Headache as an acute and post COVID-19 Symptom in COVID-19 Survivors: A Meta-analysis of the Current Literature

César Fernández-de-las-Peñas*, Marcos Navarro-Santana, Víctor Gómez-Mayordomo, María L. Cuadrado, David García-Azorín, Lars Arendt-Nielsen, Gustavo Plaza-Manzano

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

77 Citations (Scopus)
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Abstract

Background: Headache is identified as a common post-COVID sequela experienced by COVID-19 survivors. The aim of this pooled analysis was to synthesize the prevalence of post-COVID headache in hospitalized and non-hospitalized patients recovering from SARS-CoV-2 infection. Methods: MEDLINE, CINAHL, PubMed, EMBASE, and Web of Science databases, as well as medRxiv and bioRxiv preprint servers, were searched up to 31 May 2021. Studies or preprints providing data on post-COVID headache were included. The methodological quality of the studies was assessed using the Newcastle-Ottawa Scale. Random effects models were used for meta-analytical pooled prevalence of post-COVID headache. Data synthesis was categorized at hospital admission/symptoms' onset, and at 30, 60, 90, and ≥180 days afterwards. Results: From 9573 studies identified, 28 peer-reviewed studies and 7 preprints were included. The sample was 28,438 COVID-19 survivors (12,307 females; mean age: 46.6, SD: 17.45 years). The methodological quality was high in 45% of the studies. The overall prevalence of post-COVID headache was 47.1% (95% CI 35.8–58.6) at onset or hospital admission, 10.2% (95% CI 5.4–18.5) at 30 days, 16.5% (95% CI 5.6–39.7) at 60 days, 10.6% (95% CI 4.7–22.3) at 90 days, and 8.4% (95% CI 4.6–14.8) at ≥180 days after onset/hospital discharge. Headache as a symptom at the acute phase was more prevalent in non-hospitalized (57.97%) than in hospitalized (31.11%) patients. Time trend analysis showed a decreased prevalence from the acute symptoms’ onset to all post-COVID follow-up periods which was maintained afterwards. Conclusion: This meta-analysis found that the prevalence of post-COVID headache ranged from 8% to 15% during the first 6 months after SARS-CoV-2 infection.

Original languageEnglish
JournalEuropean Journal of Neurology
Volume28
Issue number11
Pages (from-to)3820-3825
Number of pages6
ISSN1351-5101
DOIs
Publication statusPublished - Nov 2021

Bibliographical note

© 2021 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.

Keywords

  • COVID-19
  • headache
  • post-COVID
  • meta-analysis
  • prevalence

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