Headache as a Cardinal Symptom of COVID-19
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Headache is one of the most frequent neurological symptoms reported in case series, epidemiological studies, and meta?analyses of COVID-19, with a prevalence ranging from 8 to 71.1%. Studies addressing the semiology of these headaches are lacking.

Via a cross-sectional study in the emergency department of a tertiary hospital, researchers described the semiology of pain and its related features in patients with coronavirus disease 2019 (COVID-19) and headache presenting to the emergency department not needing urgent services.

Patients classified according to the Manchester Triage System as standard and non-urgent and those fulfilling the criteria for probable or confirmed COVID-19 according to World Health Organization guidelines who presented with headache were included.

Of the 145 confirmed and probable COVID-19 patients, 99 reported headache.

A total of 54/99 were classified with probable COVID-19 and 45/99 with confirmed COVID-19. The mean age (44.7 ± 11.8 vs 40.4 ± 10.7, P = .061), sex distribution (35/54 [64.8%] vs 28/45 [62.2%] female, P = .768), and headache comorbidity (19/54 [35.2%] vs 17/45 [37.8%], P = .789) were similar between the probable and confirmed COVID-19 groups, along with other medical comorbidities and laboratory data.

The study results suggested that headache is a very prevalent COVID-19 symptom among patients presenting to the emergency room, most frequently presenting as holocranial or bifrontal moderate to severe, and pressing quality headache. Individuals with migraine tend to present with earlier, longer, and more intense headaches.A higher incidence of anosmia and pneumonia, headache at onset, and hospital admission was seen among patients with confirmed COVID-19, and the headache appeared simultaneously with other COVID?19 symptoms in most patients. Fever was identified as the most common trigger and physical activity and coughing as the most frequently seen aggravating factors.

Source: https://headachejournal.onlinelibrary.wiley.com/doi/full/10.1111/head.13967?af=R
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