Acute and Preventive Treatment of COVID-19-Related Headache: A Series of 100 Patients
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Outcomes
2.2. Eligibility Criteria
2.3. Recruitment, Sampling, and Sample Size
2.4. Study Period
2.5. Intervention
2.6. Acute Medication
2.7. Preventive Medication
2.8. Ethics
2.9. Statistical Analysis
3. Results
3.1. COVID-19 Infection
3.2. COVID-19-Related Headache
3.3. Acute Medication
3.4. COVID-19 Infection
3.5. Responder Rate
3.6. Tolerability
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
Severity | Description |
---|---|
Mild illness | Patients with uncomplicated upper respiratory tract viral infection symptoms and non-specific symptoms such as fever, fatigue, cough (with or without sputum production), anorexia, malaise, muscle pain, sore throat, dyspnea, nasal congestion, diarrhea, nausea, or vomiting. |
Pneumonia | Presence of pneumonia but no signs of severe pneumonia and no need for supplemental oxygen. CURB scale ≤ 1. |
Severe pneumonia | Confirmed respiratory infection, plus one of the following: Respiratory rate > 30 breaths/min. Severe respiratory distress. SpO2 ≤ 93% on room air. |
Acute respiratory distress syndrome (ARDS)2 | Onset: within 1 week of a known clinical insult or new or worsening respiratory symptoms. Chest imaging (radiograph, CT scan, or lung ultrasound): bilateral opacities, not fully explained by volume overload, lobar or lung collapse, or nodules. Origin of pulmonary infiltrates: respiratory failure not fully explained by cardiac failure or fluid overload. Need objective assessment (e.g., echocardiography) to exclude hydrostatic causes of infiltrates/edema if no risk factor present. Oxygenation impairment in adults: Mild ARDS: 200 mmHg < PaO2/FiO2a ≤ 300 mmHg (with PEEP or CPAP ≥ 5 cmH2O, or non-ventilated) Moderate ARDS: 100 mmHg < PaO2/FiO2 ≤ 200 mmHg (with PEEP ≥ 5 cmH2O, or non-ventilated) Severe ARDS: PaO2/FiO2 ≤ 100 mmHg (with PEEP ≥ 5 cmH2O, or non-ventilated) When PaO2 is not available, SpO2/FiO2 ≤ 315 implies ARDS (including in non-ventilated patients). |
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Variable | Proportion (n = 100) |
---|---|
Headache location | |
Strictly holocranial | 63% |
Strictly hemicranial | 15% |
Both holocranial and hemicranial | 22% |
Headache topography | |
Frontal | 48% |
Occipital | 36% |
Temporal | 27% |
Periocular | 21% |
Parietal | 15% |
Vertex | 9% |
Cervical | 5% |
Facial | 4% |
Quality of pain | |
Pressing | 75% |
Throbbing | 27% |
Stabbing | 27% |
Associated symptoms | |
Photophobia | 58% |
Phonophobia | 47% |
Osmophobia | 10% |
Cranial autonomic symptoms | 7% |
Nausea | 36% |
Vomiting | 7% |
Worsening by physical activity | 46% |
Drug n, % | Not Tolerated | No Response (0–30%) | Partial Response (31–50%) | Standard Response (50–75%) | Optimal Response (>75%) |
---|---|---|---|---|---|
Amitriptyline (n = 66) | 2 (3.0%) | 16 (24.2%) | 18 (27.3%) | 19 (28.8%) | 11 (16.7%) |
Anesthetic blockade (n = 18) | 1 (5.6%) | 8 (44.4%) | 2 (11.1%) | 5 (27.8%) | 2 (11.1%) |
OnabotulinumtoxinA (n = 11) | 0 (0%) | 3 (27.3%) | 5 (45.4%) | 1 (9.1%) | 2 (18.2%) |
Duloxetine (n = 8) | 1 (12.5%) | 4 (50%) | 1 (12.5%) | 2 (25%) | 0 (0%) |
Betablockers (n = 7) | 1 (14.3%) | 5 (71.4%) | 0 (0%) | 0 (05) | 1 (14.3%) |
Pregabaline (n = 6) | 0 (0%) | 3 (50%) | 2 (33.3%) | 1 (16.7%) | 0 (0%) |
Topiramate (n = 6) | 1 (16.7%) | 3 (50%) | 2 (33.3%) | 0 (0%) | 0 (0%) |
Mirtazapine (n = 5) | 0 (0%) | 2 (40%) | 1 (20%) | 1 (20%) | 1 (20%) |
Flunarizine (n = 5) | 1 (20%) | 1 (20%) | 2 (40%) | 0 (0%) | 1 (20%) |
Steroids (n = 4) | 1 (25%) | 1 (25%) | 1 (25%) | 1 (25%) | 0 (0%) |
Venlafaxine (n = 4) | 1 (25%) | 2 (50%) | 1 (25%) | 0 (0%) | 0 (0%) |
Gabapentine (n = 1) | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | 0 (0%) |
Zonisamide (n = 1) | 0 (0%) | 0 (0%) | 1 (100%) | 0 (0%) | 0 (0%) |
Candesartan (n = 1) | 0 (0%) | 0 (0%) | 1 (100%) | 0 (0%) | 0 (0%) |
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García-Azorín, D.; García-Ruiz, C.; Sierra-Mencía, Á.; González-Osorio, Y.; Recio-García, A.; González-Celestino, A.; García-Iglesias, C.; Planchuelo-Gómez, Á.; Íñiguez, A.E.; Guerrero-Peral, Á.L. Acute and Preventive Treatment of COVID-19-Related Headache: A Series of 100 Patients. Life 2024, 14, 910. https://doi.org/10.3390/life14070910
García-Azorín D, García-Ruiz C, Sierra-Mencía Á, González-Osorio Y, Recio-García A, González-Celestino A, García-Iglesias C, Planchuelo-Gómez Á, Íñiguez AE, Guerrero-Peral ÁL. Acute and Preventive Treatment of COVID-19-Related Headache: A Series of 100 Patients. Life. 2024; 14(7):910. https://doi.org/10.3390/life14070910
Chicago/Turabian StyleGarcía-Azorín, David, Claudia García-Ruiz, Álvaro Sierra-Mencía, Yésica González-Osorio, Andrea Recio-García, Ana González-Celestino, Cristina García-Iglesias, Álvaro Planchuelo-Gómez, Ana Echavarría Íñiguez, and Ángel L. Guerrero-Peral. 2024. "Acute and Preventive Treatment of COVID-19-Related Headache: A Series of 100 Patients" Life 14, no. 7: 910. https://doi.org/10.3390/life14070910