Title : Post covid headache, in 510 cases presented in emergency department on regional hospital durres, albania in period november 2020 –november 2022
SARSCoV2 the virus responsible for the COVID19 pandemic had not only respiratory symptoms,butalso neurological symptoms, and headache is a frequent complaint.Pathophysiologyof headache in the context of COVID 19 has some mechanisms that can be involved in persistence of headache after acute stage of the disease. These mechanisms include systemic inflammation that can stimulate cytokine storm,canactivate trigeminovascularsystem at the meninges,andin some patients this inflammatory response may be sustained after infection and can play role at post Covid headache.
We have seen 510 patients that have been presented at emergency department and neurology consult at SRD with headache after covid19(2-10months after infections).15%of patients had severe covidinfections with respiratory insuficienceand have been recovered in hospital(76 patients)and85%(434 patients) have been treated ambulatory.themost of patients had bilateral frontal headache(52%)and holocranicheadache(22%), and hemicranicmigraine type(26%).
Most of patients had oppressive pain,72%(367 patients)had moderate headache and 28%(143patients) had severe continousheadache. Middle age of patients was52years old and65%were female(331)and 35%male(179) and mean time of headache was 3.6month from all patients 30%(153 patients) have been known with primary headache, and76%had migraine (116 patients,78 female,38 male),22%tensive type headache (34 patients, 20 female and 14 male) and2% had cluster headache (3patients were mens) .From all 510 of patients 45%(230) had also other post covidsymptoms like dizziness,memoryproblems, insomnia,brainfog,depressionand anxiousestate etc.
The mechanisms of persistent headache for months after covid19 infections means to be stimulate by inflammatory mechanisms with stimulation of the trigeminovascularsystem,andCGRP(calcitonigene-related peptide) released by pulmonary endings nerve during viral infections may stimulate migraine.