Background and purpose: Headache is an important manifestation during SARS‐CoV‐2 infection. In this study, the aim was to identify factors associated with headache in COVID‐19 and headache characteristics.Methods: This case–control study includes COVID‐19 hospitalized patients with pneumonia during March 2020. Controls comprise COVID‐19 patients without headache and the cases are COVID‐19 patients with headache. Demographic, clinical and laboratory data were obtained from the medical records. Headache characteristics were evaluated by semi‐structured telephonic interview after discharge.Results: Of a total of 379 COVID‐19 patients, 48 (13%) developed headache. Amongst these, 30 (62%) were men and the median age was 57.9 (47–73) years. Headache was associated with younger age, fewer comorbidities and reduced mortality, as well as with low levels of C‐reactive protein, mild acute respiratory distress syndrome and oropharyngeal symptoms. A logistic multiple regression model revealed that headache was directly associated with D‐dimer and creatinine levels, the use of high flow nasal cannula and arthromyalgia, whilst urea levels, beta‐lactamic treatment and hypertension were negatively associated with headache. COVID‐19‐associated headache characteristics were available for 23/48 (48%) patients. Headache was the onset symptom in 8/20 (40%) patients, of mild or moderate intensity in 17/20 (85%) patients, with oppressive characteristics in 17/18 (94%) and of holocranial 8/19 (42%) or temporal 7/19 (37%) localization.Conclusions: Our results show that headache is associated with a more benign SARS‐CoV‐2 infection. COVID‐19‐associated headache appears as an early symptom and as a novel headache with characteristics of headache attributed to systemic viral infection. Further research addressing the underlying mechanisms to confirm these findings is warranted.

Migraine is one of the most wide-spread neurological disorders, and its medical treatment represents a high percentage of the costs of health systems. In some patients, characteristic symptoms that precede the headache appear. However, they are nonspecific, and their prediction horizon is unknown and pretty variable; hence, these symptoms are almost useless for prediction, and they are not useful to advance the intake of drugs to be effective and neutralize the pain. To solve this problem, this paper sets up a realistic monitoring scenario where hemodynamic variables from real patients are monitored in ambulatory conditions with a wireless body sensor network (WBSN). The acquired data are used to evaluate the predictive capabilities and robustness against noise and failures in sensors of several modeling approaches. The obtained results encourage the development of per-patient models based on state-space models (N4SID) that are capable of providing average forecast windows of 47 min and a low rate of false positives.

BACKGROUND: APRIL (A Double-Blind, Placebo-Controlled, Randomized, Phase Ib/IIa Clinical Study of ApTOLL for the Treatment of Acute Ischemic Stroke), a randomized placebo-controlled phase Ib/IIa trial, showed safety and reduced mortality and disability at 90 days of ApTOLL 0.2 mg/kg in combination with endovascular treatment in patients with acute large vessel occlusion within a 6-hour window. We studied the effect of ApTOLL against placebo on final infarct volume, infarct growth, and cerebral edema. METHODS: Post hoc analysis of a trial was conducted between 2020 and 2022 in Spain and France. Patients allocated to ApTOLL doses of 0.05 and 0.2 mg/kg and placebo were selected. The early infarct growth rate was defined as admission relative cerebral blood flow 10 mL/h. An imaging core laboratory evaluated final infarct volume and cerebral edema on fluid-attenuated inversion recovery or noncontrast computed tomography at 72 hours if fluid-attenuated inversion recovery was not available. Cerebral edema was evaluated according to the SITS-MOST (Safe Implementation of Thrombolysis in Stroke-Monitoring Study) edema scale (cerebral edema degree [CED]; less severe: CED1; more severe: CED2; and with midline shift: CED3). Infarct growth was calculated as the final infarct volume: relative cerebral blood flow <30% volume at admission. Associations were studied through linear or ordinal models adjusted by prespecified variables. Admission relative cerebral blood flow <30% volume, fast recruitment, and final expanded Thrombolysis in Cerebral Infarction, among others, were examined for interaction with ApTOLL on final infarct volume and CED. RESULTS: A total of 136 of 139 patients had sufficient radiological data. Median admission relative cerebral blood flow <30% was 18 mL, and median final infarct volume was 36.53 mL. Edema grade was CED1 in 45%, CED2 in 34%, and CED3 in 21% patients. Compared with placebo, ApTOLL 0.2 mg/kg was independently associated with a lower final infarct volume (relative reduction, –45.2% [95% CI, −65% to −15%]), a lower infarct growth (61.51% [95% CI, −79% to −29%]), and a lower edema grade (common odds ratio, 0.38 [95% CI, 0.15–0.96]). No associations were found for ApTOLL 0.05 mg/kg. The study of interactions showed a greater benefit of ApTOLL 0.2 mg/kg among patients with larger core volume at admission, fast progressors, and patients achieving incomplete reperfusion (expanded Thrombolysis in Cerebral Infarction <2b). CONCLUSIONS: ApTOLL 0.2 mg/kg in combination with mechanical thrombectomy significantly reduced final infarct volume, infarct growth, and cerebral edema at 72 hours. ApTOLL seemed to be more effective under conditions prone to infarct growth.