Headache May Predict Clinical Evolution of COVID-19
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Headache may be a key symptom of COVID-19 that predicts the disease's clinical evolution in individual patients, new research suggests.

Headache is one of the main symptoms of COVID-19. A recent study of 214 patients with COVID-19 showed that approximately 13% of the participants had headache and 5% had anosmia.

SARS-CoV2 penetrates the cells through the ACE2 receptor, which is present throughout the body.

"SARS-CoV2 enters the body through the nasal cavity and it probably penetrates the nervous system in the periphery through afferent branches of the olfactory and trigeminal nerve," researchers said.

It travels to the lungs and, later, the bloodstream. This generates systemic inflammation that may turn into a cytokine storm. Evidence has identified cortical hyperintensities and olfactory bulb hyperintensities in patients with COVID-19, suggesting that the virus directly infects the central nervous system.

Interleukin-6 (IL-6), one of the main inflammatory molecules, has been proven to be related to COVID-19 and has become a therapeutic target. Levels of IL-6 may be lower and tend to be more stable in patients with both COVID-19 and headache than in patients with COVID-19 only.

Patients with headache tended to be younger than those without headache (mean age, 50 years vs 63 years, respectively) and tended to be women (58.6% vs 29.4%).

Approximately one third of patients with headache had a history of migraine. Most reported mild to moderate pain that resembled tension-type headache. In participants with severe pain and migraine-like features, headache more often began during the asymptomatic phase of COVID-19.

Most therapies, including ibuprofen, candesartan, and anti-CGRP monoclonal antibodies, are safe for treating headache in COVID-19, the investigators note.

Source: https://www.medscape.com/viewarticle/932637#vp_2
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