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Mitsikostas DD, Caronna E, De Tommaso M, Deligianni CI, Ekizoglu E, Bolay H, Göbel CH, Kristoffersen ES, Lampl C, Moro E, Pozo‐Rosich P, Sellner J, Terwindt G, Irimia‐Sieira P. Headaches and facial pain attributed to SARS-CoV-2 infection and vaccination: a systematic review. Eur J Neurol 2024; 31:e16251. [PMID: 38415282 PMCID: PMC11235838 DOI: 10.1111/ene.16251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 01/23/2024] [Accepted: 02/01/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND AND PURPOSE The aim was to provide insights to the characteristics of headache in the context of COVID-19 on behalf of the Headache Scientific Panel and the Neuro-COVID-19 Task Force of the European Academy of Neurology (EAN) and the European Headache Federation (EHF). METHODS Following the Delphi method the Task Force identified six relevant questions and then conducted a systematic literature review to provide evidence-based answers and suggest specific diagnostic criteria. RESULTS No data for facial pain were identified in the literature search. (1) Headache incidence during acute COVID-19 varies considerably, with higher prevalence rates in prospective compared to retrospective studies (28.9%-74.6% vs. 6.5%-34.0%). (2) Acute COVID-19 headache is usually bilateral or holocranial and often moderate to severe with throbbing pain quality lasting 2-14 days after first signs of COVID-19; photo-phonophobia, nausea, anosmia and ageusia are common associated features; persistent headache shares similar clinical characteristics. (3) Acute COVID-19 headache is presumably caused by immune-mediated mechanisms that activate the trigeminovascular system. (4) Headache occurs in 13.3%-76.9% following SARS-CoV-2 vaccination and occurs more often amongst women with a pre-existing primary headache; the risk of developing headache is higher with the adenoviral-vector-type vaccines than with other preparations. (5) Headache related to SARS-CoV-2 vaccination is mostly bilateral, and throbbing, pressing, jolting or stabbing. (6) No studies have been conducted investigating the underlying mechanism of headache attributed to SARS-CoV-2 vaccines. CONCLUSION The results of this joint EAN/EHF initiative provide a framework for a better understanding of headache in the context of SARS-CoV-2 infection and vaccination.
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Affiliation(s)
| | - Edoardo Caronna
- Headache Unit, Neurology DepartmentHospital Universitari Vall d'HebronBarcelonaSpain
- Headache and Neurological Pain Research Group, Department of MedicineVall d'Hebron Research Institute, Universitat Autònoma de BarcelonaBarcelonaSpain
| | - Marina De Tommaso
- Neurophysiopathology Unit, DiBrain DepartmentAldo Moro UniversityBariItaly
| | | | - Esme Ekizoglu
- Department of Neurology, Faculty of MedicineIstanbul University, IstanbulIstanbulTurkey
| | - Hayrunnisa Bolay
- Department of Neurology and Algology, NÖROMGazi University AnkaraAnkaraTurkey
| | - Carl H. Göbel
- Department of NeurologyUniversity Hospital Schleswig‐HolsteinLübeckGermany
| | - Espen Saxhaug Kristoffersen
- Department of NeurologyAkershus University HospitalLørenskogNorway
- NorHEAD, Norwegian Centre for Headache ResearchAkershus University HospitalLørenskogNorway
- Department of General Practice, HELSAMUniversity of OsloOsloNorway
| | - Christian Lampl
- Department of Neurology and Stroke UnitKonventhospital Barmherzige Brüder LinzLinzAustria
- Headache Medical Center LinzLinzAustria
| | - Elena Moro
- Division of Neurology, CHU of Grenoble, Grenoble Institute of Neurosciences, Grenoble Alpes UniversityGrenobleFrance
| | - Patricia Pozo‐Rosich
- Headache Unit, Neurology DepartmentHospital Universitari Vall d'HebronBarcelonaSpain
- Headache and Neurological Pain Research Group, Department of MedicineVall d'Hebron Research Institute, Universitat Autònoma de BarcelonaBarcelonaSpain
| | - Johann Sellner
- Department of NeurologyLandesklinikum Mistelbach‐GänserndorfMistelbachAustria
| | - Gisela Terwindt
- Department of NeurologyLeiden University Medical CenterLeidenThe Netherlands
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Eberle RJ, Coronado MA, Gering I, Sommerhage S, Korostov K, Stefanski A, Stühler K, Kraemer-Schulien V, Blömeke L, Bannach O, Willbold D. Tau protein aggregation associated with SARS-CoV-2 main protease. PLoS One 2023; 18:e0288138. [PMID: 37603556 PMCID: PMC10441795 DOI: 10.1371/journal.pone.0288138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/20/2023] [Indexed: 08/23/2023] Open
Abstract
The primary function of virus proteases is the proteolytic processing of the viral polyprotein. These enzymes can also cleave host cell proteins, which is important for viral pathogenicity, modulation of cellular processes, viral replication, the defeat of antiviral responses and modulation of the immune response. It is known that COVID-19 can influence multiple tissues or organs and that infection can damage the functionality of the brain in multiple ways. After COVID-19 infections, amyloid-β, neurogranin, tau and phosphorylated tau were detected extracellularly, implicating possible neurodegenerative processes. The present study describes the possible induction of tau aggregation by the SARS-CoV-2 3CL protease (3CLpro) possibly relevant in neuropathology. Further investigations demonstrated that tau was proteolytically cleaved by the viral protease 3CL and, consequently, generated aggregates. However, more evidence is needed to confirm that COVID-19 is able to trigger neurodegenerative diseases.
