الفهرس 
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Abstract
T
he first cases of unknown severe pneumonia were observed in Wuhan, the capital of Hubei Province, China, in December 2019. The WHO officially named the disease Coronavirus Disease 2019 (COVID-19), and declared it as pandemic on 11 March 2020. Over the years, several different respiratory viruses have been shown to be able to penetrate the CNS (neuroinvasion). Most of them can infect neurons and glial cells (neurotropism) and result in the induction of neurological diseases.
However, it has now been proven indubitably that coronaviruses possess neurotropic and neuroinvasive properties in various hosts including humans, rats, pigs, rodents and fowl.
Coronaviruses first target respiratory and mucosal surfaces and then, depending on the host and virus strain, may spread to other tissues (brain, eyes, liver, kidneys and spleen) and cause a range of pathologies such as pneumonia, encephalitis, neurodegenerative demyelination, hepatitis, enteritis, and nephritis among others.
Many neurological manifestations have been reported in the literature associated with COVID-19, which we can classify into central nervous system (CNS)-related manifestations including headache, dizziness, impaired consciousness, acute cerebrovascular disease, and epilepsy, or peripheral nervous system (PNS) related manifestations such as hyposmia/anosmia, hypogeusia/ageusia, muscle pain, and Guillain–Barre syndrome.
There are some studies and reviews highlighting that the most common neurological symptom is headache, often accompanied by high fever, moreover headache can occasionally be seen alone as the first sign of the disease.
We created our study to focus on the correlation between COVID-19 severity and headache characteristics.
This study was conducted on 50 patients suffering from headache within 6 months after diagnosis of Covid-19 according to the ICDH-III criteria of headache, with mean age of 44.68 ± 18.33 years, with female predominance (60%).
The majority of the current study cases had mild COVID-19 (68%). 28% of the patients had headache before COVID-19 infection, 52% had headache with COVID-19 and 20% after the infection.
60% of patients had worse headache with fever, in 24% fever had no effect on headache and in 16% fever decreased with headache. Paracetamol use induced headache improvement in 76% of the study patients, while in 24% no effect was observed. Headache onset had highly significant correlation with fever, while headache onset had insignificant correlation with paracetamol use.
In the present study, age and gender had insignificant effect on headache onset, frequency and duration.
COVID-19 severity had highly significant effect on headache onset. Headache severity and frequency among this study participants showed highly significant difference as regards headache onset. However, headache duration had insignificant correlation with headache onset.
In the present study, the age had highly significant correlation with COVID-19 severity. Sex showed non-significant correlation with COVID-19 severity.
COVID-severity had highly significant correlation with headache onset, severity and frequency. Also, Headache duration had a significant correlation with COVID-severity.
COVID-19 severity had highly significant correlation with fever and also, COVID-19 severity had highly significant correlation with paracetamol use.
Headache severity and frequency had statistically highly significant negative correlation with age and also, Headache duration has a significant negative correlation with age.
In conclusion COVID-19 infection severity had highly significant correlation with post-COVID headache onset, severity and frequency. Also, it has a significant correlation with headache duration. Age has a significant correlation with post covid headache characters, however gender has a non-significant correlation with post-COVID headache onset, severity, frequency and duration.