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

• Published in: Journal of headache and pain 2022-08, Vol.23 (1), p.101-10, Article 101
• Main Authors: Magdy, Rehab, Elmazny, Alaa, Soliman, Shaimaa H., Elsebaie, Eman H., Ali, Sara H., Abdel Fattah, Ali M., Hassan, Mahmoud, Yassien, Ahmed, Mahfouz, Noha A., Elsayed, Radwa M., Fathy, Wael, Abdel-Hamid, Hoda M., Mohamed, Jehan, Hussein, Mona
• Format: Article
• Language: English
• Subjects: Anosmia; Case-Control Studies; Chronic infection; Coronaviruses; COVID-19; COVID-19 - complications; Headache; Headache - epidemiology; Headache - etiology; Headaches; Humans; Infections; Internal Medicine; Long COVID-19; Medicine; Medicine & Public Health; Mental disorders; Migraine; Migraine Disorders; Neurological disorders; Neurology; Neuropsychiatric symptoms; Olfaction disorders; Pain Medicine; Patients; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Sleep disorders; Statistical analysis; Survivor; Survivors
• ISSN: 1129-2369; 1129-2377; 1129-2377
• DOI: 10.1186/s10194-022-01468-y

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.