Patterns of COVID-19-related headache: A cross-sectional study.

BACKGROUND: Headache is the most common COVID-19-related neurological symptom. We investigated the characteristics of COVID-19-related headache and their relationship with clinical severity in Kirsehir Province, Turkey. METHODS: This cross-sectional study prospectively enrolled 226 COVID-19-positive patients who developed headache during acute infection. Demographic data, headache characteristics, and infection symptoms were recorded. The clinical severity of COVID-19 was documented in each participant. RESULT: New-onset COVID-19-related headaches lasting 4 days were reported in 164 patients (72.5 %); these were mostly bilaterally or localized to the forehead (58.4 %), pulsating (42.5 %), moderate to severe intensity (30.1 %), with a partial response to paracetamol (23.5 %). The other 62 patients (27.4 %) reported headaches before COVID-19. Their COVID-related headaches were fiery type (p = 0.025), of very severe intensity (p = 0.008), had a holocranial distribution (p = 0.004), and were less response to paracetamol (p = 0.003); the headaches were significantly more frequent after COVID-19 than before COVID-19. Older age, high body mass index, and low education level were significantly higher in the severe group (all p < 0.001). Female sex (p = 0.019) and being a healthcare worker (p < 0.001) were significantly more frequent in mild cases. CONCLUSIONS: Bilateral, prolonged, moderate to severe headaches that were analgesic resistant are more frequent in patients with COVID-19 infection. Further study should examine whether the headache characteristics distinguish COVID-19-related headaches from other types, particularly in asymptomatic subjects.

Plasma biomarkers of brain injury in COVID-19 patients with neurological symptoms.

OBJECTIVE: Neurological symptoms (NS) were often reported in COVID-19 infection. We examined the plasma levels of glial fibrillary acidic protein (GFAP) and S100B together, as brain injury biomarkers, in relation to persistent NS in a cohort of patients with COVID-19 during the acute phase of the disease. METHODS: A total of 20 healthy controls and 58 patients with confirmed COVID-19 were enrolled in this prospective study. Serum GFAP and S100B levels were measured by using enzymle linked immunoassay method from blood samples. RESULTS: Serum GFAP levels were found to be significantly higher in the severe group than in the controls (p = 0.007). However, serum S100B levels were similar between control and disease groups (p > 0.05). No significant results for GFAP and S100B were obtained between the disease groups depending on whether the sampling time was below or above 5 days (p > 0.05). We did not find a correlation between serum GFAP and S100B levels and the presence of NS (p > 0.05). However, serum S100B levels were slightly higher in patients with multiple NS than in those with a single symptom (p = 0.044). CONCLUSIONS: Elevated GFAP was associated with disease severity but not with NS in COVID-19 patients. Whereas, high serum S100B was associated with the multipl NS in these patients. Our data suggest that GFAP and S100B may be of limited value currently in order to represent the neuronal damage, though serving a basis for the future work.