How many more people have been diagnosed with migraine because of COVID-19?

One of Migraine Australia's greatest fears is a migraine pandemic to follow the COVID-19 pandemic. It's a fear that could well become reality. 

There has been much written about the long tail of COVID-19 - both in terms of long covid, and in terms of the costs to other health concerns that were denied or delayed treatment. 

We already know about the pain endured by many with migraine who had Botox treatments cancelled, specialist appointments cancelled, delays to getting medication because of supply chain challenges. And of course, there were many thousands of patients who simply couldn't access their doctors across State borders we previously never thought about as a barrier. 

Our advocacy team has worked hard to assist people affected by these inconveniences. These issues are not our fear. Our fear is that thousands more people will be diagnosed with migraine. And it's a fear well based in research. Let's take a look.

Australian researchers Haghdoost et al. (2021) reported an increase in the frequency of migraine attacks throughout the pandemic, even when controlling for the four most common Migraine attack triggers of stress, lack of sleep, neck pain and anxiety. 

Grassini et al. (2021) argued that inflammatory processes induced by SARS-CoV-2 infection may increase the frequency of Migraine attacks, probably through an activation of the trigeminovascular system.​ 

​​Initial reports into the presentation of COVID-19-related headaches have found that people with a pre-existing diagnosis of Migraine are experiencing a more severe Migraine-like headache (Angus-Leppan, Guiloff, Benso & Guiloff, 2021). Early case reports have documented people with Migraine presenting to hospital and primary medical care with aura and severe pain symptoms, that to date, was not part of their regular Migraine attack for these patients (Grassini et al., 2021; Singh & Ali, 2020; Waliszewska-Prosol & Budrewicz, 2021). 

Further research in a sample of COVID-19 patients that presented with headache as a primary symptom of infection found that 25.3% had a previous diagnosis of migraine. Importantly, of the subset with pre-existing migraine, over 90% of patients presented with different symptoms than was usual migraine attack (92%) and were more likely to have a headache onset prior to respiratory symptoms (96%). The migraine-like headache was longer in duration (80%) and was more intense (100%), when compared to patients without migraine (Membrilla, de Lorenzo, Sastre & Diaz de Teran, 2020).  

This is the really scary bit: the neurological form of long covid may be previously dormant migraine, activated by the virus. Some researchers have hypothesised Long Covid may be underlying Migraine activated by the virus (Arca & Starling 2021), and others hypothesise it is a dysfunction of the brainstem, similar to the involvement of brainstem dysfunction in chronic migraine (Yong, 2021).

Davis et al. (2021) found that 77% of people with Long Covid experienced headache, and 23% experienced migraine attack. Of those who experienced migraine, 56.4% did not list migraine as a pre-existing condition.  

Or, in English, if you have migraine and get COVID-19, your migraine and headache is likely to get worse.

If you don't currently experience migraine, but have the underlying genes that cause migraine, COVID-19 will wake the disorder up and you may progress to severe migraine quite quickly.

We don't want thousands more people to have migraine, but we need to be ready for it, because science is telling us that's what's coming. And we don't manage the migraine we have well as it is. 

We have tried, and tried, and tried to get governments at both the state and federal level to act. To warn people that if they have migraine they are at much greater risk of COVID-19, and gear up their health systems for a crushing increase in migraine presentations.

They all need to understand that around 12% of the people who get COVID-19 will also start getting migraine attacks. We don't know how many people that will be as so many people are still getting infected every day, but it's a lot. 

We have been ignored. Dismissed. Nothing has been done.  

You deserved to be told by the health experts that you were at a much greater risk from COVID-19. You have every right to get angry. You have every right to demand that action is taken to bring migraine Out of the Dark.

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