CMAAO CORONA FACTS and MYTH : Friendly Headache

January 14, 2021

Author : Dr K Aggarwal , President CMAAO, HCFI, , With input from Dr Monica Vasudev

India

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New Delhi, January 14, 2021 :

China puts 22 million people under lockdown, worst coronavirus flare-up since last summer: Authorities have ordered testing of every resident, shutting down transportation and canceling weddings and other events. They’ve ordered more than 22 million people to remain inside their homes, double the number affected last January in Wuhan, the world’s first coronavirus lockdown. The flare-ups remain small compared with the devastation facing other countries — an average of 109 new cases a day over the past week — but they threaten to undercut the success the country has had in subduing the virus and restarting the economy.

Scientists in Brazil have downgraded the efficacy of its CoronaVac vaccine to just over 50 percent — far below the 78 percent level announced last week. The implications could be significant for China’s push to provide its vaccine to the developing world.

Officials at the Butantan Institute in São Paulo said on Tuesday that a trial conducted in Brazil showed that the CoronaVac vaccine, made by the Beijing-based company Sinovac, had an efficacy rate just over 50 percent. That rate, slightly above the benchmark that the World Health Organization has said would make a vaccine effective for general use, was far below the 78 percent level announced last week. At least 10 countries have ordered more than 380 million doses of CoronaVac, though regulatory agencies have yet to fully approve it.

CoronaVac, unlike some of the other vaccines, relies on older technology that uses chemicals to weaken or kill the virus, which is then put into a vaccine to spark antibodies in the recipient. But the process of killing the virus can weaken a vaccine’s potency, resulting in an immune response that could be shorter or less effective. The lower efficacy would mean it would take longer for countries that used CoronaVac’s vaccine to reach “herd immunity,”.

Study identifies factors and characteristics associated with headache in COVID‐19

Findings from a study published in the European Journal of Neurology show that headache was associated with a more benign severe COVID 19.

“We have found that [younger] age and the absence of baseline pathologies such as hypertension, atrial fibrillation and Charlson comorbidities are associated with the presence of headache in hospitalised coronavirus disease 2019 (COVID-19) patients,” wrote Alicia Gonzalez-Martinez, MD, Hospital Universitario de La Princesa, Madrid, Spain, and colleagues. “This indicates that headache may present as a COVID-19 symptom in individuals with healthier backgrounds suggesting that healthy immune systems could have a role in the development of headache.”

The case-control study included 379 patients with COVID-19 who were hospitalised in a tertiary hospital in Madrid in March 2020. Of the patients, 48 (13%) developed headache, with a median age of 57.9 years and 62% were men. The remaining 331 patients who did not develop headache during their hospitalisation were selected as controls.

The researchers found that headache was associated with younger age, lower Charlson comorbidity index, and reduced mortality, as well as with lower levels of C-reactive protein, mild acute respiratory distress syndrome, and presence of oropharyngeal symptoms.

Furthermore, baseline hypertension and atrial fibrillation were more prevalent among controls. A logistic multiple regression model revealed that headache was directly associated with D-dimer and creatinine  levels, the use of high flow nasal cannula and arthromyalgia, while urea levels, beta-lactamic treatment  and hypertension were negatively associated with headache.

Headache was of mild or moderate intensity in 17 patients, with oppressive characteristics in 17 patients. Meanwhile, headache with holocranial localisation was reported in 8 patients and temporal localisation in 7 patients. The authors noted that headache was never accompanied by trigeminal autonomic symptoms among the patients.

“COVID-19-associated headache appears as an early symptom and as a novel headache with characteristics of headache attributed to systemic viral infection.

Collectively, the results from our case-control study show that the presence of headache is associated with mild inflammation and mild pulmonary alterations and with a better prognosis during COVID -19.

SOURCE: European Journal of Neurology

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