For some people with COVID-19, the pain in their skull is so intense they consider a trip to the emergency room.
For others, it might come in throbbing waves or feel like a constant mild ache; it could be gone within minutes of taking painkillers or still be there months later.
“My head felt like it would explode, and no medication was enough to make it better,” said Ananda Pires, who fell ill in late December.
After two days during which she was barely able to move from her bed, the Guelph, Ont., woman said her headache mostly disappeared, with just minor pain and sensitivity to light in the days that followed.
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While loss of smell, fever and dry cough may be more publicized symptoms of COVID-19, headache is a common one, too. And, two years into the pandemic, patients and physicians are beginning to recognize that, for some, it may be by far the worst symptom — and one that lingers after others are gone.
It’s why there’s been a push by researchers, including the U.S. National Institutes of Health, to study the little-understood long-term neurological symptoms reported in some acute COVID-19 patients, which can include headaches, brain inflammation and damage to brain blood vessels.
While some people’s headaches disappear alongside the illness, other patients can’t seem to shake them — even long after their other COVID symptoms are gone.
Dr. Nili Kaplan-Myrth tested positive for COVID at the start of April. The Ottawa family physician is now well enough to resume seeing patients, but she still has an incessant headache that she describes as “like a vise.”
“It’s like you’re wearing a hat that’s too small,” Kaplan-Myrth told CBC News. “It’s a dull pain that’s just always there.”
For Scott Schmidt, the COVID headache “was like living under water for a few weeks,” with a constant pressure behind his eyes.
“I was like, I just cannot shake this headache for the life of me. I became used to it. I honestly just started going about my day with a headache,” Schmidt, a journalist from Medicine Hat, Alta., said.
‘Just a headache’ — or is it COVID?
Headaches are common to viral infections, including colds and flu. They are often one of the earliest symptoms of COVID-19, which, physicians have noticed, can make it difficult to distinguish whether it’s just a headache — or a sign of a developing illness.
Dr. Sumon Chakrabarti, an infectious disease specialist in Mississauga, Ont., says he’s seen patients present at emergency rooms with a severe headache and then test positive for COVID.
But others might brush off a minor headache and not realize they’re infected.
“So many people come and tell you, ‘You know what? It was so weird, I had a little bit of headache, a little bit of a sore throat, I just thought I drank too much wine, but I was positive.'”
Chakrabarti said if someone develops a new headache in the middle of a rising wave of COVID, it’s worth taking a rapid test.
He also points out that a sudden, severe headache can also be indicative of other medical emergencies, like a brain bleed, stroke or viral meningitis — some symptoms of which can be similar to those of COVID.
“If you’re having a massive headache and a high fever, it’s also a good idea to go to the emergency [room]. If you’re having a bad headache and vomiting that won’t stop, you go in as well.”
Headaches that just won’t quit
For some people, the headache just won’t go away — long after they’re no longer infected. Exactly why isn’t yet well understood.
“There are multiple possibilities at this point, and I don’t think we have a good handle on it yet,” says Dr. Jennifer Frontera, a neurology professor at the NYU Grossman School of Medicine, who is researching post-COVID conditions.
Some of those possibilities, she says, include complications from severe COVID, autoimmune conditions, high blood pressure impacting blood vessels in the brain, or even pandemic stress that results in tension headaches.
Given the number of potential causes, she says, “it’s worth going to a clinician and seeing what the treatment strategies are.”
The good news is that most long COVID patients respond to existing treatments for headaches and migraines, says Dr. Angela Cheung, a long COVID researcher based out of Toronto’s University Health Network.
Those treatments can include prescription medications, massage and mindfulness, depending on the diagnosis.
Cheung also reminds patients who despair about their long COVID symptoms that “it doesn’t mean that you will have this forever.”
Her advice: “Trying to deal with what you’re currently experiencing one step at a time, because we are learning so much every day with COVID.”
Headaches and another infection
Though Kaplan-Myrth is still struggling through her daily headache, the Ottawa physician also has another worry: if she gets reinfected in future, will the headache return?
“The fear that I could get COVID again and go through this again, particularly when I’m not back to baseline as it is, is just like, I don’t think I would cope,” she said.
It’s a concern shared by Schmidt, whose COVID headache finally went away after about three weeks.
“Now I actually live in just a tiny little bit of fear … Before, I was being careful because I pay attention and people told me to be careful,” she said. “Now I’m being careful, because I’m actually legitimately concerned for myself.”
Rare Cases of Monkeypox Diagnosed in Britain | Health | thesuburban.com – The Suburban Newspaper
TUESDAY, May 17, 2022 (HealthDay News) — Four men in England have been infected with a “rare and unusual” monkeypox virus.
Investigators from the U.K. Health Security Agency are investigating the cases and whether there is any connection between the men, according to the Associated Press. None of the individuals had traveled to the African countries where the virus is endemic. Three of the men are in London, and one is in Northeast England.
Three earlier cases were announced last week. In those cases, two of the patients lived in the same household. The third person had previously traveled to Nigeria, one of the countries where the virus is endemic in animals. Most people who get monkeypox recover quickly, within several weeks. The virus has symptoms that include fever, muscle ache, chills, and fatigue. A rash similar to that found in chickenpox and smallpox can form on the face and genitals in more severe cases.
