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Post-COVID-19 persistent headache: A multicentric 9-months follow-up study of 905 patients
David Garcia-Azorin1, Almudena Layos-Romero2, Jesús Porta-Etessam3,4,5
1Hospital Clinico Universitario de Valladolid, Headache Unit, Department of Neurology, Valladolid, Spain.
Insights
Headache is a common COVID-19 symptom. This study found that while most headaches resolved, about a fifth of patients experienced persistent headaches for up to nine months, sometimes becoming chronic.
Area of Science:
- Neurology
- Infectious Diseases
- Public Health
Background:
- Headache is a frequent symptom of coronavirus disease 2019 (COVID-19).
- The long-term evolution and persistence of COVID-19-associated headaches are not well understood.
- Understanding the chronicity of headaches post-COVID-19 is crucial for patient management.
Purpose of the Study:
- To evaluate the long-term duration of headaches in patients who experienced headaches during the acute phase of COVID-19.
- To identify factors associated with prolonged headache duration after COVID-19 infection.
- To characterize the pattern of persistent headaches following COVID-19.
Main Methods:
- A post-hoc, multicenter, ambispective study design.
- Inclusion of 905 patients from six tertiary hospitals, with follow-up data available for 9 months.
- Data collection on headache characteristics, duration, and intensity during acute COVID-19 and follow-up periods.
Main Results:
- The median headache duration was 14 days.
- Headache persisted beyond 3 months in 19.0% and beyond 9 months in 16.0% of patients.
- Higher headache intensity during the acute phase was significantly associated with a more prolonged headache duration (HR 0.655).
Conclusions:
- While the median duration of COVID-19-related headache is approximately two weeks, a significant proportion of patients develop persistent headaches.
- Approximately one-fifth of patients experienced headaches that persisted for months, potentially adopting a chronic daily pattern.
- These findings highlight the need for monitoring and management strategies for long-term headache sequelae of COVID-19.
Background:
Headache is a frequent symptoms of coronavirus disease 2019 (COVID-19). Its long-term evolution remains unknown. We aim to evaluate the long-term duration of headache in patients that presented headache during the acute phase of COVID-19.
Methods:
This is a post-hoc multicenter ambisective study including patients from six different third-level hospitals between 1 March and 27 April 2020. Patients completed 9 months of neurological follow-up.
Results:
We included 905 patients. Their median age was 51 (IQR 45-65), 66.5% were female, and 52.7% had a prior history of primary headache. The median duration of headache was 14 (6-39) days; however, the headache persisted after 3 months in 19.0% (95% CI: 16.5-21.8%) and after 9 months in 16.0% (95% confidence interval: 13.7-18.7%). Headache intensity during the acute phase was associated with a more prolonged duration of headache (Hazard ratio 0.655; 95% confidence interval: 0.582-0.737).
Conclusion:
The median duration of headache was 2 weeks, but in approximately a fifth of patients it became persistent and followed a chronic daily pattern.
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