Post-COVID-19 neuropsychiatric manifestations among COVID-19 survivors suffering from migraine: a case-control study

Rehab Magdy; Alaa Elmazny; Shaimaa H Soliman; Eman H Elsebaie; Sara H Ali; Ali M Abdel Fattah; Mahmoud Hassan; Ahmed Yassien; Noha A Mahfouz; Radwa M Elsayed; Wael Fathy; Hoda M Abdel-Hamid; Jehan Mohamed; Mona Hussein

doi:10.1186/s10194-022-01468-y

Post-COVID-19 neuropsychiatric manifestations among COVID-19 survivors suffering from migraine: a case-control study

J Headache Pain. 2022 Aug 12;23(1):101. doi: 10.1186/s10194-022-01468-y.

Authors

Rehab Magdy¹, Alaa Elmazny^{1

2}, Shaimaa H Soliman³, Eman H Elsebaie⁴, Sara H Ali⁵, Ali M Abdel Fattah⁶, Mahmoud Hassan⁷, Ahmed Yassien⁸, Noha A Mahfouz⁹, Radwa M Elsayed¹⁰, Wael Fathy¹¹, Hoda M Abdel-Hamid¹², Jehan Mohamed¹¹, Mona Hussein¹³

Affiliations

¹ Neurology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
² Internal Medicine Department, Arabian Gulf University, Manama, Bahrain.
³ Neurology Department, Faculty of Medicine, Cairo University, Cairo, Egypt. shoshosoliman@yahoo.com.
⁴ Department of Public Health and Community Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt.
⁵ Department of Otolaryngology, Faculty of Medicine, Beni-Suef University, Beni- Suef, Egypt.
⁶ Department of Gastroenterology, Hepatology, and Endemic Medicine, Faculty of Medicine, Beni-Suef University, Beni- Suef, Egypt.
⁷ Department of Internal Medicine, Faculty of Medicine, Beni-Suef University, Beni- Suef, Egypt.
⁸ Department of Critical Care Medicine, Beni-Suef University, Beni-Suef, Egypt.
⁹ Department of Psychiatry Faculty of Medicine, Cairo University, Cairo, Egypt.
¹⁰ Department of Family Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt.
¹¹ Department of Anaesthesia, Surgical ICU and Pain Management, Beni-Suef University, Beni-Suef, Egypt.
¹² Department of Chest Diseases, Faculty of Medicine, Cairo University, Cairo, Egypt.
¹³ Neurology department, Beni-Suef University, Beni-Suef, Egypt.

Abstract

Background: The burden of post-coronavirus disease (COVID)-19 symptoms has been increasing and is of great concern in patients with pre-existing chronic medical conditions.This study aimed to delineate the post-COVID-19 neuropsychiatric symptoms among migraine patients compared to the non-migraine control group.

Methods: Two groups, each of 204 COVID-19 survivors, were enrolled in the study after 3 months of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, one group fulfilling the episodic migraine criteria and the other serving as a matching control group. Subjects were evaluated through an in-person interview for post-COVID-19 neuropsychiatric symptoms, including detailed headache patterns and severity, using the visual analogue scale.

Results: The Frequency of headache during the acute phase of COVID-19 was more frequent in migraine patients (OR = 1.60, 95%CI = 1.04-2.45, P-value = 0.031). The reported significant post-COVID-19 neuropsychiatric symptoms in migraine patients compared to controls were fatigue (OR = 1.662, 95%CI = 1.064-2.596, P-value = 0.025), anosmia/hyposmia (OR = 2.06, 95%CI = 1.164- 3.645, P-value = 0.012), cacosmia (OR = 2.663, 95%CI = 1.145-6.195, P-value = 0.019), depression (OR = 2.259, 95%CI = 1.284- 3.975, P-value = 0.004), anxiety (OR = 3.267, 95%CI = 1.747- 6.108, P-value ≤ 0.001), insomnia (OR = 2.203, 95%CI = 1.298- 3.739, P-value = 0.003), and headache (OR = 3.148, 95%CI = 1.616-6.136, P-value = ≤ 0.001).While there was no statistically significant difference between migraine patients and controls regarding the post-COVID-19 functional status score (P-value = 0.102). The pattern of post-COVID-19 headache was reported as chronic headache transformation in 17.6% of the migraine group, with the median intensity rate being 5.5 and IQR (3-7). In the control group, 14% experienced chronic headache attributed to systemic viral infection with a median intensity rate of 2 and IQR (2-5), while 12% experienced a new daily persistent headache with a median intensity of 5 and IQR (1-6).

Conclusion: The study highlighted the importance of follow-up migraine patients upon recovery from COVID-19 infection, being more vulnerable to post-COVID-19 symptoms.

Keywords: Headache; Long COVID-19; Migraine; Neuropsychiatric symptoms; SARS-CoV-2.

MeSH terms

COVID-19* / complications
Case-Control Studies
Headache / epidemiology
Headache / etiology
Humans
Migraine Disorders*
SARS-CoV-2
Survivors