COVID-19-associated headache: Difference between revisions

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{{SI}}
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{{CMG}}; {{AE}} {{Fs}}  {{sali}}
{{CMG}}; {{AE}} {{Fs}}


{{SK}}  
{{SK}}  


==Overview==
==Overview==
The association between COVID-19 and headache was made in 2020. COVID-19 associated headache may be caused by the [[SARS-CoV-2|SARS-CoV-2 virus]]. There is no established system for the [[classification]] of COVID-19 associated headache. The exact [[pathogenesis]] of [[headache]] in COVID-19 patients is not fully understood. It is thought that [[Cluster headache|headache]] is the result of [[cytokine]] release, direct [[invasion]], metabolic disturbances, [[Cervicitis|inflammation]], [[dehydration]], and [[hypoxia]]. COVID-19-associated headache must be differentiated from other diseases that cause [[headache]], such as [[migraine]], [[tension-type headache]], [[Cluster headache (patient information)|cluster headache]], [[seizure]], [[meningitis]], [[encephalitis]], [[neurosyphilis]], [[Subarachnoid hemorrhage|SAH]], [[subdural hematoma]], [[brain tumor]], [[hypertensive encephalopathy]], [[brain abscess]], [[multiple sclerosis]], [[hemorrhagic stroke]], [[Wernicke's encephalopathy|Wernickes encephalopathy]], and [[drug toxicity]]. A positive history of [[fever]] and [[cough]] in addition to headache is suggestive of [[COVID]]-19-associated headache.                 


==Historical Perspective==
==Historical Perspective==
[Disease name] was first discovered by [name of scientist], a [nationality + occupation], in [year]/during/following [event].


The association between [important risk factor/cause] and [disease name] was made in/during [year/event].
* The association between COVID-19 and [[headache]] was made in December, 2019 during the [[SARS-CoV-2]] [[outbreak]] initiated in Wuhan, Hubei Province, China.<ref name="pmid32563019">{{cite journal |vauthors=Meng X, Deng Y, Dai Z, Meng Z |title=COVID-19 and anosmia: A review based on up-to-date knowledge |journal=Am J Otolaryngol |volume=41 |issue=5 |pages=102581 |date=June 2020 |pmid=32563019 |pmc=7265845 |doi=10.1016/j.amjoto.2020.102581 |url=}}</ref>


In [year], [scientist] was the first to discover the association between [risk factor] and the development of [disease name].
==Classification==
 
In [year], [gene] mutations were first implicated in the pathogenesis of [disease name].
 
There have been several outbreaks of [disease name], including -----.


In [year], [diagnostic test/therapy] was developed by [scientist] to treat/diagnose [disease name].
* There is no established system for the [[classification]] of COVID-19 associated headache.
 
==Classification==
There is no established system for the classification of COVID-19 associated headache.


