Relative Frequency and Risk Factors of COVID-19 Related Headache in a Sample of Egyptian Population: A Hospital-Based Study

Mona Hussein; Wael Fathy; Ragaey A Eid; Hoda M Abdel-Hamid; Ahmed Yehia; Mostafa S Sheemy; Christine Ragaie; Ahmed Dahshan; Hoda I Rizk; Nabila Laz; Rehab Magdy

doi:10.1093/pm/pnab020

Relative Frequency and Risk Factors of COVID-19 Related Headache in a Sample of Egyptian Population: A Hospital-Based Study

Pain Med. 2021 Sep 8;22(9):2092-2099. doi: 10.1093/pm/pnab020.

Authors

Mona Hussein¹, Wael Fathy², Ragaey A Eid³, Hoda M Abdel-Hamid⁴, Ahmed Yehia⁵, Mostafa S Sheemy⁶, Christine Ragaie⁷, Ahmed Dahshan⁷, Hoda I Rizk⁸, Nabila Laz⁹, Rehab Magdy⁷

Affiliations

¹ Department of Neurology, Beni-Suef University, Beni-Suef, Egypt.
² Department of Anaesthesia, Surgical ICU and Pain management, Beni-Suef University, Beni-Suef, Egypt.
³ Department of Tropical medicine, Beni-suef University, Beni-Suef, Egypt.
⁴ Department of Chest diseases, Cairo University, Cairo, Egypt.
⁵ Department of Internal medicine, Beni-suef University, Beni-Suef, Egypt.
⁶ Department of Medical Microbiology and Immunology, Beni-suef University, Beni-Suef, Egypt.
⁷ Department of Neurology, Cairo University, Cairo, Egypt.
⁸ Department of Public Health and Community Medicine, Cairo University, Cairo, Egypt.
⁹ Department of Chest diseases, Beni-Suef University, Beni-Suef, Egypt.

Abstract

Objectives: Headache is considered one of the most frequent neurological manifestations of coronavirus disease 2019 (COVID-19). This work aimed to identify the relative frequency of COVID-19-related headache and to clarify the impact of clinical, laboratory findings of COVID-19 infection on headache occurrence and its response to analgesics.

Design: Cross-sectional study.

Setting: Recovered COVID-19 patients.

Subjects: In total, 782 patients with a confirmed diagnosis of COVID-19 infection.

Methods: Clinical, laboratory, and imaging data were obtained from the hospital medical records. Regarding patients who developed COVID-19 related headache, a trained neurologist performed an analysis of headache and its response to analgesics.

Results: The relative frequency of COVID-19 related headache among our sample was 55.1% with 95% confidence interval (CI) (.516-.586) for the estimated population prevalence. Female gender, malignancy, primary headache, fever, dehydration, lower levels of hemoglobin and platelets and higher levels of neutrophil/lymphocyte ratio (NLR) and CRP were significantly associated with COVID-19 related headache. Multivariate analysis revealed that female gender, fever, dehydration, primary headache, high NLR, and decreased platelet count were independent predictors of headache occurrence. By evaluating headache response to analgesics, old age, diabetes, hypertension, primary headache, severe COVID-19, steroid intake, higher CRP and ferritin and lower hemoglobin levels were associated with poor response to analgesics. Multivariate analysis revealed that primary headache, steroids intake, moderate and severe COVID-19 were independent predictors of non-response to analgesics.

Discussion: Headache occurs in 55.1% of patients with COVID-19. Female gender, fever, dehydration, primary headache, high NLR, and decreased platelet count are considered independent predictors of COVID-19 related headache.

Keywords: COVID-19 Related Headache; Dehydration; Fever; NLR; Primary Headache.

MeSH terms

COVID-19*
Cross-Sectional Studies
Egypt / epidemiology
Female
Headache / diagnosis
Headache / epidemiology
Hospitals
Humans
Risk Factors
SARS-CoV-2