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Vol 57, No 1 (2023)
Review Article
Submitted: 2022-04-30
Accepted: 2022-05-24
Published online: 2022-06-27
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COVID-19-related headache and innate immune response — a narrative review

Marcin Straburzyński1, Ewa Kuca-Warnawin2, Marta Waliszewska-Prosół3
DOI: 10.5603/PJNNS.a2022.0049
·
Pubmed: 35758225
·
Neurol Neurochir Pol 2023;57(1):43-52.
Affiliations
  1. Department of Family Medicine and Infectious Diseases, University of Warmia and Mazury, Olsztyn, Poland
  2. Department of Pathophysiology and Immunology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
  3. Department of Neurology, Wroclaw Medical University, Wrocław, Poland

open access

Vol 57, No 1 (2023)
REVIEW ARTICLES — LEADING TOPIC
Submitted: 2022-04-30
Accepted: 2022-05-24
Published online: 2022-06-27

Abstract

Headache is one of the most prevalent, although often underreported, symptoms of coronavirus disease 2019 (COVID-19). It is generally accepted that this symptom is a form of secondary headache due to systemic viral infection. There are several hypotheses that try to explain its aetiopathogenesis. One of the most compelling is related to innate immune response to viral infection. This rationale is supported by similarities to other viral infections and the temporal overlap between immunological reactions and headache. Moreover, several key factors in innate immunity have been shown to facilitate headache e.g. interferons, interleukin (IL) –1-β, IL-6, and tumour necrosis factor. There is also a possibility that the virus causes headache by the direct activation of afferents through pattern recognition receptors (i.e. Toll-like receptor 7). Moreover, some data on post-COVID-19 headache and after vaccination against SARS-CoV-2 infection suggests a similar cytokine-mediated pathomechanism in these clinical situations. Future research should look for evidence of causality between particular immune response factors and headache. Identifying key molecules responsible for headache during acute viral infection would be an important step towards managing one of the most prevalent secondary headache disorders.

Abstract

Headache is one of the most prevalent, although often underreported, symptoms of coronavirus disease 2019 (COVID-19). It is generally accepted that this symptom is a form of secondary headache due to systemic viral infection. There are several hypotheses that try to explain its aetiopathogenesis. One of the most compelling is related to innate immune response to viral infection. This rationale is supported by similarities to other viral infections and the temporal overlap between immunological reactions and headache. Moreover, several key factors in innate immunity have been shown to facilitate headache e.g. interferons, interleukin (IL) –1-β, IL-6, and tumour necrosis factor. There is also a possibility that the virus causes headache by the direct activation of afferents through pattern recognition receptors (i.e. Toll-like receptor 7). Moreover, some data on post-COVID-19 headache and after vaccination against SARS-CoV-2 infection suggests a similar cytokine-mediated pathomechanism in these clinical situations. Future research should look for evidence of causality between particular immune response factors and headache. Identifying key molecules responsible for headache during acute viral infection would be an important step towards managing one of the most prevalent secondary headache disorders.

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Keywords

SARS-CoV-2, pain, innate immune response, IL-1β, IL-6, TNF, IFN, TLR-7

About this article
Title

COVID-19-related headache and innate immune response — a narrative review

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 57, No 1 (2023)

Article type

Review Article

Pages

43-52

Published online

2022-06-27

Page views

3632

Article views/downloads

954

DOI

10.5603/PJNNS.a2022.0049

Pubmed

35758225

Bibliographic record

Neurol Neurochir Pol 2023;57(1):43-52.

Keywords

SARS-CoV-2
pain
innate immune response
IL-1β
IL-6
TNF
IFN
TLR-7

Authors

Marcin Straburzyński
Ewa Kuca-Warnawin
Marta Waliszewska-Prosół

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