==Pathophysiology==
==Pathophysiology==
*The exact pathogenesis of headache in COVID 19 patients is not fully understood.
*The exact [[pathogenesis]] of [[headache]] in COVID 19 patients is not fully understood.
*It is thought that headache is the result of:<ref name="BaigKhaleeq2020">{{cite journal|last1=Baig|first1=Abdul Mannan|last2=Khaleeq|first2=Areeba|last3=Ali|first3=Usman|last4=Syeda|first4=Hira|title=Evidence of the COVID-19 Virus Targeting the CNS: Tissue Distribution, Host–Virus Interaction, and Proposed Neurotropic Mechanisms|journal=ACS Chemical Neuroscience|volume=11|issue=7|year=2020|pages=995–998|issn=1948-7193|doi=10.1021/acschemneuro.0c00122}}</ref><ref name="pmid15280490">{{cite journal |vauthors=St-Jean JR, Jacomy H, Desforges M, Vabret A, Freymuth F, Talbot PJ |title=Human respiratory coronavirus OC43: genetic stability and neuroinvasion |journal=J. Virol. |volume=78 |issue=16 |pages=8824–34 |date=August 2004 |pmid=15280490 |pmc=479063 |doi=10.1128/JVI.78.16.8824-8834.2004 |url=}}</ref><ref name="Rossi2008">{{cite journal|last1=Rossi|first1=Andrea|title=Imaging of Acute Disseminated Encephalomyelitis|journal=Neuroimaging Clinics of North America|volume=18|issue=1|year=2008|pages=149–161|issn=10525149|doi=10.1016/j.nic.2007.12.007}}</ref><ref name="St-JeanJacomy2004">{{cite journal|last1=St-Jean|first1=Julien R.|last2=Jacomy|first2=Hélène|last3=Desforges|first3=Marc|last4=Vabret|first4=Astrid|last5=Freymuth|first5=François|last6=Talbot|first6=Pierre J.|title=Human Respiratory Coronavirus OC43: Genetic Stability and Neuroinvasion|journal=Journal of Virology|volume=78|issue=16|year=2004|pages=8824–8834|issn=0022-538X|doi=10.1128/JVI.78.16.8824-8834.2004}}</ref>
*It is thought that headache is the result of:<ref name="BaigKhaleeq2020">{{cite journal|last1=Baig|first1=Abdul Mannan|last2=Khaleeq|first2=Areeba|last3=Ali|first3=Usman|last4=Syeda|first4=Hira|title=Evidence of the COVID-19 Virus Targeting the CNS: Tissue Distribution, Host–Virus Interaction, and Proposed Neurotropic Mechanisms|journal=ACS Chemical Neuroscience|volume=11|issue=7|year=2020|pages=995–998|issn=1948-7193|doi=10.1021/acschemneuro.0c00122}}</ref><ref name="pmid15280490">{{cite journal |vauthors=St-Jean JR, Jacomy H, Desforges M, Vabret A, Freymuth F, Talbot PJ |title=Human respiratory coronavirus OC43: genetic stability and neuroinvasion |journal=J. Virol. |volume=78 |issue=16 |pages=8824–34 |date=August 2004 |pmid=15280490 |pmc=479063 |doi=10.1128/JVI.78.16.8824-8834.2004 |url=}}</ref><ref name="Rossi2008">{{cite journal|last1=Rossi|first1=Andrea|title=Imaging of Acute Disseminated Encephalomyelitis|journal=Neuroimaging Clinics of North America|volume=18|issue=1|year=2008|pages=149–161|issn=10525149|doi=10.1016/j.nic.2007.12.007}}</ref><ref name="St-JeanJacomy2004">{{cite journal|last1=St-Jean|first1=Julien R.|last2=Jacomy|first2=Hélène|last3=Desforges|first3=Marc|last4=Vabret|first4=Astrid|last5=Freymuth|first5=François|last6=Talbot|first6=Pierre J.|title=Human Respiratory Coronavirus OC43: Genetic Stability and Neuroinvasion|journal=Journal of Virology|volume=78|issue=16|year=2004|pages=8824–8834|issn=0022-538X|doi=10.1128/JVI.78.16.8824-8834.2004}}</ref>
**Cytokine release  
**[[Cytokine release syndrome|Cytokine release]]
***There is higher concentration on IL-6 and INF-gamma in patients infected with SARS/ CoV2.
***There is higher concentration on [[IL-6]] and [[Interferon-gamma|INF-gamma]] in [[Patient|patients]] infected with [[SARS-CoV-2|SARS/ CoV2]].
***Cytokines can disrupt blood brain barrier and cause tissue injury and cerebral edema.
***[[Cytokine|Cytokines]] can disrupt [[Blood-brain barrier|blood brain barrier]] and cause [[tissue]] injury and [[cerebral edema]].
***
***
***
***
**Direct invasion
**Direct [[invasion]]
**Metabolic disturbances
**Metabolic disturbances
**Inflammation
**[[Inflammation]]
**Dehydration
**[[Dehydration]]
**Hypoxia
**[[Hypoxia]]


[[File:Photo 2020-06-24 15-35-07.jpg|500px|none|thumb|By {{Fs}} / https://en.wikipedia.org/wiki/File:Migraine.jpg]]
[[File:Photo 2020-06-24 15-35-07.jpg|500px|none|thumb|By {{Fs}} / https://en.wikipedia.org/wiki/File:Migraine.jpg]]


==Causes==
==Causes==
COVID-19 associated headache may be caused by SARS-CoV-2 virus.
 
* COVID-19 associated headache may be caused by [[SARS-CoV-2|SARS-CoV-2 virus]].


==Differentiating COVID-19-associated headache from other Diseases==
==Differentiating COVID-19-associated headache from other Diseases==
[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].


OR
* For further information about the differential diagnosis, [[COVID-19-associated headache differential diagnosis|click here]].
 
* To view the differential diagnosis of COVID-19, [[COVID-19 differential diagnosis|click here]].
[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].


