Abstract
Given the increasing number of patients with COVID-19 and the rapid changes that the pandemic has brought about in lifestyles, this document was developed with the aim of providing a recommendation to neurologists and doctors in general for the approach of the patient with headache. Initially, the headache was treated as one of the symptoms of COVID-19, reviewing the case series and proposing possible diagnostic classifications to explain its presence in these patients. Subsequently, headache secondary to other neurological disorders also reported in patients with COVID-19 and the warning signs will be evaluated to carry out complementary studies. Finally, it will be reviewed how the follow-up of patients with primary headache in the midst of the pandemic has changed, recommendations on adjustments to be made during this time in its management and formulation, and finally recommendations on drug interactions in case of illness due to COVID-19.
References
Baig AM, Khaleeq A, AH U, Syeda H. Evidence of the Covid-19 virus targeting the CNS: tissue distribution, host-virus interaction, and proposed neurotropic mechanisms. ACS Chem Neurosci. 2020;11(7):995-8.
Paniz-Mondolfi A, Bryce C, Grimes Z, Gordon RE, Reidy J, Lednicky J, et al. Central nervous system involvement by severe acute respiratory syndrome Coronavirus -2 (SARS-CoV-2). J Med Virol. 2020 Apr 21. doi: 10.1002/jmv.25915.
Moriguchi T, Harii N, Goto J, Harada D, Sugawara H, Takamino J, et al. A first case of meningitis/encephalitis associated with SARS-Coronavirus-2. Int J Infect Dis. 2020;94:55-8.
Chen T, Wu D, Chen H, Yan W Yang D, Chen G, et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ 2020; Mar 26. doi: 10.1136/bmj.m1091.
Chang D, Lin M, Wei L, Xie L, Zhu G, Dela Cruz CS, et al. Epidemiologic and clinical characteristics of novel coronavirus infections involving 13 patients outside Wuhan, China. JAMA. 2020;323(11):1092-3.
Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol. 2020 Apr 10. doi: 10.1001/jamaneurol.2020.1127.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13.
Tian S, Hu N, Lou J, Chen K, Kang X, Xiang Z, et al. Characteristics of Covid-19 infection in Beijing. J Infect. 2020;80(4):401-6.
Xu XW, Wu XX, Jiang XG, Xu KJ, Ying LJ, Ma CL, et al. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: Retrospective case series. BMJ. 2020 Feb 19. doi: 10.1136/bmj.m606.
Volcy Gómez M. Cefalea en el servicio de urgencias: nuevos conceptos en el diagnóstico, la epidemiología y el tratamiento. Acta Neurol Colomb. 2008;24:118-33.
Bolay H, Gül A, Baykan B. Covid-19 is a real headache! Headache J Head Face Pain. 2020 May 15. doi: 10.1111/head.13856.
Zhu J, Ji P, Pang J, Zhong Z, Li H, He C, et al. Clinical characteristics of 3,062 Covid-19 patients: a meta-analysis. J Med Virol. 2020 Apr 15. doi: 10.1002/jmv25884.
Vincent M, Wang S. Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38(1):1-211.
Stovner LJ, Nichols E, Steiner TJ, Abd-Allah F, Abdelalim A, Al-Raddadi RM, et al. Global, regional, and national burden of migraine and tension-type headache, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol;17(11):954-76.
Lipton RB, Dodick D, Sadovsky R, Kolodner K, Endicott J, Hettiarachchi J, et al. A self-administered screener for migraine in primary care: The ID migraine TM validation study. Neurology. 2003;61(3):375-82.
Detsky ME, McDonald DR, Baerlocher MO, Tomlinson GA, McCrory DC, Booth CM. Does this patient with headache have a migraine or need neuroimaging? J Am Med Assoc. 2006;296(10):1274-83.
Ezpeleta D, García D. Manual Covid-19 para el neurólogo general. Madrid: Sociedad Española de Neurología; 2020.
Katz M. The cost-effective evaluation of uncomplicated headache. Med Clin North Am. 2016;100(5):1009-17.
Ong JJY, Bharatendu C, Goh Y, Tang JZY, Sooi KWX, Tan YL, et al. Headaches associated with personal protective equipment - a cross-sectional study among frontline healthcare workers during Covid-19. Headache. 2020;60(5):864-77.
Krymchantowski AV. Headaches due to external compression. Curr Pain Headache Rep. 2010;14(4):321-4.
Marmura MJ. Triggers, protectors, and predictors in episodic migraine. Curr Pain Headache Rep. 2018;22(12):81. doi: 10.1007/s11916-018-0734-0.
Bernstein CA, Nir RR, Noseda R, Fulton AB, Huntington S, Lee AJ, et al. The migraine eye: distinct rod-driven retinal pathways' response to dim light challenges the visual cortex hyperexcitability theory. Pain. 2019;160(3):569-78.
Müller KI, Alstadhaug KB, Bekkelund SI. Telemedicine in the management of non-acute headaches: A prospective, open-labelled non-inferiority, randomised clinical trial. Cephalalgia. 2017;37(9):855-63.
Qubty W, Patniyot I, Gelfand A. Telemedicine in a pediatric headache clinic: A prospective survey. Neurology. 2018;90(19):e1702-5.
Müller KI, Alstadhaug KB, Bekkelund SI. A randomized trial of telemedicine efficacy and safety for nonacute headaches. Neurology. 2017;89(2):153-62.
Grazzi L, Rizzoli P. The adaptation of management of chronic migraine patients with medication overuse to the suspension of treatment protocols during the Covid-19 pandemic: lessons from a tertiary headache center in Milan, Italy. Headache. 2020 Apr 30. doi: 10.1111/head.13825.
