RT info:eu-repo/semantics/doctoralThesis
T1 Cefalea relacionada con Covid19: Prevalencia, fenotipo y fisiopatología
A1 Trigo López, Javier
A2 Universidad de Valladolid. Escuela de Doctorado
K1 Neurología
K1 Headache
K1 Cefalea
K1 COVID19
K1 Prevalence
K1 Prevalencia
K1 Phenotype
K1 Fenotipo
K1 32 Ciencias Médicas
AB BACKGROUNDAt the beginning of December 2019, a series of cases of viral profile pneumonia were reported in the city of Wuhan, China. In January 2020, a new type of betacoronavirus was identified as responsible for these pneumonias, which was called Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV2), while the disease produced by it was called coronavirus disease of 2019 or COVID19. The first series of cases indicated fever (83-98 %), cough (59-82 %) and dyspnea (31-69 %) as the most frequent symptoms in hospitalized patients, while neurological symptoms such as myalgias (11-44%), headache (6-13 %), dizziness (9 %) or confusion (8 %) were also common. The epidemiological, clinical and pathophysiological characteristics of headache caused by SARS-CoV2 remained unknown. OBJETIVEThe objectives of this project were: 1) To estimate the prevalence of headache in patients with SARS-CoV2 infection; 2) to analyze whether the presence of headache in COVID19 patients had prognostic implications for mortality; 3) to describe the phenotypic characteristics of headache in COVID19 patients; and 4) to analyze whether patients with headache had differences in their cytochemical profile.METHODSTo address these objectives, three observational studies were carried out, one with a retrospective cohort study, a case-control study, and a cross-sectional study nested in a prospective cohort. The studies were carried out in a public tertiary university hospital. The three studies had common inclusion criteria and all consecutive patients admitted to said hospital with a confirmed diagnosis of SARS-CoV2 infection were screened for eligibility. In the third study, the sampling was done by randomly selecting one in every five patients. The study period was between March 8 and April 11, 2020. The diagnosis was done according to the protocols and definitions of the World Health Organization (WHO). Data were collected from medical records or by telephone. Baseline variables (demographics, comorbidity, previous treatments, modified Rankin scale), intermediate variables (presenting symptoms, laboratory parameters upon admission and results of imaging work-up) and prognostic variables (severity, need for intensive care, mortality) were retrieved and analyzed.RESULTS:A total of 576 hospitalized patients with a diagnosis of COVID19 were included, among whom 137 (24 %) patients reported headache. In multivariate analysis, patients with headache had a lower risk of in-hospital all-cause mortality (OR: 0.39, 95 % CI: 0.17-0.88, p=0.007). In the study of the clinical phenotype, 130 patients were included. Headache was described as bilateral in 85 %, frontal in 83 %, and oppressive in quality in 62 %. The mean intensity described on a visual analogue scale was 7 out of 10. The criteria of the current edition of the International Classification of Headache Disorders (ICHD-3) for headache attributed to systemic viral infection were met in 94 % of the patients, tension-type headache phenotypic criteria were met in 54 % of the patients and migraine phenotypic criteria were met in 25 % of the patients. In the comparison of inflammatory parameters between COVID19 patients with and without headache, 104 patients were analyzed, among whom 29 (28 %) had headache. After adjusting the values for age, sex, baseline situation, and severity of the COVID-19 disease, interleukin-10 values remained higher in patients with headache (3.3 vs. 2.2 ng/dL, p=0.042).CONCLUSIONS:Headache is a common symptom in patients with SARS-CoV2 infection. Its phenotype is nonspecific and may resemble tension-type headache and/or migraine. Its presence is associated with a better prognosis, possibly as a consequence of a more efficient immune response.
YR 2024
FD 2024
LK https://uvadoc.uva.es/handle/10324/66287
UL https://uvadoc.uva.es/handle/10324/66287
LA spa
NO Escuela de Doctorado
DS UVaDOC
RD 16-jul-2024