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Affiliation(s)
- Raphael Josef Eberle
- Institute of Biological Information Processing (IBI-7: Structural Biochemistry), Forschungszentrum Jülich, Jülich, Germany
- Institute of Physical Biology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Mônika Aparecida Coronado
- Institute of Biological Information Processing (IBI-7: Structural Biochemistry), Forschungszentrum Jülich, Jülich, Germany
| | - Ian Gering
- Institute of Biological Information Processing (IBI-7: Structural Biochemistry), Forschungszentrum Jülich, Jülich, Germany
| | - Simon Sommerhage
- Institute of Biological Information Processing (IBI-7: Structural Biochemistry), Forschungszentrum Jülich, Jülich, Germany
| | - Karolina Korostov
- Institute of Biological Information Processing (IBI-7: Structural Biochemistry), Forschungszentrum Jülich, Jülich, Germany
| | - Anja Stefanski
- Molecular Proteomics Laboratory (MPL), BMFZ, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Kai Stühler
- Molecular Proteomics Laboratory (MPL), BMFZ, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Victoria Kraemer-Schulien
- Institute of Biological Information Processing (IBI-7: Structural Biochemistry), Forschungszentrum Jülich, Jülich, Germany
| | - Lara Blömeke
- Institute of Biological Information Processing (IBI-7: Structural Biochemistry), Forschungszentrum Jülich, Jülich, Germany
- Institute of Physical Biology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Oliver Bannach
- Institute of Biological Information Processing (IBI-7: Structural Biochemistry), Forschungszentrum Jülich, Jülich, Germany
- Institute of Physical Biology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- attyloid GmbH, Düsseldorf, Germany
| | - Dieter Willbold
- Institute of Biological Information Processing (IBI-7: Structural Biochemistry), Forschungszentrum Jülich, Jülich, Germany
- Institute of Physical Biology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- JuStruct: Jülich Centre for Structural Biology, Forschungszentrum Jülich, Jülich, Germany
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Mutiawati E, Kusuma HI, Fathima R, Syahrul S, Musadir N. A comparison study of headache characteristics and headache-associated quality-of-life of COVID-19 and non-COVID-19 patients. NARRA J 2022; 2:e93. [PMID: 38449902 PMCID: PMC10914131 DOI: 10.52225/narra.v2i3.93] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/06/2022] [Indexed: 03/08/2024]
Abstract
Headache is prevalent in coronavirus disease 2019 (COVID-19) patients. The main objective of this study was to compare the characteristics of COVID-19-associated headache to non-COVID-19 headache. The quality-of-life (QoL) and its associated determinants between COVID-19 and non-COVID-19 patients were also compared. A cross-sectional study was conducted in Banda Aceh, Indonesia. Headache and QoL were assessed using the International Classification of Headache Disorders, version 3 (ICHD-3), and the 36-item Short Form Health Survey (SF-36), respectively. Factors associated with poor QoL in COVID-19 and non-COVID-19 patients were examined using logistic regression. A total of 356 headache patients were included: 215 COVID-19 and 141 non-COVID-19 patients. Our data suggested that the headache in COVID-19 patients was bilateral; pain centered on one specific area with a pulsating or pressing sensation; pain intensity ranging from moderate to severe; and the frequency ranging from more than twice per week to every day. Non-COVID-19 headache was bilateral; pain centered on one side of the head resembling a migraine with pulsating or pressing sensation; mild to moderate pain intensity; and the frequency of one or two times per month. In COVID-19, low QoL was associated with unemployment status, having non-health-related jobs, having used painkillers to reduce the pain, having long duration of headache, having more frequency of attacks, and having headaches that were worsened by activities or light, and having additional symptom during a headache attach. In non-COVID-19 patients, poor QoL was associated with the use of painkillers, long duration of headache, and having conditions that aggravate the headache. To prevent long-term effects of headache associated with COVID-19, studies exploring the photobiology of headache are needed, along with the necessity of having standardised guideline on headache prevention.
