Patients With Migraine And COVID-19 Pandemic

Since the declaration COVID-19 as a pandemic, healthcare systems around the world have faced a huge challenge in managing patients with chronic diseases, including patients with migraine, who were specifically vulnerable to inadequate medical care. “The Journal of Headache and Pain” investigate the “real-world” impact of COVID-19 pandemic on migraine patients, and to identify risk factors for poor outcome.

“We administered an online, self-reported survey that included demographic, migraine-related, COVID-19-specific and overall psychosocial variables between July 15 and July 30, 2020. We recruited a sample of patients with migraine from headache clinic registry and via social media to complete an anonymous survey. Outcomes included demographic variables, change in migraine frequency and severity during the lockdown period, communication with treating physician, compliance to migraine treatment, difficulty in getting medications, medication overuse, symptoms of anxiety and/or depression, sleep and eating habits disturbance, screen time exposure, work during pandemic, use of traditional medicine, effect of Botox injection cancellation, and overall worries and concerns during pandemic,” – said in the article.

The Survey Among Patients With Migraine

This cross-sectional, internet-based study, recruited patients with migraine between July 15 and July 30, 2020, using an online free, open access “Google Forms” survey. The study was approved by the Institutional Review Board Committee of Ministry of health of the state of Kuwait.

The survey investigated demographic variables, frequency and severity of migraine attacks, patient’s ability to get proper medical care, symptoms of depression, anxiety, insomnia, perceived stress, analgesics overuse, the use of other traditional/alternative remedies, and patient’s COVID-19-specific concerns during the pandemic.

Participants were recruited from 2 sources:

1. patients with migraine who are registered in headache outpatient clinic at Ibn Sina Hospital, the largest neurology tertiary center in Kuwait
2. and, through sharing the survey via two medical social media accounts in Kuwait, with participants who have received a medical diagnosis of migraine prior to the pandemic only included.

In this survey, the main outcome variable was the change in migraine frequency and severity during the pandemic, in comparison to the 3 months’ pre-pandemic period. We aim to explore risk factors associated with worsening of headache frequency and severity.

Results

A total of 1018 patients completed the survey. Of the respondents, 859 (84.3%) were females; 733 (71.9%) were aged 20 to 40 years, 630 (61.8%) were married, and 466 (45.7%) reported working during the pandemic.

In comparison to the pre-pandemic period, 607 respondents (59.6%) reported increase in migraine frequency, 163 (16%) reported decrease in frequency, and 105 (10.3%) transformed to chronic migraine. Severity was reported to increase by 653 (64.1%) respondents. The majority of respondents; 626 (61.5%) did not communicate with their neurologists, 477 (46.9%) reported compliance to treatment, and 597 (58.7%) reported overuse of analgesics.

Botox injections cancellation had a negative impact on 150 respondents (66.1%) from those receiving it. Forty-one respondents (4%) were infected with COVID-19; 26 (63.4%) reported worsening of their headaches amid infection period. Sleep disturbance was reported by 794 (78.1%) of respondents, and 809 (79.5%) reported having symptoms of anxiety and/or depression.

“COVID-19 pandemic had an overall negative impact on patients with migraine. Several risk factors for poor outcome were identified. Long-term strategies should be validated and implemented to deliver quality care for patients with migraine, with emphasis on psychosocial well-being,” – summed up in the article.