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García-Azorín D, Santana-López L, Lozano-Alonso JE, Ordax-Díez A, Vega-Alonso T, Macias Saint-Gerons D, González-Osorio Y, Rojo-Rello S, Eiros JM, Sánchez-Martínez J, Sierra-Mencía Á, Recio-García A, Martín-Toribio A, Sanz-Muñoz I, Guerrero-Peral ÁL. Factors associated to the presence of headache in patients with influenza infection and its consequences: a 2010-2020 surveillance-based study. J Headache Pain 2024; 25:18. [PMID: 38331709 PMCID: PMC10854039 DOI: 10.1186/s10194-024-01728-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 01/29/2024] [Indexed: 02/10/2024] Open
Abstract
Headache is a common symptom of influenza infection; however, its causes and consequences remain uncertain. In this manuscript, we analyzed which demographic and clinical factors were associated with the presence of headache during the course of influenza infection and whether patients with headache had a different prognosis, evaluated by need of hospitalization, sick leave or school absenteeism. The influence study (NCT05704335) was an observational study that analyzed data routinely collected from the Health Sentinel Network between 2010 and 2020. During the study period, 7832 cases were considered, among which, 5275 (67.4%) reported headache. The presence of headache was independently associated with myalgia (2.753; 95%CI: 2.456-3.087, P < 0.001), asthenia (OR: 1.958; 95%CI: 1.732-2.214, P < 0.001), shivering (OR: 1.925; 95%CI: 1.718-2.156, P < 0.001), nasopharyngeal erythema (OR: 1.505; 95%CI: 1.293-1.753, P < 0.001), fever (OR: 1.469; 95%CI: 1.159-1.861; P = 0.001), sudden onset of symptoms (OR: 1.380; 95%CI: 1.120-1.702, p = 0.004), female sex (OR: 1.134; 95%CI: 1.023-1.257, P = 0.018), and gastrointestinal symptoms (OR: 1.169; 95%CI: 1.039-1.315; P = 0.01). Patients with headache had a sex and age adjusted lower odds of being referred to the hospital (OR: 0.463; 95%CI: 0.264-0.812, P = 0.007) and a higher odd of having a sick leave and/or school absenteeism (absenteeism (OR: 1.342; 95%CI: 1.190-1.514, P < 0.001). In conclusion, the presence of headache seems associated with symptoms caused by the innate immune response. These findings support a headache pathophysiology linked with the innate immune response. Due to the potential negative consequences and its treatable nature, clinicians should systematically evaluate it and, whenever necessary, treat it too.
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Affiliation(s)
- David García-Azorín
- Department of Neurology, Headache Unit, Hospital Clínico Universitario de Valladolid, Hospital Clínico Universitario de Valladolid, Rondilla Santa Teresa Streat S/N, Edificio Rondilla, 47010, Valladolid, Spain.
- Department of Medicine, Faculty of Medicine, Universidad de Valladolid, Hospital Clínico Universitario de Valladolid, Rondilla Santa Teresa Streat S/N, Edificio Rondilla, 47010, Valladolid, Spain.
| | - Laura Santana-López
- Department of Neurology, Headache Unit, Hospital Clínico Universitario de Valladolid, Hospital Clínico Universitario de Valladolid, Rondilla Santa Teresa Streat S/N, Edificio Rondilla, 47010, Valladolid, Spain
| | - José Eugenio Lozano-Alonso
- Fundación Instituto de Estudios de Ciencias de La Salud de Castilla y León, ICSCYL, Valladolid, Soria, Spain
| | - Ana Ordax-Díez
- Fundación Instituto de Estudios de Ciencias de La Salud de Castilla y León, ICSCYL, Valladolid, Soria, Spain
| | - Tomas Vega-Alonso
- Dirección General de Salud Pública, Consejería de Sanidad, Junta de Castilla y León, Valladolid, Spain
| | - Diego Macias Saint-Gerons
- Department of Medicine, University of Valencia; INCLIVA Health Research Institute and CIBERSAM, Valencia, Spain
| | - Yésica González-Osorio
- Department of Neurology, Headache Unit, Hospital Clínico Universitario de Valladolid, Hospital Clínico Universitario de Valladolid, Rondilla Santa Teresa Streat S/N, Edificio Rondilla, 47010, Valladolid, Spain
| | - Silvia Rojo-Rello
- Department of Microbiology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - José M Eiros
- Department of Microbiology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
- National Influenza Centre, Valladolid, Spain
| | | | - Álvaro Sierra-Mencía
- Department of Neurology, Headache Unit, Hospital Clínico Universitario de Valladolid, Hospital Clínico Universitario de Valladolid, Rondilla Santa Teresa Streat S/N, Edificio Rondilla, 47010, Valladolid, Spain
| | - Andrea Recio-García
- Department of Neurology, Headache Unit, Hospital Clínico Universitario de Valladolid, Hospital Clínico Universitario de Valladolid, Rondilla Santa Teresa Streat S/N, Edificio Rondilla, 47010, Valladolid, Spain
| | - Alejandro Martín-Toribio
- Fundación Instituto de Estudios de Ciencias de La Salud de Castilla y León, ICSCYL, Valladolid, Soria, Spain
- National Influenza Centre, Valladolid, Spain
| | - Ivan Sanz-Muñoz
- Department of Microbiology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
- National Influenza Centre, Valladolid, Spain
| | - Ángel Luis Guerrero-Peral
- Department of Neurology, Headache Unit, Hospital Clínico Universitario de Valladolid, Hospital Clínico Universitario de Valladolid, Rondilla Santa Teresa Streat S/N, Edificio Rondilla, 47010, Valladolid, Spain
- Department of Medicine, Faculty of Medicine, Universidad de Valladolid, Hospital Clínico Universitario de Valladolid, Rondilla Santa Teresa Streat S/N, Edificio Rondilla, 47010, Valladolid, Spain
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