Headache a Common Acute Symptom Among Hospitalized COVID-19 Survivors

woman with a headache
Presenting at the 2022 AAN Annual Meeting, researchers evaluated acute and persistent headache in patients hospitalized with COVID-19.
(HealthDay News) — COVID-19 is associated with increased risk of specific neurological disorders, although apart from ischemic stroke, there is no excess risk compared to infection with influenza A/B and community-acquired pneumonia, according to a study presented at the annual Congress of the European Academy of Neurology, held from June 25 to 28 in Vienna.

Pardis Zarifkar, M.D., from Copenhagen University Hospital in Denmark, and colleagues examined the association between COVID-19 and specific central and peripheral neurological diseases. Patients with COVID-19 were compared to those without and to patients with influenza A/B and community-acquired bacterial pneumonia. The incidence of neurological disease was assessed one, three, six, and 12 months after positive test results. Data were included for 42,535 people with COVID-19; 8,329 with influenza; 1,566 with pneumonia; and 2,392,400 without COVID-19.

The researchers found that patients with COVID-19 had increased relative risk of developing Guillain Barré syndrome, multiple sclerosis, narcolepsy, Parkinson disease, Alzheimer disease, dementia of any type, and ischemic stroke compared to individuals without COVID-19 (relative risks, 3.1, 1.4, 3.2, 2.8, 4.9, 5.2, and 2.3, respectively). Patients hospitalized with COVID-19 had an increased risk of ischemic stroke at one, three, and six months compared to patients hospitalized with influenza (relative risks, 1.9, 1.8, and 1.9, respectively). The risk of neurological diseases was not increased compared to patients hospitalized with pneumonia.

“Reassuringly, apart for ischemic stroke, most neurological disorders do not appear to be more frequent after COVID-19 than after influenza or community-acquired bacterial pneumonia,” Zarifkar said in a statement.

Abstract No. OPR-033

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Headache was a relatively common acute symptom in a racially and ethnically diverse group of patients who had been hospitalized with COVID-19, according to study findings presented at the 2022 American Academy of Neurology (AAN) Annual Meeting, held from April 2 to April 7 in Seattle, Washington, and virtually from April 24-26, 2022.

Recognizing that headache is a common symptom of acute SARS-CoV-2 infection and of post-acute sequela of COVID-19 (PASC), the researchers sought to evaluate the clinical course and associated factors observed in a group of individuals who had been hospitalized between February 2020 and November 2020 with COVID-19. Among a total of 411 patients who had been hospitalized with COVID-19, a single-center chart review study was completed regarding the presence of headache during their hospitalization. Patients provided their consent and agreed to be interviewed at a 12-month follow-up, to evaluate the clinical course of their symptoms and any associated factors.

Among those patients who were evaluated, 17% (50 of 287) reported having a headache. Overall, 331of the 411 patients survived hospitalization. At the 12-month follow-up, a total of 43 patients were interviewed. Of these individuals, 44% were female, 74% were White, 19% were Black, 65% were Hispanic, and 58% spoke Spanish only. The mean participant age was 65±15 years.

Overall, 28% of those interviewed reported experiencing a new or a worsening headache with COVID-19 (58% of whom were female and 30% of whom were Migraine Disability Assessment [MIDAS] grade III to IV). Among 75% of the participants, their headache began within 7 days of a COVID-19 diagnosis. Overall, 12% of the patients reported persistent attacks that lasted for more than 3 months.

In a comparison of those who experienced a headache vs those who did not, 92% vs 65%, respectively, reported an impact on their lifestyle; 58% vs 23%, respectively, reported an effect on their employment/financial status; and 50% vs 23%, respectively, reported an impact on their sleep.

In the headache group compared with the no-headache group, an average of 5 symptoms vs 2 symptoms, respectively, persisted for more than 3 months. Further, among those in the headache group vs those in the no-headache group, 33% vs 13%, respectively, had persistent taste/smell abnormalities; 42% vs 26%, respectively, experienced persistent fatigue; 33% vs 16%, respectively, reported persistent imbalance; and 25% vs 16% had persistent cognitive impairment.

The researchers concluded that “persistent symptoms and psychosocial impact were common in those who had new or worsening headache, suggesting an early marker for PASC and the need for future multicenter studies to evaluate the impact of headache in PASC.”

Disclosure: None of the study authors has declared affiliations with biotech, pharmaceutical, and/or device companies.  


Monteith T, Cocores A, Mukhtarzada M, et al. Headache as an early symptom post-acute sequela of COVID19 in hospitalized COVID19 survivors. Presented at: the 2022 AAN Annual Meeting; April 2-7, 2022; Seattle, Washington; April 24-26, 2022; Virtual Meeting. Abstract S4.008.

This article originally appeared on Neurology Advisor