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Review
. 2023 Oct;23(10):551-560.
doi: 10.1007/s11910-023-01296-w. Epub 2023 Sep 4.

Headache in COVID-19 and Long COVID: to Know Facts for Clinical Practice

Laura Gómez-Dabó #  1 , Laura Melgarejo-Martínez #  1 , Edoardo Caronna  2   3 , Patricia Pozo-Rosich  4   5
Affiliations
Review

Headache in COVID-19 and Long COVID: to Know Facts for Clinical Practice

Laura Gómez-Dabó et al. Curr Neurol Neurosci Rep. 2023 Oct.

Abstract

Purpose of review: Headache is one of the most frequent symptoms of the acute and post-acute phase of COVID-19. Specific epidemiology, clinical features, risk factors, pathophysiology, and treatment have been reported in these two scenarios. With this narrative review of the literature, we aim to provide updated knowledge on headache in the COVID-19 setting and give clinicians a practical approach on this topic to guide them in their clinical practice.

Recent findings: Headache mechanisms in COVID-19 are still poorly understood. Strong evidence is also lacking on how to best treat and manage these patients, especially those with persistent and disabling headache after COVID-19. Data are also scarce on the characteristics of headache in COVID-19 caused by the new SARS-CoV-2 (Omicron) variants and how these may influence the acute and persistent symptoms of COVID-19. Patients with pre-existing primary headache disorders remain a particularly concerning population due to their biological predisposition in suffering from headaches and the potential risk of worsening in the setting of SARS-CoV-2 infection. Although there is an exponential growth of scientific evidence, studies are often controversial and focused on the first wave of the pandemic, making COVID-19 headache still a challenging matter for clinicians. New research is therefore needed.

Keywords: COVID-19; Headache; Long COVID; Post-COVID syndrome.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
    1. •• Caronna E, Ballvé A, Llauradó A, Gallardo VJ, María Ariton D, Lallana S, et al. Headache: a striking prodromal and persistent symptom, predictive of COVID-19 clinical evolution. Cephalalgia. 2020;40(13):1410–21. First prospective study describing COVID-19 headache (incidence, characteristics, related inflammatory responses etc), observing that presence of headache in the acute phase of COVID-19 is predictive of a shorter disease duration.
    1. Caronna E, Alpuente A, Torres-Ferrus M, Pozo-Rosich P. Toward a better understanding of persistent headache after mild COVID-19: three migraine-like yet distinct scenarios. Headache. 2021;61(8):1277–80. - PubMed - PMC - DOI
    1. Sampaio Rocha-Filho PA. Headache associated with COVID-19: epidemiology, characteristics, pathophysiology, and management. Headache. 2022;62(6):650–6. - PubMed - PMC - DOI
    1. Tana C, Bentivegna E, Cho SJ, Harriott AM, García-Azorín D, Labastida-Ramirez A, et al. Long COVID headache. J Headache Pain. 2022;23:1. - DOI
    1. Coronavirus Search Trends-Google Trends. https://trends.google.com/trends/story/GB_cu_JSW_pHABAADqAM_en . Accessed 8 April 2023.

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