==Epidemiology and Demographics==
==Epidemiology and Demographics==
The incidence/prevalence of [disease name] is approximately [number range] per 100,000 individuals worldwide.
OR
In [year], the incidence/prevalence of [disease name] was estimated to be [number range] cases per 100,000 individuals worldwide.
OR
In [year], the incidence of [disease name] is approximately [number range] per 100,000 individuals with a case-fatality rate of [number range]%.
Patients of all age groups may develop [disease name].
OR
The incidence of [disease name] increases with age; the median age at diagnosis is [#] years.
OR
[Disease name] commonly affects individuals younger than/older than [number of years] years of age.
OR
[Chronic disease name] is usually first diagnosed among [age group].
OR


[Acute disease name] commonly affects [age group].
=== Incidence / Prevalence ===


*[[WHO]] reported that more than 462,801 people have been infected worldwide, more than 380,723 of which are outside of China.<ref name="pmid32315723">{{cite journal| author=Tu H, Tu S, Gao S, Shao A, Sheng J| title=Current epidemiological and clinical features of COVID-19; a global perspective from China. | journal=J Infect | year= 2020 | volume= 81 | issue= 1 | pages= 1-9 | pmid=32315723 | doi=10.1016/j.jinf.2020.04.011 | pmc=7166041 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32315723  }} </ref>
*The [[incidence]]/[[prevalence]] of COVID-19-associated headache is still unknown.
*Guan et al. recently reported 13 percent of COVID-19-associated headache among 1099 laboratory-confirmed cases.


===Age===


There is no racial predilection to [disease name].
* There is insufficient information regarding age-specific [[prevalence]] or [[incidence]] of COVID-19-associated headache.


OR
===Gender===


[Disease name] usually affects individuals of the [race 1] race. [Race 2] individuals are less likely to develop [disease name].
* There is insufficient information regarding gender-specific [[prevalence]] or [[incidence]] of COVID-19-associated headache.


===Race===


 
* There is insufficient information regarding race-specific [[prevalence]] or [[incidence]] of COVID-19-associated headache.
[Disease name] affects men and women equally.
 
OR
 
[Gender 1] are more commonly affected by [disease name] than [gender 2]. The [gender 1] to [gender 2] ratio is approximately [number > 1] to 1.
 
 
 
The majority of [disease name] cases are reported in [geographical region].
 
OR
 
[Disease name] is a common/rare disease that tends to affect [patient population 1] and [patient population 2].


==Risk Factors==
==Risk Factors==
There are no established risk factors for [disease name].


OR
* There are no established [[Risk factor|risk factors]] for COVID-19-associated headache.


The most potent risk factor in the development of [disease name] is [risk factor 1]. Other risk factors include [risk factor 2], [risk factor 3], and [risk factor 4].
==Screening==
 
OR
 
Common risk factors in the development of [disease name] include [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].
 
OR


Common risk factors in the development of [disease name] may be occupational, environmental, genetic, and viral.
* There is insufficient evidence to recommend routine [[Screening (medicine)|screening]] for [[COVID]]-19 associated headache.
 
==Screening==
There is insufficient evidence to recommend routine screening for COVID-19 associated headache.


==Natural History, Complications, and Prognosis==
==Natural History, Complications, and Prognosis==
If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].


OR
===Natural History===
* At this point, the [[natural history]] of [[COVID-19]]-associated [[headache]] is unknown.
* Further studies are needed to better understand the [[COVID-19]]-associated [[headache]].


Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
===Complication===


OR
* Patients with a history [[migraine]] may experience [[headache]] as their first [[symptom]], and these [[patients]] experience more severe [[headache]] and are more disabled by the [[HIV AIDS|infection]] compared with age‐matched [[cohorts]].
 
* Further studies are needed to better understand [[complication]]<nowiki/>s.
Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
* Larger retrospective studies are needed for evaluating the experience of [[COVID-19|COVID‐19]] in [[patients]] with a [[History and Physical examination|history]] of a primary [[headache]] disorder.


==Diagnosis==
==Diagnosis==
===Diagnostic Study of Choice===
===Diagnostic Study of Choice===
The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].


OR
* The [[diagnosis]] of COVID-19-associated [[headache]] is based on the [[clinical]] presentation.


The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
* There are no established criteria for the diagnosis of COVID-19-associated headache.


