Factors associated with the presence of headache in hospitalized COVID-19 patients and impact on prognosis: a retrospective cohort study
Factors associated with the presence of headache in hospitalized COVID-19 patients and impact on prognosis: a retrospective cohort study
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DOI：
10.1186/s10194-020-01165-8
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发表时间：
2020-07-29
影响因子：
7.4
通讯作者：
Guerrero, Angel L.
中科院分区：
文献类型：
--
作者：
Trigo, Javier;Garcia-Azorin, David;Guerrero, Angel L.
头痛是COVID-19最常见的神经系统表现之一。我们的目的是分析哪些症状和实验室异常与头痛的存在相关，并评估头痛患者是否有较高的调整后住院死亡风险。方法回顾性队列研究。我们纳入了2020年3月8日至4月11日期间确诊SARS-CoV-2感染的所有连续住院患者。我们收集了人口统计学数据、临床变量和实验室异常。我们使用多元回归分析。结果在研究期间，576例患者被纳入，年龄67.2岁（SD：14.7），其中250/576（43.3%）为女性。137例（23.7%）患者描述了头痛。全因住院死亡率为127/576（20.0%）。在多因素分析中，头痛患者的死亡风险较低（OR：0.39，95%CI：0.17- 0.88，p = 0.007）。在多变量分析中调整多重比较后，与COVID-19患者头痛几率较高独立相关的变量为嗅觉丧失、肌痛、女性性别和发热;与头痛发生率较低相关的变量包括年龄较小、改良兰金量表评分较低，以及入院时的实验室变量，C反应蛋白升高、血小板值异常，淋巴细胞减少和D-二聚体增加。结论头痛是COVID-19患者的常见症状，其存在是COVID-19住院患者死亡风险较低的独立预测因素。
Introduction Headache is one of the most frequent neurologic manifestations in COVID-19. We aimed to analyze which symptoms and laboratory abnormalities were associated with the presence of headache and to evaluate if patients with headache had a higher adjusted in-hospital risk of mortality. Methods Retrospective cohort study. We included all consecutive patients admitted to the Hospital with confirmed SARS-CoV-2 infection between March 8th and April 11th, 2020. We collected demographic data, clinical variables and laboratory abnormalities. We used multivariate regression analysis. Results During the study period, 576 patients were included, aged 67.2 (SD: 14.7), and 250/576 (43.3%) being female. Presence of headache was described by 137 (23.7%) patients. The all-cause in-hospital mortality rate was 127/576 (20.0%). In the multivariate analysis, patients with headache had a lower risk of mortality (OR: 0.39, 95% CI: 0.17-0.88,p = 0.007). After adjusting for multiple comparisons in a multivariate analysis, variables that were independently associated with a higher odds of having headache in COVID-19 patients were anosmia, myalgia, female sex and fever; variables that were associated with a lower odds of having headache were younger age, lower score on modified Rankin scale, and, regarding laboratory variables on admission, increased C-reactive protein, abnormal platelet values, lymphopenia and increased D-dimer. Conclusion Headache is a frequent symptom in COVID-19 patients and its presence is an independent predictor of lower risk of mortality in COVID-19 hospitalized patients.