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Multicenter Study
. 2020 Nov;40(13):1459-1473.
doi: 10.1177/0333102420965139.

I stay at home with headache. A survey to investigate how the lockdown for COVID-19 impacted on headache in Italian children

Laura Papetti  1 , Pierfrancesco Alaimo Di Loro  2 , Samuela Tarantino  1 , Licia Grazzi  3 , Vincenzo Guidetti  4 , Pasquale Parisi  5 , Vincenzo Raieli  6 , Vittorio Sciruicchio  7 , Cristiano Termine  8 , Irene Toldo  9 , Elisabetta Tozzi  10 , Paola Verdecchia  4 , Marco Carotenuto  11 , Matteo Battisti  5 , Angela Celi  8 , Daniela D'Agnano  7 , Noemi Faedda  4 , Michela An Ferilli  1 , Giovanni Grillo  6 , Giulia Natalucci  4 , Agnese Onofri  10 , Maria Federica Pelizza  9 , Fabiana Ursitti  1 , Michelangelo Vasta  12 , Margherita Velardi  5 , Martina Balestri  13 , Romina Moavero  1   12 , Federico Vigevano  13 , Massimiliano Valeriani  1   14
Affiliations
Multicenter Study

I stay at home with headache. A survey to investigate how the lockdown for COVID-19 impacted on headache in Italian children

Laura Papetti et al. Cephalalgia. 2020 Nov.

Abstract

Objective: The present Italian multicenter study aimed at investigating whether the course of primary headache disorders in children and adolescents was changed during the lockdown necessary to contain the COVID-19 emergency in Italy.

Methods: During the lockdown, we submitted an online questionnaire to patients already diagnosed with primary headache disorders. Questions explored the course of headache, daily habits, psychological factors related to COVID-19, general mood and school stress. Answers were transformed into data for statistical analysis. Through a bivariate analysis, the main variables affecting the subjective trend of headache, and intensity and frequency of the attacks were selected. The significant variables were then used for the multivariate analysis.

Results: We collected the answers of 707 patients. In the multivariate analysis, we found that reduction of school effort and anxiety was the main factor explaining the improvement in the subjective trend of headache and the intensity and frequency of the attacks (p < 0.001). The greater the severity of headache, the larger was the clinical improvement (p < 0.001). Disease duration was negatively associated with the improvement (p < 0.001). It is noteworthy that clinical improvement was independent of prophylaxis (p > 0.05), presence of chronic headache disorders (p > 0.05) and geographical area (p > 0.05).

Conclusions: Our study showed that lifestyle modification represents the main factor impacting the course of primary headache disorders in children and adolescents. In particular, reduction in school-related stress during the lockdown was the main factor explaining the general headache improvement in our population.

Keywords: COVID-19; Migraine; lifestyle; lockdown.

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Conflict of interest statement

Declaration of conflicting interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
(a) Trend of infections for COVID-19 in Italy during the period of submission of questionnaire (blue line). (b) Geographical distribution of deaths for COVID-19. Asterisks show the locations of the headache centers participating in the study.
Figure 2.
Figure 2.
Study design. *Results concerning these variables are not discussed because they failed to show significance in multivariate analysis. Severity: Average of headache attack frequency before lockdown and monthly consumption of drug for attacks before lockdown.
Figure 3.
Figure 3.
Distribution of patients according to the primary endpoints. (a) trend of headache; (b) intensity of attacks; (c) difference in frequency of attacks between before and during lockdown.
Figure 4.
Figure 4.
Results from multivariate analysis. Relations between frequency log ratio and severity score (a), duration of headache in months (b), school anxiety (c) and reduction of school effort (d).
See this image and copyright information in PMC

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