The Relationship of Headache with Inflammatory Serum Parameters and Disease Severity in COVID-19 Patients

Aim: Most of the coronavirus disease 2019 (COVID-19) patients have respiratory symptoms;

however, various neurological symptoms, such as headache, can be seen. The

pathophysiological mechanism of headache in COVID-19 is unknown completely. In our

study, we aimed to investigate the relationship between headache and inflammatory markers

and disease severity in COVID-19 patients.

Material and Methods: Two hundred and three hospitalized patients with a polymerase chain

reaction (PCR)-confirmed COVID-19 diagnosis between 15 March and 01 June 2020 were

retrospectively investigated. A total of 62 patients with headache symptoms (n=31) and

without headache symptoms (n=31), who were age and gender-matched, were included in the

study. The demographic characteristics, inflammatory serum parameters,

neutrophil/lymphocyte ratio (NLR), C-reactive protein (CRP)/albumin ratio (CAR),

hospitalization times, and disease severity were determined.

Results: Of the 203 COVID-19 patients, 36 (17.7%) had a headache, and it was the fourth

most common symptom. Headache accompanied other symptoms in all patients. Of the

patients with headache, 14 (45.2%) were female, 17 (54.8%) were male, and the mean age was

37.74±16.65 years. In our COVID-19 patients, the neutrophil count, NLR, CRP, CAR were

significantly higher, and hospital stay was longer in patients with headache than those without

headache (p=0.023, p=0.041, p=0.034, p=0,048 and p=0.049, respectively).

Conclusion: As a result, the increased inflammatory response may play a role in the

pathogenesis of headache in COVID-19 patients. Our study is the first study that evaluated the

relationship between headache symptom and inflammation in COVID-19 patients. Further

research is needed on this subject.

Keywords: COVID-19; headache; neutrophil-lymphocyte ratio; C-reactive protein; albumin.