Does a nasopharyngeal swab for COVID-19 trigger migraineand what has been the impact of COVID-19 lockdown on patients with migraine in Argentina and India? The results of studies detailed in three posters at IHC2021 provide new insights on these topics to inform the management of people with migraine.
Does a nasopharyngeal swab for COVID-19 trigger migraine?1
A descriptive retrospective online survey of 309 healthcare professionals at University Hospital Marqués de Valdecilla, Spain, was carried out to determine whether nasopharyngeal swabs taken for COVID-19 polymerase chain reaction (PCR) tests trigger migraine attacks.
Over one-third of migraineurs had a migraine attack within 24 hours of their PCR test
The results were detailed in a poster presented by J Madera Fernández and colleagues.
Among the participants:
- 37% were migraineurs
- 47 (15%) reported a migraine attack within 24 hours of the PCR test — 37% of migraineurs and 3% of non-migraineurs (X2=66.6, p<0.00; odds ratio 22.6, 95% CI [8.6–59.4])
The characteristics of the post-PCR migraine attack including migraine aura were similar from those of previous migraine attacks.
The results suggest that purely peripheral trigeminal stimuli can induce migraine
The authors concluded that a nasopharyngeal swab taken for a COVID-19 PCR test could therefore induce a migraine attack in migraineurs, suggesting that purely peripheral trigeminal stimuli can induce migraine.
What has been the impact of COVID-19 lockdown on patients with migraine in Argentina?2
A descriptive, retrospective review of electronical medical records of patients attending a headache clinic in Argentina between May 26 and June 30, 2020, was carried out to evaluate the impact of the lockdown on patients with migraine.
During lockdown, 50% of Argentinian migraine patients experienced worsening frequency of headache
The results were detailed in a poster presented by María Vanesa Nagel and colleagues.
Of the 304 patients evaluated, 88% were female and mean age was 41 years.
Most of the patients (47%) had episodic migraine, 35% had chronic migraine, 9% had migraine with aura, and 9% had medication overuse headache.
During lockdown, 50% of patients experienced worsening frequency of headache, 29% remained stable, and 21% experienced improved frequency of headache.
- The main reasons for headache worsening were work (29%, with 70% of patients working from home), and mood changes (24%)
- The main reasons for headache improving were pharmacological preventive therapies (35%) and work (29%, with 24% of patients working from home)
Reasons related to work during the lockdown were a main cause for both worsening and improvement of headache
The authors concluded that reasons related to work were a main cause for both worsening and improvement of headache and that home working can impact differently on each patient.
What has been the impact of COVID-19 lockdown on patients with migraine in India?3
A cross-sectional, internet-based questionnaire was carried out between 27th April and 31st July 2020 to assess the impact of the COVID-19 lockdown in India on patients with migraine.
During lockdown, 51% of Indian migraine patients experienced worsening headache
The results were detailed in a poster presented by Debashish Chowdhury and colleagues.
Of the participants recruited, 4078 completed the full survey and 984 (24%) with a mean age of 35 years were physician-diagnosed migraineurs or fulfilled the criteria for a diagnosis of migraine.
Among the participants with migraine, 51% reported worsening headache, with 88–96% reporting increased attack frequency, increased headache days, increased attack duration, and increased headache severity.
The COVID-19 lockdown significantly reduced the quality of life of Indian migraine patients
The worsening headache was attributed to:
- Anxiety caused by the COVID-19 pandemic by 80%
- Inability or difficulty accessing healthcare and migraine medicines by 49%
- Financial worries by 68%
Compared with non-migraineurs, a greater proportion of migraineurs reported a bad and very bad quality of life (27% versus 7%; p<0.0001).
The authors concluded that the COVID-19 pandemic-related lockdown had significantly reduced the quality of life of Indian migraine patients.
Our correspondent’s highlights from the symposium are meant as a fair representation of the scientific content presented. The views and opinions expressed on this page do not necessarily reflect those of Lundbeck.