OR
===History and Symptoms===


The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
* The hallmark of COVID-19-associated headache is [[headache]].  


OR
* A positive history of [[fever]] and [[cough]] in addition to headache is suggestive of [[COVID]]-19-associated headache.


There are no established criteria for the diagnosis of [disease name].
====Common Symptoms====


===History and Symptoms===
*Common [[symptoms]] of COVID-19-associated [[headache]] are:
The majority of patients with [disease name] are asymptomatic.
**[[Fever]]
**[[Shortness of breath]]
**[[Consciousness|Cognitive]] impairment
**[[Cough]]
**[[Fatigue]]


OR
====Less Common Symptoms====


The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. Common symptoms of [disease] include [symptom 1], [symptom 2], and [symptom 3]. Less common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
*Less common [[symptoms]] of COVID-19-associated [[headache]] are:
**[[Facial droop]]
**[[Myoclonus]]
**[[Dysarthria]]
**<nowiki/><nowiki/>[[Generalized seizure|S]]<nowiki/>[[Generalized seizure|eiz]]<nowiki/>[[Generalized seizure|ures]]
**[[Paralysis|P]]<nowiki/>[[Paralysis|ar]][[Paralysis|a]]<nowiki/>[[Paralysis|ly]][[Paralysis|sis]]
**[[Dizziness]]
**[[Sedation]]
**[[Comatose|Coma]]


===Physical Examination===
===Physical Examination===
Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].
OR


Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].
* Patients with [[COVID]]-19-associated [[headache]] usually appear normal.  
 
*Physical examination of patients with COVID-19-associated [[headache]] is usually remarkable for [[fever]], [[cough]], and [[malaise]].
OR
 
The presence of [finding(s)] on physical examination is diagnostic of [disease name].
 
OR
 
The presence of [finding(s)] on physical examination is highly suggestive of [disease name].


===Laboratory Findings===
===Laboratory Findings===
An elevated/reduced concentration of serum/blood/urinary/CSF/other [lab test] is diagnostic of [disease name].
OR
Laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
OR
[Test] is usually normal among patients with [disease name].
OR
Some patients with [disease name] may have elevated/reduced concentration of [test], which is usually suggestive of [progression/complication].


OR
* Additional diagnostic tests like [[blood]] [[chemistry]] and [[urine]] [[analysis]] may be needed to rule out other [[medical]] conditions.


There are no diagnostic laboratory findings associated with [disease name].
* There are no diagnostic [[laboratory]] findings associated with [[COVID]]-19-associated [[headache]].


===Electrocardiogram===
===Electrocardiogram===
There are no ECG findings associated with [disease name].
OR


An ECG may be helpful in the diagnosis of [disease name]. Findings on an ECG suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
*There are no [[ECG]] findings associated with [[COVID]]-19-associated [[headache]].


===X-ray===
===X-ray===
There are no x-ray findings associated with [disease name].
OR
An x-ray may be helpful in the diagnosis of [disease name]. Findings on an x-ray suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR


There are no x-ray findings associated with [disease name]. However, an x-ray may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
*There are no [[x-ray]] findings associated with COVID-19-associated [[headache]].


===Echocardiography or Ultrasound===
===Echocardiography or Ultrasound===
There are no echocardiography/ultrasound  findings associated with [disease name].
OR
Echocardiography/ultrasound  may be helpful in the diagnosis of [disease name]. Findings on an echocardiography/ultrasound suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR


There are no echocardiography/ultrasound  findings associated with [disease name]. However, an echocardiography/ultrasound  may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
*There are no [[echocardiography]]/[[ultrasound]] findings associated with [[COVID]]-19-associated headache.


===CT scan===
===CT scan===
There are no CT scan findings associated with [disease name].
OR
[Location] CT scan may be helpful in the diagnosis of [disease name]. Findings on CT scan suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR


There are no CT scan findings associated with [disease name]. However, a CT scan may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
*There are no [[CT scan]] findings associated with COVID-19-associated headache.


===MRI===
===MRI===
There are no MRI findings associated with [disease name].
OR
[Location] MRI may be helpful in the diagnosis of [disease name]. Findings on MRI suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR


There are no MRI findings associated with [disease name]. However, a MRI may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
*There are no [[MRI]] findings associated with COVID-19-associated headache.


===Other Imaging Findings===
===Other Imaging Findings===
There are no other imaging findings associated with [disease name].


OR
*There are no other imaging findings associated with COVID-19-associated headache.
 
