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

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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.

Summary

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.

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Author notes

  1. Laura Gómez-Dabó and Laura Melgarejo-Martínez contributed equally to this work.

Authors and Affiliations

  1. Neurology Department, Hospital Universitari Vall d’Hebron, Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain

    Laura Gómez-Dabó & Laura Melgarejo-Martínez

  2. Headache Unit, Neurology Department, Hospital Universitari Vall d’Hebron, Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain

    Edoardo Caronna & Patricia Pozo-Rosich

  3. Headache and Neurological Pain Research Group, Vall d’Hebron Research Institute, Department of Medicine, Universitat Autònoma de Barcelona, Ps. Vall d’Hebron 119-129, 08035, Barcelona, Spain

    Edoardo Caronna & Patricia Pozo-Rosich

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  1. Laura Gómez-Dabó
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  3. Edoardo Caronna
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Contributions

LGD, LMM, EC and PPR made substantial contributions to conception of the work. LGD, LMM and EC worked for acquisition and interpretation of data and wrote first draft. LGD, LMM, EC and PPR critically revised and finally approved the version to be published. All authors fully comply with and approve the version to be published.

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Correspondence to Edoardo Caronna.

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Conflict of Interest

LGD reports no disclosures. LMM reports no disclosures. EC has received honoraria from Novartis, Chiesi, Lundbeck, MedScape; his salary has been partially funded by Río Hortega grant Acción Estratégica en Salud 2017–2020, Instituto de Salud Carlos III (CM20/00217). He is a junior editor for Cephalalgia. PPR has received, in the last three years, honoraria as a consultant and speaker for: AbbVie, Biohaven, Chiesi, Eli Lilly, Lundbeck, Medscape, Novartis, Pfizer, and Teva. Her research group has received research grants from AbbVie, Novartis and Teva; as well as, Instituto Salud Carlos III, EraNet Neuron, European Regional Development Fund (001-P-001682) under the framework of the FEDER Operative Programme for Catalunya 2014-2020 - RIS3CAT; has received funding for clinical trials from AbbVie, Amgen, Biohaven, Eli Lilly, Novartis, and Teva. She is the Honorary Secretary of the International Headache Society. She is in the editorial board of Revista de Neurologia. She is an associate editor for Cephalalgia, Headache, Neurologia, The Journal of Headache and Pain, and Frontiers of Neurology. She is a member of the Clinical Trials Guidelines Committee of the International Headache Society. She has edited the Guidelines for the Diagnosis and Treatment of Headache of the Spanish Neurological Society. She is the founder of http://www.midolordecabeza.org. PPR does not own stocks from any pharmaceutical company.

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Gómez-Dabó, L., Melgarejo-Martínez, L., Caronna, E. et al. Headache in COVID-19 and Long COVID: to Know Facts for Clinical Practice. Curr Neurol Neurosci Rep 23, 551–560 (2023). https://doi.org/10.1007/s11910-023-01296-w

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