The Impact of the COVID-19 pandemic on primary headache disorders with a particular focus on migraine disorders

https://doi.org/10.25143/rsu-bjcmr.2024.01.026-037

Abstract

Keywords. Migraine, primary headache disorders, COVID-19, Pandemic,

Objectives. The goal of this research work is to identify “real life” changes of headache days (MHD) and headache intensity of migraineurs during the pandemic, and to demonstrate exact pandemic specific headache-triggers considering the social, economic, and occupational consequences of the COVID-19 Pandemic.

Material and methods. This study included 222 migraineurs currently undergoing treatment at the West German Headache Center. The “pen-paper” survey consisted of 37 questions (dichotomic questions, even/uneven Likert scales, Perceived Stress Scale (PSS), open questions) and compared physical, intellectual, psychological, psychosocial, financial, and professional variables before and during the COVID-19 pandemic, with consequent changes of MHD frequency and intensity in our patient collective.

Results. 2/3 of patients experienced consistent and 1/3 of patients an increase in headache days and headache intensity during the Pandemic. The MHD increased significantly from 14,2±10,1 to 15,3±10,0 (p=<0,01).

Significant correlations between an increase in 1:MHD or 2:Headache-Intensity were found with: Age(2:p=.016;r_s=-.168), no spouse(1:p=.049;r_s=-.138), COVID-19 cases in private environment(1:p=.035;r_s=.146), reduced physical performance(1:p=.023;r_s=-.161), temporary (forced) work reduction(1:p=.023;r_s=-.170), Homeschooling(1:p=.013;r_s=.220), “Home Childcare”(1:p=.007;r_s=.240; 2:p=.011;r_s=.227), fear of own infection(1:p<.001;r_s=.267; 2:p=.002;r_s=.217), fear of infection of others(1:p=.042;r_s=.140), fear of financial hardship(1:p=016;r_s=.170; 2:p=.013; r_s=.177), fear of loneliness(2:p=.005;r_s=.198), fear of meeting people(1:p<.001;r_s=.248; 2:p=.003;r_s=.205), 1:p=.024;r_s=-.158), more conflicts with own children(1:p=.013;r_s=.216; 2:p=.004;r_s=.251), PSS(2:p=.003;r_s=.222). Additionally, the second COVID-19 wave demonstrated a significant worsening of migraine headache compared to the first wave.

Conclusions. Beyond the actual infection, the COVID-19 Pandemic negatively affects the lives and disease experiences of migraineurs. Pandemic-specific stress, worries, fears, as well as various physical and psychological factors caused an increase in migraine headaches in our patients. Only the optimistic feeling of being able to cope well with the pandemic correlated positively with a reduction in MHD.