[Imaging modality] may be helpful in the diagnosis of [disease name]. Findings on an [imaging modality] suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].


===Other Diagnostic Studies===
===Other Diagnostic Studies===
There are no other diagnostic studies associated with [disease name].
OR
[Diagnostic study] may be helpful in the diagnosis of [disease name]. Findings suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].


OR
* There are no other diagnostic studies associated with [[COVID]]-19-associated headache.
 
Other diagnostic studies for [disease name] include [diagnostic study 1], which demonstrates [finding 1], [finding 2], and [finding 3], and [diagnostic study 2], which demonstrates [finding 1], [finding 2], and [finding 3].


==Treatment==
==Treatment==
===Medical Therapy===
===Medical Therapy===
There is no treatment for [disease name]; the mainstay of therapy is supportive care.
OR
Supportive therapy for [disease name] includes [therapy 1], [therapy 2], and [therapy 3].


OR
* Medical [[therapy]] for [[COVID]]-assocaited-[[headache]] is still controversial.<ref name="pmid32334062">{{cite journal| author=Zhang J, Xie B, Hashimoto K| title=Current status of potential therapeutic candidates for the COVID-19 crisis. | journal=Brain Behav Immun | year= 2020 | volume= 87 | issue=  | pages= 59-73 | pmid=32334062 | doi=10.1016/j.bbi.2020.04.046 | pmc=7175848 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32334062  }} </ref><ref name="pmid32334535">{{cite journal |vauthors=MaassenVanDenBrink A, de Vries T, Danser AHJ |title=Headache medication and the COVID-19 pandemic |journal=J Headache Pain |volume=21 |issue=1 |pages=38 |date=April 2020 |pmid=32334535 |pmc=7183387 |doi=10.1186/s10194-020-01106-5 |url=}}</ref><ref name="pmid32171062">Fang L, Karakiulakis G, Roth M (2020) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=32171062 Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection?] ''Lancet Respir Med'' 8 (4):e21. [http://dx.doi.org/10.1016/S2213-2600(20)30116-8 DOI:10.1016/S2213-2600(20)30116-8] PMID: [https://pubmed.gov/32171062 32171062]</ref><ref name="pmid32198292">FitzGerald GA (2020) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=32198292 Misguided drug advice for COVID-19.] ''Science'' 367 (6485):1434. [http://dx.doi.org/10.1126/science.abb8034 DOI:10.1126/science.abb8034] PMID: [https://pubmed.gov/32198292 32198292]</ref>
 
* The use of [[NSAIDs]], who received [[treatment]] early in the [[disease]] causes worsening of [[COVID-19]] symptoms according to some anecdotal evidences.  
The majority of cases of [disease name] are self-limited and require only supportive care.
*In March 11, 2020, Fang et al. reported the hypothesis that [[ibuprofen]] (40 mg/kg/dose) can increase the risk of developing severe and fatal [[COVID-19]] since [[ibuprofen]] is known to upregulate ACE2 [[receptors]].
 
* In March 23, 2020, US [[FDA]] announced that it is not aware of any evidence that [[NSAIDs]] such as [[ibuprofen]] could worsen [[COVID-19]].
OR
* The [[European Medicines Agency]] and [[World Health Organization]] (WHO) have not yet recommended that NSAIDs be avoided.
 
* Despite this recommendation, as a precautionary measure many providers are avoiding [[NSAIDs]] in patients with [[COVID-19]].
[Disease name] is a medical emergency and requires prompt treatment.
* In practice, the decision to continue or stop [[NSAIDs]] in patients with [[COVID-19]] is made in collaboration between the treating physician and the patient, after a brief discussion on the limited available evidence.
 
* More data are needed before broad recommendations are made.
OR
 
The mainstay of treatment for [disease name] is [therapy].
 
OR
The optimal therapy for [malignancy name] depends on the stage at diagnosis.
 
OR
 
[Therapy] is recommended among all patients who develop [disease name].
 
OR
 
Pharmacologic medical therapy is recommended among patients with [disease subclass 1], [disease subclass 2], and [disease subclass 3].
 
OR
 
Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].
 
OR
 
Empiric therapy for [disease name] depends on [disease factor 1] and [disease factor 2].
 
OR
 
Patients with [disease subclass 1] are treated with [therapy 1], whereas patients with [disease subclass 2] are treated with [therapy 2].


