The neurological presentations associated with COVID-19: A retrospective single-center clinical study in the Republic of Dagestan, Russia

Numerous studies have demonstrated that patients with COVID-19 may develop neurological complications, including headaches. Despite this, the available data on the clinical characteristics of affected patients remain limited. The purpose of the study was to analyze the characteristics of headaches in COVID-19 patients examined outpatiently. A retrospective single-center study of the patients with confirmed COVID-19 was conducted from 1st May to 30th June 2020. Epidemiological, demographic, clinical, laboratory and radiological data were collected and analyzed. All patients were divided into 4 groups based on their chest CT scans: CT-0 - no evidence of pneumonia, CT-1 < 25% involvement, CT-2–25-50%, CT-3–50-75%, CT-4 > 75%. 175 COVID-19 patients were enrolled during the study period. The mean age was 49.8 ± 12.3 years (64% females). The leading neurological signs were fatigue (81.2%), headache (64.6%), anosmia/ageusia (54.8%/52.0%), anxiety/depression (58.8%/57.7%). The main features of headache were bilateral localization (72.5%), a pressing quality (69.1%), onset in the frontal and periorbital regions (60.2%) and spontaneous regression after the acute phase of the disease. 57.5% of the patients had no previous history of any primary headache. Headache intensity, according to the VAS, was significantly higher in patients with more severe lung damage (p = 0.033), probably due to hypoxia. Most of the neurological manifestations were comparable in frequency to those reported in the literature. The incidence of headache in our population was higher than reported in the literature, possibly due to the higher rate of primary headache history in our sample of patients compared to available studies.