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Affiliation(s)
- Endang Mutiawati
- Department of Neurology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
- Department of Neurology, Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia
| | - Hendrix Indra Kusuma
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
- Department of Biology, Faculty of Mathematics and Natural Sciences, Universitas Syiah Kuala, Banda Aceh, Indonesia
- Department of Biology Education, Faculty of Tarbiyah and Teacher Training, Universitas Islam Negeri Ar-Raniry, Banda Aceh, Indonesia
| | - Raisha Fathima
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Syahrul Syahrul
- Department of Neurology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
- Department of Neurology, Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia
| | - Nasrul Musadir
- Department of Neurology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
- Department of Neurology, Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia
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Togha M, Hashemi SM, Yamani N, Martami F, Salami Z. A Review on Headaches Due to COVID-19 Infection. Front Neurol 2022; 13:942956. [PMID: 35911910 PMCID: PMC9327440 DOI: 10.3389/fneur.2022.942956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
Since December 2019, the time when the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was spotted, numerous review studies have been published on COVID-19 and its neuro invasion. A growing number of studies have reported headaches as a common neurological manifestation of COVID-19. Although several hypotheses have been proposed regarding the association between headache and the coronavirus, no solid evidence has been presented for the mechanism and features of headache in COVID-19. Headache also is a common complaint with the omicron variant of the virus. COVID-19 vaccination also is a cause of new-onset headaches or aggravation of the previous headache in migraine or tension headache sufferers. In this review study, the types of headaches reported in previous studies and their possible pathogenic mechanisms are outlined. To accomplish this objective, various types of headaches are classified and their patterns are discussed according to ICHD-3 diagnostic criteria, including, headaches attributed to systemic viral infection, viral meningitis or encephalitis, non-infectious inflammatory intracranial disease, hypoxia and/or hypercapnia, cranial or cervical vascular disorder, increased cerebrospinal fluid (CSF) pressure, refractive error, external-compression headache, and cough headache. Then, their pathogeneses are categorized into three main categories, direct trigeminal involvement, vascular invasion, and inflammatory mediators. Furthermore, persistent headache after recovery and the predictors of intensity is further investigated. Post-vaccination headache is also discussed in this review.
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Affiliation(s)
- Mansoureh Togha
- Headache Department, Iranian Center of Neurological Researches, Institute of Neuroscience, Tehran University of Medical Sciences, Tehran, Iran
- Headache Department, Neurology Ward, Sina Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyedeh Melika Hashemi
- Headache Department, Iranian Center of Neurological Researches, Institute of Neuroscience, Tehran University of Medical Sciences, Tehran, Iran
| | - Nooshin Yamani
- Neurology Department, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Fahimeh Martami
- Headache Department, Iranian Center of Neurological Researches, Institute of Neuroscience, Tehran University of Medical Sciences, Tehran, Iran
| | - Zhale Salami
- Headache Department, Iranian Center of Neurological Researches, Institute of Neuroscience, Tehran University of Medical Sciences, Tehran, Iran
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Aragão MDFVV, Araújo LC, Valença MM. Headache and infections of the central nervous system: neuroradiology. HEADACHE MEDICINE 2022. [DOI: 10.48208/headachemed.2022.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Headache may be a cardinal symptom in a patient with an intracranial infection. Meningitis, meningoencephalitis, empyema, and brain abscess are the most frequent infections of the central nervous system. They are usually accompanied by severe headache, usually acute at onset, accompanied by high temperature, altered level of consciousness, in addition to alterations in the neurologic examination. In this minireview, the authors intend to show and comment on some neuroimaging aspects found during the investigation of patients with a headache caused by an infectious intracranial lesion.
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Neurological Prognostic Factors in Hospitalized Patients with COVID-19. Brain Sci 2022; 12:brainsci12020193. [PMID: 35203956 PMCID: PMC8870483 DOI: 10.3390/brainsci12020193] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 01/27/2022] [Accepted: 01/28/2022] [Indexed: 02/06/2023] Open
Abstract
We aimed to search whether neurological symptoms or signs (NSS) and the MEWS (Modified Early Warning Score) score were associated with in-hospital mortality or oxygen requirement during the first 14 days of hospitalization in COVID-19 patients recruited at the University Hospital in Krakow, Poland. The detailed clinical questionnaires on twenty NSS were either filled out by patients prospectively or retrospectively assessed by neurologists based on daily medical records. NSS were considered high or low-risk if they were associated with increased or decreased mortality in the univariable analysis. This cohort study included 349 patients with COVID-19 (median age 64, interquartile range (51–77), women 54.72%). The presence of high-risk NSS (decreased level of consciousness, delirium, seizures, and symptoms of stroke or transient ischemic attack) or its combination with the absence of low-risk NSS (headache, dizziness, decreased mood, and fatigue) increased the risk of in-hospital mortality in SARS-CoV-2 infection 3.13 and 7.67-fold, respectively. The presence of low-risk NSS decreased the risk of in-hospital mortality in COVID-19 patients more than 6-fold. Death in patients with SARS-CoV-2 infection, apart from NSS, was predicted by older age, neoplasm, and higher MEWS scores on admission. High-risk NSS or their combination with the absence of low-risk NSS increased the risk of oxygen requirement during hospitalization in COVID-19 patients 4.48 and 1.86-fold, respectively. Independent predictors of oxygen therapy during hospitalization in patients with SARS-CoV-2 infection were also older age, male sex, neoplasm, and higher MEWS score on admission.
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