COVID-19 vaccination-related headache showed two different clusters in the long-term course: a prospective multicenter follow-up study (COVA-Head Study).

Autor: Atalar AÇ; Department of Neurology, Health Sciences University, Kanuni Sultan Süleyman Education and Research Hospital, Istanbul, Turkey. cimenatalar@gmail.com., Acarlı ANÖ; Department of Neurology, Ermenek State Hospital, Karaman, Turkey., Baykan B; Department of Neurology, Headache Center, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey.; Department of Neurology, EMAR Medical Center, Istanbul, Turkey., Martelletti P; Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy., Bolay H; Medical Faculty, Department of Neurology and Algology, Gazi University, Ankara, Turkey., Ertaş M; Department of Neurology, Headache Center, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey., Ekizoğlu E; Department of Neurology, Headache Center, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey., Karadaş Ö; Department of Neurology, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey., Polat B; School of Medicine, Department of Neurology, Istanbul Medipol University, Istanbul, Turkey., Gençdal IY; Bakirkoy Prof. Dr. Mazhar Osman Training and Research Hospital for Psychiatric, Neurologic and Neurosurgical Diseases, University of Health Sciences, Istanbul, Turkey., Azorin DG; Department of Neurology, Hospital Clínico Universitario de Valladolid, Headache Unit, Valladolid, Spain., Mitsikostas D; First Neurology Department, Medical School, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece., Apostolakopoulou L; First Neurology Department, Medical School, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece., Genç H; University of Health Sciences, Van Training and Research Hospital, Van, Türkiye., Dikmen PY; School of Medicine, Department of Neurology, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey., Demirel EA; Bülent Ecevit University Neurology Department, Zonguldak, Turkey., Aydınlar EI; School of Medicine, Department of Neurology, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey., Gözübatık-Celik RG; Bakirkoy Prof. Dr. Mazhar Osman Training and Research Hospital for Psychiatric, Neurologic and Neurosurgical Diseases, University of Health Sciences, Istanbul, Turkey., Shafiyev J; Department of Neurology, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey., Taşdelen B; Department of Biostatistics and Medical Informatic, Mersin University School of Medicine, Mersin, Turkey., Özge A; Medical Faculty, Department of Neurology, Mersin University, Mersin, Türkiye.
Jazyk: angličtina
Zdroj: The journal of headache and pain [J Headache Pain] 2023 Sep 29; Vol. 24 (1), pp. 132. Date of Electronic Publication: 2023 Sep 29.
DOI: 10.1186/s10194-023-01665-3
Abstrakt: Background: Although acute headache following COVID-19 vaccination is widely acknowledged, the long-term progression of these headaches remains poorly understood. Our objective was to identify various phenotypes of prolonged or worsened headaches associated with COVID-19 vaccination and document any changes in these phenotypes over an extended period. Additionally, we aimed to document the diverse headache presentations among patients with pre-existing primary headaches.
Methods: A multinational, prospective observational study was conducted to investigate prolonged or worsened headaches associated with COVID-19 vaccination. Questionnaires assessing COVID-19 vaccination-related headaches at three time points (initial visit, 3 rd month follow-up, and 6th month follow-up) were developed for the study. Headache specialists/clinicians evaluated patients using these questionnaires in a prospective manner. Repeated K-means cluster analysis was performed to identify patient profiles with prolonged or worsened headaches related to COVID-19 vaccination.
Results: Among the 174 patients included in the study, there was a female-to-male ratio of 128 (73.6%) to 46 (26.4%). The mean age of the patient group was 45.2 ± 13.3 years, and 107 patients (61.5%) had a pre-existing history of primary headaches. Through the analysis, two major clusters were identified based on headache characteristics at each visit. During the first visit (n = 174), Cluster 1 primarily comprised patients with a history of primary headaches, frontal localization of pain, throbbing pain type, more severe headaches accompanied by symptoms such as nausea, phonophobia, photophobia, and osmophobia, and worsened by physical activity. In contrast, Cluster 2 consisted of patients with longer headache durations (over one month) and a stabbing/pressing quality of pain. Patients in Cluster 1 had a higher prevalence of migraine as the pre-existing primary headache disorder compared to Cluster 2 (90.48% vs. 68.18%, respectively; p = 0.005).
Conclusion: The identification of two distinct phenotypes of prolonged or worsened headaches related to COVID-19 vaccination can provide valuable clinical insights. Having an awareness of the potential worsening of headaches following COVID-19 vaccination, particularly in patients with a primary headache disorder such as migraine, can help clinicians and headache experts anticipate and adjust their treatment strategies accordingly. This knowledge can aid in preplanning treatment modifications and optimize patient care.
(© 2023. Springer-Verlag Italia S.r.l., part of Springer Nature.)
Databáze: MEDLINE
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