COVID-19 vaccination-related headache showed two different clusters in the long-term course: a prospective multicenter follow-up study (COVA-Head Study)

The Journal of Headache and Pain

Research

Işıl Yazıcı Gençdal¹  Rabia Gökçen Gözübatık-Celik¹  Esra Acıman Demirel²  Bahar Taşdelen³  Paolo Martelletti⁴  Ayşe Nur Özdağ Acarlı⁵  Mustafa Ertaş⁶  Esme Ekizoğlu⁶  Betül Baykan⁷  Arife Çimen Atalar⁸  David Garcia Azorin⁹  Javid Shafiyev^1,10  Ömer Karadaş^1,10  Dimos Mitsikostas^1,11  Loukia Apostolakopoulou^1,11  Hayrunnisa Bolay^1,12  Aynur Özge^1,13  Pınar Yalınay Dikmen^1,14  Elif Ilgaz Aydınlar^1,14  Burcu Polat^1,15  Hamit Genç^1,16 

[1] Bakirkoy Prof. Dr. Mazhar Osman Training and Research Hospital for Psychiatric, Neurologic and Neurosurgical Diseases, University of Health Sciences, Istanbul, Turkey;Bülent Ecevit University Neurology Department, Zonguldak, Turkey;Department of Biostatistics and Medical Informatic, Mersin University School of Medicine, Mersin, Turkey;Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy;Department of Neurology, Ermenek State Hospital, Karaman, Turkey;Department of Neurology, Headache Center, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey;Department of Neurology, Headache Center, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey;Department of Neurology, EMAR Medical Center, Istanbul, Turkey;Department of Neurology, Health Sciences University, Kanuni Sultan Süleyman Education and Research Hospital, Istanbul, Turkey;Department of Neurology, Hospital Clínico Universitario de Valladolid, Headache Unit, Valladolid, Spain;Department of Neurology, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey;First Neurology Department, Medical School, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece;Medical Faculty, Department of Neurology and Algology, Gazi University, Ankara, Turkey;Medical Faculty, Department of Neurology, Mersin University, Mersin, Türkiye;School of Medicine, Department of Neurology, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey;School of Medicine, Department of Neurology, Istanbul Medipol University, Istanbul, Turkey;University of Health Sciences, Van Training and Research Hospital, Van, Türkiye;

关键词: COVID;    Vaccination;    Long-COVID;    Headache;    Primary headache;   

DOI  :  10.1186/s10194-023-01665-3

 received in 2023-07-10, accepted in 2023-09-05,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundAlthough acute headache following COVID-19 vaccination is widely acknowledged, the long-term progression of these headaches remains poorly understood. Our objective was to identify various phenotypes of prolonged or worsened headaches associated with COVID-19 vaccination and document any changes in these phenotypes over an extended period. Additionally, we aimed to document the diverse headache presentations among patients with pre-existing primary headaches.MethodsA multinational, prospective observational study was conducted to investigate prolonged or worsened headaches associated with COVID-19 vaccination. Questionnaires assessing COVID-19 vaccination-related headaches at three time points (initial visit, 3rd month follow-up, and 6th month follow-up) were developed for the study. Headache specialists/clinicians evaluated patients using these questionnaires in a prospective manner. Repeated K-means cluster analysis was performed to identify patient profiles with prolonged or worsened headaches related to COVID-19 vaccination.ResultsAmong the 174 patients included in the study, there was a female-to-male ratio of 128 (73.6%) to 46 (26.4%). The mean age of the patient group was 45.2 ± 13.3 years, and 107 patients (61.5%) had a pre-existing history of primary headaches. Through the analysis, two major clusters were identified based on headache characteristics at each visit. During the first visit (n = 174), Cluster 1 primarily comprised patients with a history of primary headaches, frontal localization of pain, throbbing pain type, more severe headaches accompanied by symptoms such as nausea, phonophobia, photophobia, and osmophobia, and worsened by physical activity. In contrast, Cluster 2 consisted of patients with longer headache durations (over one month) and a stabbing/pressing quality of pain. Patients in Cluster 1 had a higher prevalence of migraine as the pre-existing primary headache disorder compared to Cluster 2 (90.48% vs. 68.18%, respectively; p = 0.005).ConclusionThe identification of two distinct phenotypes of prolonged or worsened headaches related to COVID-19 vaccination can provide valuable clinical insights. Having an awareness of the potential worsening of headaches following COVID-19 vaccination, particularly in patients with a primary headache disorder such as migraine, can help clinicians and headache experts anticipate and adjust their treatment strategies accordingly. This knowledge can aid in preplanning treatment modifications and optimize patient care.

【 授权许可】

CC BY   
© Springer-Verlag Italia S.r.l., part of Springer Nature 2023

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