Effect of the COVID-19 Pandemic on Headache in Pediatric Migraine Patients at a Single Tertiary Center

Abstract

Purpose: The aim of this study was to evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on children and adolescents with migraine. Methods: This longitudinal cohort study enrolled children and adolescents with migraine from the Department of Pediatric Neurology at our hospital from January 2017 to June 2021. Self-reported data from individual headache diaries were used. The patients were questioned about their headache frequency and intensity, stress, physical activity, changes in mood and sleep, and their school and home lives during the COVID-19 pandemic. The Pediatric Migraine Disability Assessment (Ped-MIDAS) scoring system was applied to assess headache-related disability. Results: In total, 325 pediatric migraine patients (mean age 12.8±5.6 years, 62.5% female) were included in this study. The average monthly frequency of migraine headaches was 2.17±1.32 and 4.62±3.29 before and during the COVID-19 pandemic (P<0.001), respectively. The Ped-MIDAS score was obtained for 207 patients both before and during the pandemic, and the total score slightly increased from 13.8 to 14.7 points (P=0.295). Sixty patients (18.5%) showed significantly worsening migraine headaches. Younger age (P=0.017), mood deterioration (P<0.001), sleep problems (P<0.001), increased acute medication use (P=0.010), and larger changes in the Ped-MIDAS score (P=0.002) were significantly associated with worsening headache in the logistic regression analysis. Conclusion: Headache attacks in children and adolescents with migraine were more frequent during the COVID-19 pandemic than before it. Worsening headaches could be independently attributed to younger age, mood deterioration, and poor sleep during the COVID-19 pandemic.