===Surgery===
===Surgery===
Surgical intervention is not recommended for the management of [disease name].


OR
*[[Surgical]] intervention is not recommended for the management of [[COVID]]-19-associated headache.


Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and [indication 3]
===Primary Prevention===
 
OR


The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either [indication 1], [indication 2], and/or [indication 3].
* There are no established measures for the [[primary prevention]] of COVID-19 associated headache.
 
OR
 
The feasibility of surgery depends on the stage of [malignancy] at diagnosis.
 
OR
 
Surgery is the mainstay of treatment for [disease or malignancy].
 
===Primary Prevention===
There are no established measures for the primary prevention of COVID-19 associated headache.


===Secondary Prevention===
===Secondary Prevention===
There are no established measures for the secondary prevention of [disease name].
OR


Effective measures for the secondary prevention of [disease name] include [strategy 1], [strategy 2], and [strategy 3].
* There are no established measures for the [[secondary prevention]] of COVID-19-associated headache.


==References==
==References==
{{reflist|2}}
{{reflist|2}}
[[Category:Up-To-Date]]


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Patents on COVID-19-associated headache

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List of terms related to COVID-19-associated headache

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D. Syed Musadiq Ali M.B.B.S.[2]

Synonyms and keywords:

Overview

The association between COVID-19 and headache was made in 2020. COVID-19 associated headache may be caused by the SARS-CoV-2 virus. There is no established system for the classification of COVID-19 associated headache. The exact pathogenesis of headache in COVID-19 patients is not fully understood. It is thought that headache is the result of cytokine release, direct invasion, metabolic disturbances, inflammation, dehydration, and hypoxia. COVID-19-associated headache must be differentiated from other diseases that cause headache, such as migraine, tension-type headache, cluster headache, seizure, meningitis, encephalitis, neurosyphilis, SAH, subdural hematoma, brain tumor, hypertensive encephalopathy, brain abscess, multiple sclerosis, hemorrhagic stroke, Wernickes encephalopathy, and drug toxicity. A positive history of fever and cough in addition to headache is suggestive of COVID-19-associated headache.

Historical Perspective

  • The association between COVID-19 and headache was made in December, 2019 during the SARS-CoV-2 outbreak initiated in Wuhan, Hubei Province, China.[1]

Classification

  • There is no established system for the classification of COVID-19 associated headache.

Pathophysiology

By Fahimeh Shojaei, M.D. / https://en.wikipedia.org/wiki/File:Migraine.jpg

Causes

Differentiating COVID-19-associated headache from other Diseases

  • For further information about the differential diagnosis, click here.
  • To view the differential diagnosis of COVID-19, click here.

Epidemiology and Demographics

Incidence / Prevalence

  • WHO reported that more than 462,801 people have been infected worldwide, more than 380,723 of which are outside of China.[6]
  • The incidence/prevalence of COVID-19-associated headache is still unknown.
  • Guan et al. recently reported 13 percent of COVID-19-associated headache among 1099 laboratory-confirmed cases.

Age

  • There is insufficient information regarding age-specific prevalence or incidence of COVID-19-associated headache.

Gender

  • There is insufficient information regarding gender-specific prevalence or incidence of COVID-19-associated headache.

Race

  • There is insufficient information regarding race-specific prevalence or incidence of COVID-19-associated headache.

Risk Factors

  • There are no established risk factors for COVID-19-associated headache.

Screening

  • There is insufficient evidence to recommend routine screening for COVID-19 associated headache.

Natural History, Complications, and Prognosis

Natural History

Complication

Diagnosis

Diagnostic Study of Choice

  • There are no established criteria for the diagnosis of COVID-19-associated headache.

History and Symptoms

  • The hallmark of COVID-19-associated headache is headache.
  • A positive history of fever and cough in addition to headache is suggestive of COVID-19-associated headache.

Common Symptoms

Less Common Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

  • There are no x-ray findings associated with COVID-19-associated headache.

Echocardiography or Ultrasound

CT scan

  • There are no CT scan findings associated with COVID-19-associated headache.

MRI

  • There are no MRI findings associated with COVID-19-associated headache.

Other Imaging Findings

  • There are no other imaging findings associated with COVID-19-associated headache.

Other Diagnostic Studies

  • There are no other diagnostic studies associated with COVID-19-associated headache.

