Longitudinal follow-up of headaches in the context of Post-Acute Sequelae of COVID-19 (PASC) in an outpatient neurology cohort
Sara hyman1, Rachel Kenney2, Samarah Ahmed1, Sherry Fung1, Azizi Seixas3, Girardin Jean-Louis3, Steven Galetta4, Laura Balcer5, Sujata Thawani6
1NYU Grossman School of Medicine, 2Vanderbilt School of Medicine, 3University of Miami, 4NYU Langone Medical Center, 5NYU School of Medicine, 6NYU Neurology Associates
Objective:
We characterized the evolution of headache symptoms and self-perceived recovery of non-hospitalized COVID-19 "long haulers" 12-19 months after their initial Neuro-COVID-19 baseline study evaluation.
Background:
Neurologists are seeing many patients with PASC symptoms with headache being one of the most common. It's unclear how long they persist and how they affect quality of life.
Design/Methods:
In a follow-up study of a baseline cohort of SARS-CoV-2 laboratory-positive patients evaluated for PASC between November, 2020 and August, 2021, 49.5% (46/93) participants completed follow-up phone questionnaires on their neurologic symptoms, headaches, subjective impression of recovery, and quality of life. Measures included American Migraine Prevalence and Prevention (AMPP), Quality of Life in Neurological Disorders (NeuroQoL) fatigue, anxiety, and depression, and the Headache Impact Test (HIT6).
Results:
Median time since COVID-19 symptom onset was 25.82 months (range=4.55–30.35 months) and 37% of participants were male. 47.8% had a history of a neurological disorder, and 19.6% had a migraine history. Using mixed effects models adjusting for age, sex, and migraine history, accounting for correlation between visits at baseline and follow-up, there was no significant difference in Neuro-QoL anxiety T score (p=0.30), depression T-score (p=0.16), fatigue T-score (p>0.05), and number of headache days in the past month (p>0.05) between baseline and 1-year follow-up. However, difference was found in HIT6 score between baseline and 1-year follow-up (average of +3, p<0.0001). No difference was found in scores between those with prior migraines and those without (p<0.0001, linear regression).
Conclusions:
The impact of headaches on individuals suffering from headache increased, and quality of life measures and headache days did not change from baseline. This suggests that QOL and frequency of headaches continue to be a challenge for individuals with PASC and continued efforts to monitor and treat these patients is warranted.