Uribe B, Takeuchi Y, Miranda G. Consenso de expertos de la Asociación Colombiana de Neurología para el tratamiento preventivo y agudo de la migraña Acta Neurol Colomb. 2014;30(3):175-85.
Jamieson DG. The safety of triptans in the treatment of patients with migraine. Am J Med. 2002;112(2):135-40.
Szperka CL, Ailani J, Barmherzig R, Klein BC, Minen MT, Halker Singh RB, et al. Migraine care in the era of Covid-19: clinical pearls and plea to insurers. Headache. 2020;60(5):833-42.
Brunton L, Chabner B, Knollmann B. Goodman & Gilman: las bases farmacológicas de la terapéutic, 13 edición. AccessMedicina, McGraw-Hill Medical Pub; 2018.
Silberstein SD. Preventive migraine treatment. Continuum (Minneap Minn) 2015;21(4):973-89.
Schwedt TJ. Preventive therapy of migraine. Contin Lifelong Learn Neurol. 2018;24(4):1052-65.
Thompson DF, Saluja HS. Prophylaxis of migraine headaches with riboflavin: A systematic review. J Clin Pharm Ther. 2017;42(4):394-403.
Foley HM, Steel AE. Adverse events associated with oral administration of melatonin: A critical systematic review of clinical evidence. Complement Ther. 2019;42:65-81.
Hidaka T, Fujii K, Funahashi I, Fukutomi N, Hosoe K. Safety assessment of coenzyme Q10 (CoQ10). BioFactors. 2008;32(1-4):199-208.
Ali A. Delay in onabotulinumtoxinA treatment during the Covid-19 pandemic-perspectives from a virus hotspot. Headache. 2020;60(6):1183-6.
Ministerio de Salud de Colombia. Orientaciones para la restauración gradual de los servicios de salud en las fases de mitigación y control de la emergencia sanitaria por Covid-19 en Colombia. 2020 [citado 2020 mayo 19]. Disponible en: Disponible en: https://www.minsalud.gov.co/Ministerio/Institucional/Procesosyprocedimientos/PSSS05.pdf
Ministerio de Salud de Colombia. Lineamientos para prevención control y reporte de accidente por exposición ocupacional al covid-19 en instituciones de salud. 2020 [citado 2020 mayo 19]. Disponible en: Disponible en: https://www.minsalud.gov.co/Ministerio/Institucional/Procesos_y_procedimientos/GPSG04.pdf
ClinicalTrials.gov. Safety and efficacy trial of vazegepant intranasal for hospitalized patients with covid-19 requiring supplemental oxygen [full text view].
Maassen Van Den Brink A, Meijer J, Villalón CM, Ferrari MD. Wiping out CGRP: potential cardiovascular risks. Trends Pharmacol Sci. 2016;37(9):779-88.
Kee Z, Kodji X, Brain SD. The role of calcitonin gene related peptide (CGRP) in neurogenic vasodilation and its cardio-protective effects. Front Physiol. 2018 Sep 19; 9:1249. doi: 10.3389/fphys.2018.01249.
Borkum JM. CGRP and brain functioning: cautions for migraine treatment. Headache. 2019;59(8):1339-57.
Scuteri D, Adornetto A, Rombola L, Naturale MD, Morrone LA, Bagetta G, et al. New trends in migraine pharmacology: Targeting calcitonin gene-related peptide (CGRP) with monoclonal antibodies. Front Pharmacol. 2019;9;10:363. doi: 10.3389/fphar.2019.00363
Fang L, Karakiulakis G, Roth M. Are patients with hypertension and diabetes mellrtus at increased risk for Covid-19 infection? Lancet Respir Med. 2020;8(4):e21.
FDA advises patients on use of non-steroidal anti-inflammatory drugs (NSAIDs) for Covid-19 [citado 2020 mayo 12]. Disponible en: Disponible en: https://www.fda.gov/drugs/drug-safety-and-availability/fda-advises-patients-use-non-steroidal-anti-inflammatory-drugs-nsaids-covid-19
The use of non-steroidal anti-inflammatory drugs (NSAIDs) in patients with Covid-19 [citado 2020 mayo 12]. Disponible en: Disponible en: https://www.who.int/publications-detail/the-use-of-non-steroi-dal-anti-inflammatory-drugs-(nsaids)-in-patients-with-covid-19
Maassen Van Den Brink A, de Vries T, Danser AHJ. Headache medication and the Covid-19 pandemic. J Headache Pain. 2020; 21(1):38. doi: 10.1186/s10194-020-01106-5.
Spiegel M, Schmidauer C, Kampfl A, Sarcletti M, Poewe W Cerebral ergotism under treatment with ergotamine and rito-navir. Neurology. 2001;57(4):743-4.
Acle S, Roca F, Vacarezza M, Rocha AÁ. Ergotismo secundario a la asociación ergotaminaritonavir. A propósito de 3 casos. Rev Med Chil. 2011;139(12):1597-600.
Capi M, Curto M, Lionetto L, De Andrés F, Gentile G, Negro A, et al. Eletriptan in the management of acute migraine: An update on the evidence for efficacy, safety, and consistent response. Ther Adv Neurol Disord. 2016;9(5):414-23.
Meid AD, Bighelli I, Máchler S, Mikus G, Carra G, Castellazzi M, et al. Combinations of QTc-prolonging drugs: towards disentangling pharmacokinetic and pharmacodynamic effects in their potentially additive nature. Ther Adv Psychopharmacol. 2017;7(12):251-64.
Russell B, Moss C, Rigg A, Van Hemelrijck M. Covid-19 and treatment with NSAIDs and corticosteroids: should we be limiting their use in the clinical setting? Ecancermedicalscience. 2020 Mar 30; 14:1023. doi: 10.3332/ecancer.2020.1023.

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
