Migraine tied to more COVID-19 symptoms

People with migraine were more likely to report having COVID-19 symptoms, yet less likely to utilize healthcare resources compared with infected individuals without migraine, according to a study presented at the 2021 AHS Annual Meeting.

“[Our] data suggest that people with migraine are either more susceptible to contracting COVID-19, or that they may be more sensitive to the development of symptoms once COVID-19 has been contracted, or both,” said Professor Robert Shapiro from the University of Vermont, Burlington, US.

The researchers compared data from 36,605 adults with migraine vs 4,550 people without migraine who responded to the National Health and Wellness Survey. [AHS 2021, abstract LB-01]

Respondents with migraine were more likely to report having COVID-19 than those without migraine (3.9 percent vs 2.5 percent; p<0.001), although both groups were similarly likely to test positive (33.7 percent vs 34.5 percent) or negative for COVID-19 (15.9 percent vs 17.8 percent).

Among individuals who tested positive for COVID-19, respondents with migraine were significantly more likely to report symptoms of COVID-19 such as headache/sore throat/congestion, fever, loss of smell/taste, dyspnoea, body aches, chest pain, and digestive issues, and confusion/inability to arouse (p≤0.005 for all).

“Further, once COVID-19 has been contracted, people with migraine may be less likely to develop serious COVID-19 outcomes, or they may be less likely to seek health care for COVID-19, or both,” Shapiro reported.

While all participants used healthcare resources more often after COVID-19 diagnosis than before, healthcare resource utilization was less common among infected adults with migraine compared with those without migraine (risk ratios [RRs], 1.12 vs 1.35 for visits to a healthcare provider; 2.6 vs 4.90 for emergency department visits, and 4.63 vs 7.58 for hospitalizations).

Speculating on what the implications of the study are, Shapiro suggested that headache might be a positive prognostic indicator for patients hospitalized with COVID-19.

“Taken together with [previous] data showing that headache during hospitalization for COVID-19 is associated with favourable outcomes, and that higher migraine population prevalence is associated with increased COVID-19 mortality rates, these data support a hypothesis that headache and migraine may reflect adaptive processes associated with host defence against SARS-CoV-2,” he explained.

Two genes connected to migraine susceptibility, SCN1A and IFNAR2, have recently been shown to be among 15 host loci that were associated with COVID-19 outcomes. Shapiro also pointed out that COVID-19 has been associated to lower levels of serum calcitonin gene-related peptide — a neuropeptide known to modulate migraine-related pain.