Objective

To investigate the association of headache during the acute phase of SARS-CoV-2 infection with long-term post-COVID headache and other post-COVID symptoms in hospitalised survivors.

Methods

A case-control study including patients hospitalised during the first wave of the pandemic in Spain was conducted. Patients reporting headache as a symptom during the acute phase and age- and sex-matched patients without headache during the acute phase participated. Hospitalisation and clinical data were collected from medical records. Patients were scheduled for a telephone interview 7 months after hospital discharge. Participants were asked about a list of post-COVID symptoms and were also invited to report any additional symptom they might have. Anxiety/depressive symptoms and sleep quality were assessed with the Hospital Anxiety and Depression Scale and the Pittsburgh Sleep Quality Index.

Results

Overall, 205 patients reporting headache and 410 patients without headache at hospitalisation were assessed 7.3 months (Standard Deviation 0.6) after hospital discharge. Patients with headache at onset presented a higher number of post-COVID symptoms (Incident Rate Ratio: 1.16, 95% CI: 1.03–1.30). Headache at onset was associated with a previous history of migraine (Odd Ratio: 2.90, 95% Confidence Interval: 1.41–5.98) and with the development of persistent tension-type like headache as a new post-COVID symptom (Odd Ratio: 2.65, 95% CI: 1.66–4.24). Fatigue as a long-term symptom was also more prevalent in patients with headache at onset (Odd Ratio: 1.55, 95% CI: 1.07–2.24). No between-group differences in the prevalence of anxiety/depressive symptoms or sleep quality were seen.

Conclusion

Headache in the acute phase of SARS-CoV-2 infection was associated with higher prevalence of headache and fatigue as long-term post-COVID symptoms. Monitoring headache during the acute phase could help to identify patients at risk of developing long-term post-COVID symptoms, including post-COVID headache.

中文翻译：

---

SARS-CoV-2 感染发作时出现的头痛与 COVID 后的长期头痛和疲劳有关：病例对照研究

客观的

调查 SARS-CoV-2 感染急性期头痛与长期 COVID 后头痛和住院幸存者的其他 COVID 后症状之间的关联。

方法

进行了一项病例对照研究，其中包括西班牙第一波大流行期间住院的患者。在急性期报告头痛为症状的患者和在急性期没有头痛的年龄和性别匹配的患者参与了研究。从病历中收集住院和临床数据。患者被安排在出院 7 个月后接受电话采访。参与者被问及 COVID 后症状的列表，并被邀请报告他们可能有的任何其他症状。使用医院焦虑和抑郁量表和匹兹堡睡眠质量指数评估焦虑/抑郁症状和睡眠质量。

结果

总体而言，在出院后 7.3 个月（标准偏差 0.6）对住院时报告头痛的 205 名患者和无头痛的 410 名患者进行了评估。出现头痛的患者出现更多的 COVID 后症状（发生率比：1.16，95% CI：1.03–1.30）。发作时的头痛与既往的偏头痛病史有关（奇数比：2.90，95% 置信区间：1.41-5.98）以及持续紧张型头痛作为 COVID 后新症状的发展（奇数比：2.65， 95% 置信区间：1.66–4.24）。疲劳作为长期症状在头痛患者中也更为普遍（奇数比：1.55，95% CI：1.07–2.24）。在焦虑/抑郁症状的患病率或睡眠质量方面没有观察到组间差异。

结论

SARS-CoV-2 感染急性期的头痛与作为 COVID 后长期症状的头痛和疲劳的患病率较高有关。在急性期监测头痛有助于识别有可能出现长期 COVID 后症状的患者，包括 COVID 后头痛。