Introduction: This study examined the prevalence and clinical characteristics of persistent post-Coronavirus Disease 2019 (COVID-19) headache, and explored its associations with demographic, clinical, and neuroimaging parameters within a real-world patient cohort, thereby addressing a frequently reported yet insufficiently understood neurological complication.Materials and Methods: A total of 341 patients with polymerase chain reaction (PCR)-confirmed COVID-19 who presented with persistent symptoms to a neurology outpatient clinic were evaluated. Patients were grouped according to the presence or absence of an ongoing headache. Demographic characteristics, comorbidities, accompanying neurological and systemic symptoms, and neuroimaging findings (including conventional MRI, diffusion-weighted imaging, and MR venography when available) were compared between the groups. Statistical analyses included chi-squared tests, t-tests or non-parametric equivalents for group comparisons, and logistic regression models to identify independent associations between variables.Results: Persistent headache was reported by 36.9% of patients and was significantly more common among younger individuals and women (median age 45 vs. 55 years, p 0.001; 42.9% vs. 27.5%, p = 0.004). Insomnia (p = 0.002), dizziness (p = 0.01), and myalgia/paresthesia (p = 0.03) were significantly more common in the headache group. In contrast, abnormal neuroimaging findings, including diffusion-weighted imaging (DWI) abnormalities and MR venography pathology, were significantly more frequent in patients without headaches. Among those with abnormal MRI findings, older age, comorbidity burden, and longer hospitalization duration were observed to be present. Multivariate analysis confirmed age and female sex as independent predictors of post-COVID headache.Conclusion:Post-COVID headache has a distinct clinical profile characterized by demographic susceptibility and concurrent dysautonomic or neuroinflammatory symptom clusters. These findings underline the need for focused clinical evaluation and improved understanding of the mechanisms underlying persistent headache during the post-infectious period.
Mehdiyev et al. (Tue,) studied this question.