Treatment

Medical Therapy

  • Medical therapy for COVID-assocaited-headache is still controversial.[7][8][9][10]
  • The use of NSAIDs, who received treatment early in the disease causes worsening of COVID-19 symptoms according to some anecdotal evidences.
  • In March 11, 2020, Fang et al. reported the hypothesis that ibuprofen (40 mg/kg/dose) can increase the risk of developing severe and fatal COVID-19 since ibuprofen is known to upregulate ACE2 receptors.
  • In March 23, 2020, US FDA announced that it is not aware of any evidence that NSAIDs such as ibuprofen could worsen COVID-19.
  • The European Medicines Agency and World Health Organization (WHO) have not yet recommended that NSAIDs be avoided.
  • Despite this recommendation, as a precautionary measure many providers are avoiding NSAIDs in patients with COVID-19.
  • In practice, the decision to continue or stop NSAIDs in patients with COVID-19 is made in collaboration between the treating physician and the patient, after a brief discussion on the limited available evidence.
  • More data are needed before broad recommendations are made.

Surgery

  • Surgical intervention is not recommended for the management of COVID-19-associated headache.

Primary Prevention

  • There are no established measures for the primary prevention of COVID-19 associated headache.

Secondary Prevention

References

  1. ↑ Meng X, Deng Y, Dai Z, Meng Z (June 2020). "COVID-19 and anosmia: A review based on up-to-date knowledge". Am J Otolaryngol. 41 (5): 102581. doi:10.1016/j.amjoto.2020.102581. PMC 7265845 Check |pmc= value (help). PMID 32563019 Check |pmid= value (help).
  2. ↑ Baig, Abdul Mannan; Khaleeq, Areeba; Ali, Usman; Syeda, Hira (2020). "Evidence of the COVID-19 Virus Targeting the CNS: Tissue Distribution, Host–Virus Interaction, and Proposed Neurotropic Mechanisms". ACS Chemical Neuroscience. 11 (7): 995–998. doi:10.1021/acschemneuro.0c00122. ISSN 1948-7193.
  3. ↑ St-Jean JR, Jacomy H, Desforges M, Vabret A, Freymuth F, Talbot PJ (August 2004). "Human respiratory coronavirus OC43: genetic stability and neuroinvasion". J. Virol. 78 (16): 8824–34. doi:10.1128/JVI.78.16.8824-8834.2004. PMC 479063. PMID 15280490.
  4. ↑ Rossi, Andrea (2008). "Imaging of Acute Disseminated Encephalomyelitis". Neuroimaging Clinics of North America. 18 (1): 149–161. doi:10.1016/j.nic.2007.12.007. ISSN 1052-5149.
  5. ↑ St-Jean, Julien R.; Jacomy, Hélène; Desforges, Marc; Vabret, Astrid; Freymuth, François; Talbot, Pierre J. (2004). "Human Respiratory Coronavirus OC43: Genetic Stability and Neuroinvasion". Journal of Virology. 78 (16): 8824–8834. doi:10.1128/JVI.78.16.8824-8834.2004. ISSN 0022-538X.
  6. ↑ Tu H, Tu S, Gao S, Shao A, Sheng J (2020). "Current epidemiological and clinical features of COVID-19; a global perspective from China". J Infect. 81 (1): 1–9. doi:10.1016/j.jinf.2020.04.011. PMC 7166041 Check |pmc= value (help). PMID 32315723 Check |pmid= value (help).
  7. ↑ Zhang J, Xie B, Hashimoto K (2020). "Current status of potential therapeutic candidates for the COVID-19 crisis". Brain Behav Immun. 87: 59–73. doi:10.1016/j.bbi.2020.04.046. PMC 7175848 Check |pmc= value (help). PMID 32334062 Check |pmid= value (help).
  8. ↑ MaassenVanDenBrink A, de Vries T, Danser A (April 2020). "Headache medication and the COVID-19 pandemic". J Headache Pain. 21 (1): 38. doi:10.1186/s10194-020-01106-5. PMC 7183387 Check |pmc= value (help). PMID 32334535 Check |pmid= value (help). Vancouver style error: initials (help)
  9. ↑ Fang L, Karakiulakis G, Roth M (2020) Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? Lancet Respir Med 8 (4):e21. DOI:10.1016/S2213-2600(20)30116-8 PMID: 32171062
  10. ↑ FitzGerald GA (2020) Misguided drug advice for COVID-19. Science 367 (6485):1434. DOI:10.1126/science.abb8034 PMID: 32198292


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