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How to distinguish the headache that best fits with covid-19

2020-09-19T08:07:52.487Z


Scientists have launched a 'robot portrait' of the symptom, and speak of at least four types related to the disease and the pandemic


At this point no one is indifferent to the fever-cough-difficulty breathing trio, the three symptoms that the WHO has described as the most frequent of covid-19;

To these we must add fatigue, nasal congestion, sore throat and diarrhea.

The headache, until now, seemed a secondary aspect, but it is relevant and quite frequent among people with

covid-19

.

Also, it is not exactly like the one we are used to, and that is important.

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As scientists learn more about this symptom, the

headache

of covid-19 is acquiring its own characteristics, characteristics that could open a new therapeutic, research, and, above all, diagnostic line on the tortuous path of knowing and overcoming the disease.

“Contrary to what it initially seemed, this is a very common symptom in patients with covid-19.

It seemed isolated like other minor ones (loss of smell or taste, for example) and, in fact, the first comments in the scientific literature considered it a non-specific symptom.

However, according to our experience working directly with patients, we find that headaches have very specific characteristics, so it seemed reasonable to us to define them appropriately ”, explains Jesús Porta-Etessam, vice president of the Spanish Society of Neurology and Head of Neurology at Hospital Clínico San Carlos, Madrid.

According to the International Classification of Headaches, there is a very wide range of headache groups and subgroups, all of them described and categorized to facilitate their diagnosis and, therefore, facilitate their treatment.

Some are more frequent than others.

The most common is tension headache, which affects more than 70% of the population and which usually occurs at the end of the day, when the fatigue and stresses of the day accumulate.

Migraine, a disease suffered by more than 4 million people in Spain (from 12% to 15% of the workforce) and which the WHO considers the eighth most disabling disease, is also common.

The headache associated with SARS CoV-2 infection is similar to tension headaches in some respects, in others it resembles migraines.

However, at the same time it can be distinguished from both with sufficient clarity.

To define the profile of the headache that has emerged with covid-19, a team of Spanish researchers from the Complutense University

and the hospitals

San Carlos Clinic of Madrid

and

Clinico de Valladolid analyzed 112 volunteers of health personnel with coronavirus infection (among them, doctors, nurses and assistants).

Most of those surveyed (73.2%) had no prior history of headaches, but the scientists detected pain that was different from the usual among those who did (26.8%), much more intense.

Although that is not the most interesting result of the study, in which Porta-Etessam participated and which saw the light last July in the scientific journal

Headache.

According to the job,

There are at least four types of headaches related to the SARS-CoV-2 coronavirus.

Go ahead that following the conclusions of this research work at home does not guarantee a one hundred percent accurate diagnosis, and that self-diagnosis is a terrible idea for this as for so many other

diseases

.

Still, the scientists' observations are interesting.

To begin with, because they detected two sources of headache that are not directly related to the infection.

It gets worse when you move and it wakes you up at night

Half of the respondents who used the personal protective equipment (the famous PPE) described a particular headache.

Being subjected for hours to the constant pressure exerted by wearing one or two masks, without forgetting the protective screen, was the cause.

This pain is typified in the international classification "as external compression headache", and can be extrapolated to the general population because the rubber bands of the masks often tighten excessively.

The solution is simple, says Porta-Etessam: “Simply by loosening them and modifying the way they are worn;

using these devices to join the gums from behind, without tightening the head, or using the masks with which you have entered the operating room all your life, that is, those with the loop from behind, is enough ”.

The second type of headache not directly related to infection that scientists observed is caused by the stress generated by the pandemic.

Among the headaches that are related to infection, the work includes one reserved for people who have previously suffered migraine attacks, or who suffer from tension or cluster headaches.

In these cases, the neurologist thinks that, in general, these situations worsen: "They intensify and worsen, with the possibility that, in some cases, they even become chronic."

Regarding how many people this happens to, Porta-Etessam is cautious.

"At the moment we are studying it, but it gives us the feeling that it could happen to between 2 and 5% of patients," he says.

Neurologists work with the hypothesis that this

possible chronification is related to the inflammatory character of the headache

.

As for the treatment, the same treatment that you were following is usually applied before testing positive for the coronavirus.

Finally, there is the predominant headache in covid-19 patients.

Porta-Etessam reveals that it is described with great intensity and mostly oppressive, which distinguishes it from migraine, which is pulsatile.

"It can be holo or hemicranial, that is, affect the whole head or only one side, but, as this characteristic is also common in other headaches, the location does not seem to be a piece of information that helps us distinguish it", says the doctor. .

One of the most distinctive features is that it worsens with physical activity and head movements, which distinguishes it from tension headache.

“An important aspect that keeps it away from most other headaches is that it can wake the patient up at night.

In addition, it usually lasts between 24 hours and a week, presenting itself continuously, not like the episodes of migraines, for example ”.

It does resemble migraine in that there is annoying noise and sometimes lights, so

the most common treatment is the same as that of migraine attacks

.

Fortunately, the neurologists from the Valladolid hospital who participated in the study, although in a different investigation, have seen that the headache does not seem to be a sign of a poor prognosis of covid-19.

However, the specialist remembers that this is not a reason to relax at the slightest symptom.

“A person who, in the context of the pandemic, loses his sense of smell, has a fever, a sore throat and has a headache, which worsens with activity and movement, has to suspect that he is facing a headache typical of the covid-19 ".

And act accordingly.

Source: elparis

All news articles on 2020-09-19

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