The impact of Coronavirus disease 2019 (COVID-19) pandemic on migraine disorder

DOI: https://doi.org/10.1007/s00415- 021- 10590- x

Abstract-Summary Self-reported data from a migraine tracking smartphone application, Migraine Buddy, were used.

Data were collected from users who reported at least one attack in the Jan, Feb,

Mar and Apr of 2018, 2019 and 2020.

The four commonest headache triggers in 2018, 2019 and 2020 were stress in 39.7%, 38.4% and 36.1%, lack of sleep in 25%, 25% and 22.8%, neck pain, 20%, 20.4% and 19.3% and anxiety in 19%, 18.4% and 18.4% of participants, respectively. One thousand six hundred eighty-nine users participated in the survey and they telehealth (11.9%)

they preferred face-to-face (54.29%)

to

reported that consultations.

An increase in migraine frequency from 2018 to 2020 was reported by the users

of the mobile phone.

Stress, lack of sleep, neck pain and anxiety were the commonest attack triggers. An increase in telehealth consultations with specialists was reported in the sur-

vey but migraine patients preferred face-to-face consultations.

Introduction As of March the 1st 2021, the COVID-19 pandemic has affected over 110 million people worldwide of which about 1,850,000 have died and around 60,000,000 have recovered [249].

The impact of the COVID-19 pandemic on health care delivery systems has been

overwhelming in many countries.

The unexpected number of cases has mobilised hospital teams and resources, with the ‘non-essential’ care of non-COVID patients cancelled or postponed, creat- ing a challenge in providing adequate care for patients with chronic illnesses.

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5 Future Directions

Using Migraine Buddy data, the most commonly used mobile phone application for migraine and headache tracking, we aim to investigate the impact of the COVID-19 pandemic on patients experiencing migraine.

Methods This application is designed to help users track, find migraine patterns, and report headaches and associated triggers, which can be exported to share during physician consultations to diagnose and monitor migraine.

The application has built-in reminders to allow users to input all data points related to migraine attack and can send targeted questionnaires to gain real-time insights into migraine management.

Self-reported data were collected from the users who had reported at least one

migraine attack in the respective months.

A survey including five questions to evaluate the impact of COVID-19 pandemic on migraine management from the perspective of patients was sent to Migraine Buddy users who were based in English speaking countries from 16 to 30th of July 2020.

User data were deidentified and users were given the option to share their data

for research purposes during onboarding in the Migraine Buddy application.

Results Headache frequency per month was reported higher in 2020 than 2019 and higher in 2019 than 2018.

Out of 1687 users, 55.54% reported fewer face-to-face specialist’s consultations since the beginning of the pandemic but 16.66% of the users, did not report any change in the number of face-to-face consultations.

For telehealth consultations, about 34% of users reported an increase. Smaller proportions of patients reported less and a similar number of telehealth

consultations.

The question on the impact of the mode of consultation on migraine outcome was answered by 127 users and 68.80% of the respondents reported no impact on the frequency of their headaches, with 26.40% experiencing more and 4.80% expe- riencing less migraine attacks.

Discussion and Conclusion We showed an increase in the frequency of headache in patients experiencing migraine during the pandemic compared to similar periods in the previous 2 years. Similar to these reports, another study from the Netherlands showed a decrease in migraine frequency and an increase in general well-being in migraine patients during the lock down compared to a month before the lock down [250].

It might be that the increase in the frequency of headache is caused by a change in reporting habits (for example due to more free time during the pandemic and increased confidence in using the application) with more assiduous use of the Migraine Buddy phone application during the pandemic.

Our study lacks data about the migraine changes in infected migraine patients

which have been reported in other studies [218, 220, 251].

5.2

COVID-19 and SARS-COV2 Vaccines

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Summary and Conclusion In our large study, we showed that the frequency of migraine attacks increased dur- ing the COVID-19 pandemic.

The increase in the frequency of migraine headache in 2020 compared to the same period in 2019 and 2018 likely represents a real increase but we were unable to ascertain the reason for this change and it can be due to more use of the applica- tion by the users.

Migraine Buddy users reported a preference for face-to-face consultation over

telehealth but this had no impact on the quality of care they perceived.

The frequency of migraine has increased during the COVID-19 pandemic but this is not explained by changes in the most common triggers such as stress and lack of sleep.

An increase in the frequency of headache is reported in the Migraine Buddy

phone application during the pandemic compared to before.

The four most reported triggers of migraine headache attacks in the Migraine

Buddy phone application are stress, lack of sleep, neck pain and anxiety.

Acknowledgement A machine generated summary based on the work of Haghdoost, Faraidoon; Carcel, Cheryl; Chandrasekhar, Deepak; Rodgers, Anthony; Delcourt, Candice 2021  in Journal of Neurology.

Frequency and phenotype of headache in covid-19: a study of 2194 patients