Acute and Preventive Treatment of COVID-19-Related Headache: A Series of 100 Patients

Author:

García-Azorín David12ORCID,García-Ruiz Claudia2,Sierra-Mencía Álvaro2,González-Osorio Yésica2ORCID,Recio-García Andrea2,González-Celestino Ana2,García-Iglesias Cristina2ORCID,Planchuelo-Gómez Álvaro3ORCID,Íñiguez Ana Echavarría4ORCID,Guerrero-Peral Ángel L.12ORCID

Affiliation:

1. Department of Medicine, Toxicology and Dermatology, Faculty of Medicine, University of Valladolid, 47002 Valladolid, Spain

2. Headache Unit, Department of Neurology, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain

3. Imaging Processing Laboratory, Escuela Superior de Telecomunicaciones (ETSI), Universidad de Valladolid, 47002 Valladolid, Spain

4. Department of Neurology, Hospital Universitario de Burgos, 09006 Burgos, Spain

Abstract

To describe the need and effectiveness of acute and preventive medications in a series of 100 consecutive patients referred due to COVID-19-related headaches. Patients were aged 48.0 (standard deviation (SD): 12.4), 84% were female, and 56% had a prior history of headache. The most common headache phenotype was holocranial (63%), frontal (48%), pressing (75%), of moderate intensity (7 out of 10), and accompanied by photophobia (58%). Acute medication was required by 93%, with paracetamol (46%) being the most frequently used drug, followed by ibuprofen (44%). The drugs with the highest proportion of a 2 h pain-freedom response were dexketoprofen (58.8%), triptans (57.7%), and ibuprofen (54.3%). Preventive treatment was required by 75% of patients. The most frequently used drugs were amitriptyline (66%), anesthetic blockades (18%), and onabotulinumtoxinA (11%). The drugs with the highest 50% responder rate were amitriptyline (45.5%), mirtazapine (50%), and anesthetic blockades (38.9%). The highest 75% responder rate was experienced following onabotulinumtoxinA (18.2%). In conclusion, most patients required acute medication, with triptans and non-steroidal anti-inflammatory drugs achieving the best responses. Three-quarters of patients required preventive medication. The most frequently used drug was amitriptyline, which obtained the best results. In some treatment-resistant patients, anesthetic blockades and onabotulinumtoxinA were also beneficial.

Funder

Regional Health Administration—Gerencia Regional de Salud (GRS), Castilla y León, Salud Castilla y Leon

Publisher

MDPI AG

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