World Journal of Emergency Medicine, 2020, 11(4): 274-274 doi: 10.5847/wjem.j.1920-8642.2020.04.014

Letter to the Editor

Headache may not be linked with severity of coronavirus disease 2019 (COVID-19)

Kamleshun Ramphul,1, Stephanie G. Mejias2, Yogeshwaree Ramphul3

1 Department of Pediatrics, Xinhua Hospital Affiliated to the Shanghai Jiao Tong University School of Medicine, Shanghai, China

2 University Iberoamericana UNIBE School of Medicine, Santo Domingo, The Dominican Republic

3 Department of Medicine, Sir Seewoosagur Ramgoolam National Hospital, Pamplemousses, Mauritius

Corresponding authors: Kamleshun Ramphul, Email:adramphul@hotmail.com

Received: 2020-05-6   Accepted: 2020-06-10   Online: 2020-12-15

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Kamleshun Ramphul, Stephanie G. Mejias, Yogeshwaree Ramphul. Headache may not be linked with severity of coronavirus disease 2019 (COVID-19). World Journal of Emergency Medicine, 2020, 11(4): 274-274 doi:10.5847/wjem.j.1920-8642.2020.04.014

Dear editor,

Coronavirus disease 2019 (COVID-19) is a highly infectious disease. By March 10, 2020, COVID-19 was in over 109 countries having infected over 113,702 people.[1] As the number of deaths keeps rising and with no vaccine, many countries are experiencing one of the most challenging times in their history.

We conducted a meta-analysis to understand the role of headache as a clinical presentation with the severity of COVID-19. Articles published in English and Chinese were searched on PubMed. Each result was carefully screened, and only articles comparing the severity of COVID-19 used for our study. We used R-software (https://www.r-project.org/) to conduct the meta-analysis and design a forest plot.

After a thorough evaluation, seven articles[2,3,4,5,6,7,8] were retained. Totally 1,495 patients presented as non-severe COVID-19 and 192 had headaches (Figure 1). Meanwhile, 94 of the 650 severe COVID-19 cases had a headache. The odds ratio (OR) was calculated as 1.32 (95% confidence interval [CI] 0.98-1.80). We conclude that the clinical presentation of headache in a COVID-19 patient cannot be used as a prognostic factor for severe COVID-19 disease. However, further analysis is recommended in the future with a larger sample size.

Figure 1.

Figure 1.   Association of headache with severity of COVID-19.


Funding: None.

Ethical approval: Not needed.

Conflicts of interest: There is no conflict of interest in this study.

Contributors: KR proposed the study, and wrote the first draft. All authors read and approved the final version.

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