Nuray BİLGE, Fatma KESMEZ CAN, Handan ALAY

COVID-19 Hastalarında Başağrısının Enflamatuvar Serum Parametreleri ve Hastalık Şiddeti ile İlişkisi

Amaç: Koronavirüs hastalığı 2019 (coronavirüs disease 2019, COVID-19) hastalarının çoğunun solunum semptomları vardır; ancak baş ağrısı gibi çeşitli nörolojik semptomlar da görülebilir. COVID-19'daki baş ağrısının patofizyolojik mekanizması tam olarak bilinmemektedir. Çalışmamızda COVID-19 hastalarında baş ağrısının enflamatuvar belirteçler ve hastalık şiddeti ile olan ilişkisini araştırmayı amaçladık. Gereç ve Yöntemler: 15 Mart ve 01 Haziran 2020 tarihleri arasında polimeraz zincir reaksiyonu (polymerase chain reaction, (PCR) ile doğrulanmış COVID-19 tanısıyla hastaneye yatırılan 203 hasta retrospektif olarak incelendi. Baş ağrısı semptomu olan (n=31) ve baş ağrısı semptomu olmayan (n=31) yaş ve cinsiyet eşleştirilmiş toplam 62 hasta çalışmaya dahil edildi. Hastaların demografik özellikleri, enflamatuar serum parametreleri, nötrofil/lenfosit oranı (neutrophil-lymphocyte ratio, NLR), C-reaktif protein (C-reactive protein, CRP)/albümin oranı (CRP-albumin ratio, CAR), hastanede yatış süreleri ve hastalık şiddeti belirlendi. Bulgular: İki yüz üç COVID-19 hastasının 36 (%17,7)'sında baş ağrısı semptomu vardı ve en sık dördüncü semptomdu. Baş ağrısı, hastaların tümünde diğer semptomlara eşlik ediyordu. Baş ağrısı olan hastaların 14 (%45,2)'ü kadın, 17 (%54,8)'si erkekti ve yaş ortalamaları 37,74±16,65 yıl idi. COVID-19 hastalarımızda baş ağrısı olanlarda baş ağrısı olmayanlara göre nötrofil sayısı, NLR, CRP, CAR anlamlı düzeyde yüksekti ve hastane yatış süreleri daha uzundu (sırasıyla, p=0,023; p=0,041; p=0,034; p=0,048 ve p=0,049). Sonuç: Sonuç olarak, COVID-19 hastalarında baş ağrısı patogenezinde artmış enflamatuvar yanıtın rolü olabilir. Çalışmamız, COVID-19 hastalarında baş ağrısı semptomu ile inflamasyon arasındaki ilişkiyi değerlendiren ilk çalışmadır. Bu konuda daha fazla araştırmaya ihtiyaç vardır.

Anahtar Kelimeler:

COVID-19, başağrısı, nötrofil-lenfosit oranı, C-reaktif protein, albumin

The Relationship of Headache with Inflammatory Serum Parameters and Disease Severity in COVID-19 Patients

Aim: Most of the coronavirus disease 2019 (COVID-19) patients have respiratory symptoms; however, various neurological symptoms, such as headache, can be seen. The pathophysiological mechanism of headache in COVID-19 is unknown completely. In our study, we aimed to investigate the relationship between headache and inflammatory markers and disease severity in COVID-19 patients. Material and Methods: Two hundred and three hospitalized patients with a polymerase chain reaction (PCR)-confirmed COVID-19 diagnosis between 15 March and 01 June 2020 were retrospectively investigated. A total of 62 patients with headache symptoms (n=31) and without headache symptoms (n=31), who were age and gender-matched, were included in the study. The demographic characteristics, inflammatory serum parameters, neutrophil/lymphocyte ratio (NLR), C-reactive protein (CRP)/albumin ratio (CAR), hospitalization times, and disease severity were determined. Results: Of the 203 COVID-19 patients, 36 (17.7%) had a headache, and it was the fourth most common symptom. Headache accompanied other symptoms in all patients. Of the patients with headache, 14 (45.2%) were female, 17 (54.8%) were male, and the mean age was 37.74±16.65 years. In our COVID-19 patients, the neutrophil count, NLR, CRP, CAR were significantly higher, and hospital stay was longer in patients with headache than those without headache (p=0.023, p=0.041, p=0.034, p=0,048 and p=0.049, respectively). Conclusion: As a result, the increased inflammatory response may play a role in the pathogenesis of headache in COVID-19 patients. Our study is the first study that evaluated the relationship between headache symptom and inflammation in COVID-19 patients. Further research is needed on this subject.

Keywords:

COVID-19, headache, neutrophil-lymphocyte ratio, C-reactive protein, albumin,

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