Effects of the onabotulinumtoxinA follow-up delay in migraine course during the COVID-19 lockdown.

BACKGROUND: Face-to-face procedures have been postponed during COVID-19 pandemic. We aim to evaluate the impact of onabotulinumtoxinA follow-up delay in migraine during COVID-19 pandemic. METHODS: Subjective worsening, intensity of migraine attacks, and frequency of headache and migraine were retrospectively compared between patients with unmodified and interrupted onabotulinumtoxinA follow-up in Headache Units. RESULTS: We included 67 patients with chronic migraine or high-frequency episodic migraine under onabotulinumtoxinA treatment, 65 (97.0%) female, 44.5 ± 12.1 years old. Treatment administration was voluntarily delayed in 14 (20.9%) patients and nine (13.4%) were unable to continue follow-up. Patients with uninterrupted follow-up during lockdown presented 7.6 and 8.1 less monthly days with headache (adjusted p = 0.017) and migraine attacks (adjusted p = 0.009) compared to patients whose follow-up was interrupted, respectively. CONCLUSION: Involuntary delay of onabotulinumtoxinA follow-up in patients with migraine due to COVID-19 pandemic was associated with a higher frequency of headache and migraine attacks. Safe administration of onabotulinumtoxinA during lockdown should be promoted.

Evaluation of the Impact of the COVID-19 Lockdown in the Clinical Course of Migraine.

OBJECTIVE: Previous studies have demonstrated that emotional stress, changes in lifestyle habits and infections can worsen the clinical course of migraine. We hypothesize that changes in habits and medical care during coronavirus disease 2019 (COVID-19) lockdown might have worsened the clinical course of migraine. DESIGN: Retrospective survey study collecting online responses from migraine patients followed-up by neurologists at three tertiary hospitals between June and July 2020. METHODS: We used a web-based survey that included demographic data, clinical variables related with any headache (frequency) and migraine (subjective worsening, frequency, and intensity), lockdown, and symptoms of post-traumatic stress. RESULTS: The response rate of the survey was 239/324 (73.8%). The final analysis included 222 subjects. Among them, 201/222 (90.5%) were women, aged 42.5 ± 12.0 (mean±SD). Subjective improvement of migraine during lockdown was reported in 31/222 participants (14.0%), while worsening in 105/222 (47.3%) and was associated with changes in migraine triggers such as stress related to going outdoors and intake of specific foods or drinks. Intensity of attacks increased in 67/222 patients (30.2%), and it was associated with the subjective worsening, female sex, recent insomnia, and use of acute medication during a headache. An increase in monthly days with any headache was observed in 105/222 patients (47.3%) and was related to symptoms of post-traumatic stress, older age and living with five or more people. CONCLUSIONS: Approximately half the migraine patients reported worsening of their usual pain during the lockdown. Worse clinical course in migraine patients was related to changes in triggers and the emotional impact of the lockdown.

Psychological symptoms of the outbreak of the COVID-19 confinement in Spain.

We studied the short-term psychological effects of the COVID-19 crisis and the quarantine on 3550 adults from the Spanish population in a cross-sectional survey. Symptoms of anxiety, depression, and stress were analyzed using the 21-item version of the Depression Anxiety Stress Scale. Symptoms of posttraumatic stress disorder were analyzed using the Impact of Event Scale. Symptomatic scores of anxiety, depression, and stress were observed in 20% to 30% of respondents. Symptomatic scores indicating psychological stress were found in 47.5% of respondents. Similar to the findings of other multiple studies, confinement has been found to have significant emotional impact in the Spanish population.

Longitudinal evaluation of the psychological impact of the COVID-19 crisis in Spain.

BACKGROUND: Strict confinement and social distancing measures have been imposed due to the COVID-19 pandemic in many countries. The aim was to assess the temporal evolution of the psychological impact of the COVID-19 crisis and lockdown from two surveys, separated by one month, performed in Spain. METHODS: Symptoms of depression, anxiety and stress, and the psychological impact of the situation were longitudinally analyzed using the Depression Anxiety and Stress Scale (DASS-21) and the Impact of Event Scale (IES) respectively. RESULTS: There was a total of 4,724 responses from both surveys. Symptomatic scores of anxiety, depression and stress were exhibited by 37.22%, 46.42% and 49.66% of the second survey respondents, showing a significant increase compared to the first survey (32.45%, 44.11% and 37.01%, respectively). There was no significant longitudinal change of the IES scores, with 48.30% of the second survey participants showing moderate to severe impact of the confinement. Constant news consumption about COVID-19 was found to be positively associated with symptomatic scores in the different scales, and daily physical activity to be negatively associated with DASS-21 scores. CONCLUSIONS: Results indicated a temporal increase of anxiety, depression and stress scores during the COVID-19 lockdown. Factors such as age, consumption of information about COVID-19 and physical activity seem to have an important impact on the evolution of psychological symptoms.

Psychological effects of the COVID-19 outbreak and lockdown among students and workers of a Spanish university.

The aim of this study was to analyze the psychological impact of COVID-19 in the university community during the first weeks of confinement. A cross-sectional study was conducted. The Depression Anxiety Stress Scale (DASS-21) was employed to assess symptoms of depression, anxiety and stress. The emotional impact of the situation was analyzed using the Impact of Event Scale. An online survey was fulfilled by 2530 members of the University of Valladolid, in Spain. Moderate to extremely severe scores of anxiety, depression, and stress were reported by 21.34%, 34.19% and 28.14% of the respondents, respectively. A total of 50.43% of respondents presented moderate to severe impact of the outbreak. Students from Arts & Humanities and Social Sciences & Law showed higher scores related to anxiety, depression, stress and impact of event with respect to students from Engineering & Architecture. University staff presented lower scores in all measures compared to students, who seem to have suffered an important psychological impact during the first weeks of the COVID-19 lockdown. In order to provide timely crisis-oriented psychological services and to take preventive measures in future pandemic situations, mental health in university students should be carefully monitored.