COVID-19 and Headache: A Primer for Trainees
COVID-19 and Headache: A Primer for Trainees
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DOI：
10.1111/head.13884
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发表时间：
2020-06-19
期刊：
影响因子：
5
通讯作者：
Robbins, Matthew S.
中科院分区：
文献类型：
--
作者：
Bobker, Sarah M.;Robbins, Matthew S.
目的为学员总结新冠肺炎患者头痛的可能机制，以及在临床实践中对头痛障碍患者和头痛药物的影响。研究背景新冠肺炎是一种由新型冠状病毒引起的全球大流行的严重急性呼吸综合征冠状病毒2型，其中很大一部分患者以神经系统症状为特征，通常为头痛。这种病毒具有很高的传染性，因此正在改变临床实践，强制限制面对面就诊和程序性治疗，更快地转向广泛适应远程医疗服务。设计/结果我们综述了目前已知的新冠肺炎的病理生理机制以及它与头痛的可能机制之间的关系，包括间接的、潜在的直接原因和继发性原因。还探讨了治疗头痛疾病患者和使用远程医疗的替代方案。结论新冠肺炎患者头痛的发生机制和发生时间的相关信息有限，尽管其原因可能与病毒直接侵入神经系统和细胞因子释放综合征有关。尽管新冠肺炎时代的头痛护理需要改变，但现在可用的改进的预防治疗选择以及远程医疗的可行性和安全性的证据表明，临床医生有能力照顾这类患者，特别是在纽约新冠肺炎的中心。
Objective To summarize for the trainee audience the possible mechanisms of headache in patients with COVID-19 as well as to outline the impact of the pandemic on patients with headache disorders and headache medicine in clinical practice. Background COVID-19 is a global pandemic caused by the novel coronavirus severe acute respiratory syndrome coronavirus 2, of which a large subset of patients features neurological symptoms, commonly headache. The virus is highly contagious and is, therefore, changing clinical practice by forcing limitations on in-person visits and procedural treatments, more quickly shifting toward the widespread adaptation of telemedicine services. Design/Results We review what is currently known about the pathophysiology of COVID-19 and how it relates to possible mechanisms of headache, including indirect, potential direct, and secondary causes. Alternative options for the treatment of patients with headache disorders and the use of telemedicine are also explored. Conclusions Limited information exists regarding the mechanisms and timing of headache in patients with COVID-19, though causes relate to plausible direct viral invasion of the nervous system as well as the cytokine release syndrome. Though headache care in the COVID-19 era requires alterations, the improved preventive treatment options now available and evidence for feasibility and safety of telemedicine well positions clinicians to take care of such patients, especially in the COVID-19 epicenter of New York City.