Abstract text (incl. figure legends and references)

Question

To describe the clinical characteristics of headache, that persists after acute SARS-Cov-2 infection in a sample that belongs to a tertiary outpatient clinic in Spain

Methods

This is a cross-sectional descriptive study. The study population were patients who had been diagnosed with COVID-19, either by PCR or by serology in the first wave. Demographic variables, history of previous headaches, pain characteristics, symptomatic and preventive treatment, COVID and post-COVID symptoms, and psychiatric comorbidity were collected.

Results

Twenty patients were included, 90% were women and the mean age was 48.5 years. 60% of the patients had a previous history of headache, being episodic migraine the most prevalent (35%). The accompanying symptoms that stood out during the acute phase were: anosmia/hyposmia 45% and pneumonia 45%. The pain that appeared during the postcovid headache was daily (60%) moderate (70%), bilateral (60%), frontal (30%) and oppressive (50%). The patients associated photophobia 90%, phonophobia 85%, osmophobia 35%. The most used preventive treatment was amitriptyline (55%) . Greater occipital nerve block with anesthetics was beneficial in 50% of the sample. 15% of the patients were treated with corticotherapy. The most reported post-COVID symptoms were anosmia (25%) and cognitive alterations (20%) and fatigue 20%. Four patients met clinical ICHD criteria for NDPH, and these patients had higher scores on the Hamilton anxiety scale, especially in somatic anxiety 13/28 in patients with NDPH vs 8/28 (mean of the rest of the patients). 85% of patients were responders to preventive treatment.

Conclusion: Patients who meet the NDPH criteria showed higher levels of anxiety compared to the rest of the patients. Anxiety and other psychiatric comorbidities related to the pandemic may help perpetuate the pain. Although most patients improve over time, in our sample 15% remain with persistent headache