Headache as an acute and post‐COVID‐19 symptom in COVID‐19 survivors: A meta‐analysis of the current literature

Abstract

Background Headache is identified as a common post‐COVID sequela experienced by COVID‐19 survivors. The aim of this pooled analysis was to synthesize the prevalence of post‐COVID headache in hospitalized and non‐hospitalized patients recovering from SARS‐CoV‐2 infection. Methods MEDLINE, CINAHL, PubMed, EMBASE, and Web of Science databases, as well as medRxiv and bioRxiv preprint servers, were searched up to 31 May 2021. Studies or preprints providing data on post‐COVID headache were included. The methodological quality of the studies was assessed using the Newcastle‐Ottawa Scale. Random effects models were used for meta‐analytical pooled prevalence of post‐COVID headache. Data synthesis was categorized at hospital admission/symptoms' onset, and at 30, 60, 90, and ≥180 days afterwards. Results From 9573 studies identified, 28 peer‐reviewed studies and 7 preprints were included. The sample was 28,438 COVID‐19 survivors (12,307 females; mean age: 46.6, SD: 17.45 years). The methodological quality was high in 45% of the studies. The overall prevalence of post‐COVID headache was 47.1% (95% CI 35.8–58.6) at onset or hospital admission, 10.2% (95% CI 5.4–18.5) at 30 days, 16.5% (95% CI 5.6–39.7) at 60 days, 10.6% (95% CI 4.7–22.3) at 90 days, and 8.4% (95% CI 4.6–14.8) at ≥180 days after onset/hospital discharge. Headache as a symptom at the acute phase was more prevalent in non‐hospitalized (57.97%) than in hospitalized (31.11%) patients. Time trend analysis showed a decreased prevalence from the acute symptoms’ onset to all post‐COVID follow‐up periods which was maintained afterwards. Conclusion This meta‐analysis found that the prevalence of post‐COVID headache ranged from 8% to 15% during the first 6 months after SARS‐CoV‐2 infection.

Headache, anosmia, ageusia and other neurological symptoms in COVID-19: a cross-sectional study

“…In another study carried out in Spain that included both in-patients and out-patients, headache was the symptom that most bothered 15.6% of patients [ 19 ]. A recent systematic review found a prevalence of headache in the acute phase of COVID-19 of 47.1% (95%CI: 35.8–58.6%) of patients, which is similar to our findings [ 20 ].…”

The Role of Cytochrome P450 Enzymes in COVID-19 Pathogenesis and Therapy

“…The symptoms of COVID-19 patients are varied, with the most common being fever, cough, digestive tract symptoms, sleep disorders and headaches, which are often treated by medication (Guan et al, 2020a;Bhat and Chokroverty, 2021;Fernández-De-Las-Peñas et al, 2021). Ibuprofen and acetaminophen are the most commonly used antipyretics.…”

Headache with SARS‐CoV‐2 infection: A matter of concern

“…In this issue, Fernandes‐de‐las‐Penas et al [ 2 ] confirm that headache is not only frequent in the acute phase of SARS‐CoV‐2 infection but is a notable COVID‐19 sequela in a subgroup of patients. Their findings are based on a meta‐analysis of various scientific databases up to May 2021, which involved 28,438 COVID‐19 survivors from 35 studies (longitudinal design in 40%).…”

“…The world has been kept in suspense since early 2020 by coronavirus disease 2019 (COVID-19), a multi-organ disease caused by the highly contagious severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2). Cephalalgia, the most frequent early symptom of COVID-19, not only is painful but is a disabling condition that causes substantial personal suffering, impaired quality of life, and economic burden [1]. Headache in acute viral illness is seen as a consequence of the immune response, whereas the mechanism of action leading to its persistence thereafter is not well understood.…”

“…This staggering number shows the need to build awareness in the medical community and prevent disparities in healthcare [3]. In this regard, headache in acute COVID-19 is more intense in women and is characterized by bilateral headache predominantly affecting the forehead, with pressing quality and severe intensity, and is frequently accompanied by typical migraine symptoms [1]. Individuals with headache during acute COVID-19 are generally younger and have a higher frequency of fever.…”