyte dysfunction and neuroinflammation in COVID-19 infection, related to complications and survival of the patients. The large epidemiological studies as well as basic research, focusing on migraine patients with COVID-19 will clarify these vital questions during the upcoming periods.
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