Headache as a Prognostic Factor for COVID-19. Time to Re-evaluate
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COVID-19
Headache as a Prognostic Factor for COVID-19. Time to Re-evaluate Paolo Martelletti 1,2
&
Enrico Bentivegna 2 & Michelangelo Luciani 2 & Valerio Spuntarelli 2
Accepted: 18 November 2020 / Published online: 26 November 2020 # The Author(s) 2020
Abstract Headache occurs in only about 13% of patients within the cohort of presenting COVID-19 symptoms. The hypothesis that such a painful symptomatic picture could be considered a prognostic factor for COVID-19 positive evolution or its trend of severity, or the co-generation of hyposmia/anosmia and/or hypogeusia/ageusia, needs robust epidemiological data, punctual pathophysiological demonstrations, and a detailed comparative analysis on drug–drug interactions (DDIs). Keywords COVID-19 . Headache . Prognostic factors . Drug–drug interactions (DDIs) . Emergency medicine . Cytokine release syndrome (CRS)
Viewpoint To date, scientific literature is regrettably and exceedingly generous towards the term “COVID-19”: 71,664 scientific articles published [1], 49,578,590 confirmed cases, and 1,245,717 confirmed deaths for COVID-19 in less than 1 year [2]. As the number of new registered cases continues to rise on a daily basis, 441,696 on the 9th of November 2020, so too is there an increase in questions for the scientific community while certainties struggle to emanate from this immensity of scientific data. It is clear that all systems have been crushed by this cytokine release syndrome (CRS) and that the list of epidemiological and clinical characteristics, including headache, does not appear to be subject to further updates. Headache as a symptom of COVID-19 is present in only 12.9% of patients afferent to COVID-19 emergency medicine [3]. Headache, for those experiencing the COVID-19 clinic at first hand, does not seem to be of such clinical relevance, but only an epiphenomenon secondary to the involvement of
This article is part of the Topical Collection on COVID-19 * Paolo Martelletti [email protected] 1
Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
2
Emergency Medicine & COVID-19 Unit, Sant’Andrea University Hospital, Rome, Italy
complex systems, the cardiovascular/coagulative and respiratory/neurological, other than to a febrile state. The assumption that the international scientific community should use headache as prognostic factor of COVID-19 duration or severity in a COVID-19 emergency medicine clinical setting is a recent concept. Such assumption is expressed in two recent articles, Caronna and Magdy [4, 5]. The first study has been carried out on 130 COVID-19 patients (74.6% with headache), while the latter on 172 COVID-19 patients with headache selected from a cohort total of 238 COVID-19 patients (52.9%) is the highest percentile reported in the majority of the scientific literature [1]. Interestingly, these data came from the use of face-to-face interviews in patients strongly compromised and in a clinical setting strictly sealed and in operational emergency. The methodology of the two reports is not t
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