The latest four cases all happen to be in men who identify as gay, bisexual, or men who have sex with men. However, monkeypox does not easily spread between people, and it is not known to be transmitted sexually. In Western and Central Africa, the virus is typically spread by touching or being bitten by an infected wild animal. However, it could be spread among people with extremely close contact, the British health officials said.
“The evidence suggests that there may be transmission of the monkeypox virus in the community, spread by close contact,” said Susan Hopkins, M.D., chief medical advisor for the U.K. Health Security Agency, the AP reported. “We are particularly urging men who are gay or bisexual to be aware of any unusual rashes or lesions and to contact a sexual health service without delay.”
Public health officials consider the risk to the general population to be low. They are working with hospitals and international partners to determine if there is a similar rise in cases in other places. This includes tracing people who had contacts with the monkeypox cases, including airline passengers, the AP said. Doctors who see patients with unexplained rashes should seek advice from a specialist, public health officials said.
Long COVID: Half of patients hospitalised have at least one symptom two years on – Australian Hospital + Healthcare Bulletin
Two years on, half of a group of patients hospitalised with COVID-19 in Wuhan, China, still have at least one lingering symptom, according to a study published in The Lancet Respiratory Medicine. The study followed 1192 participants in Wuhan infected with SARS-CoV-2 during the first phase of the pandemic in 2020.
While physical and mental health generally improved over time, the study found that COVID-19 patients still tend to have poorer health and quality of life than the general population. This is especially the case for participants with long COVID, who typically still have at least one symptom including fatigue, shortness of breath and sleep difficulties two years after initially falling ill.1
The long-term health impacts of COVID-19 have remained largely unknown, as the longest follow-up studies to date have spanned around one year.2 The lack of pre-COVID-19 health status baselines and comparisons with the general population in most studies has also made it difficult to determine how well patients with COVID-19 have recovered.
Lead author Professor Bin Cao, of the China-Japan Friendship Hospital, China, said, “Our findings indicate that for a certain proportion of hospitalised COVID-19 survivors, while they may have cleared the initial infection, more than two years is needed to recover fully from COVID-19. Ongoing follow-up of COVID-19 survivors, particularly those with symptoms of long COVID, is essential to understand the longer course of the illness, as is further exploration of the benefits of rehabilitation programs for recovery. There is a clear need to provide continued support to a significant proportion of people who’ve had COVID-19, and to understand how vaccines, emerging treatments and variants affect long-term health outcomes.”3
The authors of the new study sought to analyse the long-term health outcomes of hospitalised COVID-19 survivors, as well as specific health impacts of long COVID. They evaluated the health of 1192 participants with acute COVID-19 treated at Jin Yin-tan Hospital in Wuhan, China, between 7 January and 29 May 2020, at six months, 12 months and two years.
Assessments involved a six-minute walking test, laboratory tests and questionnaires on symptoms, mental health, health-related quality of life, if they had returned to work and healthcare use after discharge. The negative effects of long COVID on quality of life, exercise capacity, mental health and healthcare use were determined by comparing participants with and without long COVID symptoms. Health outcomes at two years were determined using an age-, sex- and comorbidities-matched control group of people in the general population with no history of COVID-19 infection.
Two years after initially falling ill, patients with COVID-19 are generally in poorer health than the general population, with 31% reporting fatigue or muscle weakness and 31% reporting sleep difficulties. The proportion of non-COVID-19 participants reporting these symptoms was 5% and 14%, respectively.
COVID-19 patients were also more likely to report a number of other symptoms including joint pain, palpitations, dizziness and headaches. In quality of life questionnaires, COVID-19 patients also more often reported pain or discomfort (23%) and anxiety or depression (12%) than non-COVID-19 participants (5% and 5%, respectively).
Around half of study participants had symptoms of long COVID at two years, and reported lower quality of life than those without long COVID. In mental health questionnaires, 35% reported pain or discomfort and 19% reported anxiety or depression. The proportion of COVID-19 patients without long COVID reporting these symptoms was 10% and 4% at two years, respectively. Long COVID participants also more often reported problems with their mobility (5%) or activity levels (4%) than those without long COVID (1% and 2%, respectively).
The authors acknowledged limitations to their study, such as moderate response rate; slightly increased proportion of participants who received oxygen; it was a single centre study from early in the pandemic.
1. – National Institute for Health and Care Excellence – Scottish Intercollegiate Guidelines Network – Royal College of General Practitioners. COVID-19 rapid guideline: managing the long-term effects of COVID-19. https://www.nice.org.uk/guidance/ng188
2. – Soriano – JB Murthy – S Marshall – JC Relan – P Diaz JV – on behalf of the WHO Clinical Case Definition Working Group on Post-COVID-19 Condition. A clinical case definition of post-COVID-19 condition by a Delphi consensus. Lancet Infect Dis. 2021; 22: e102-e107
3. – Huang L – Yao Q – Gu X – et al. 1-year outcomes in hospital survivors with COVID-19: a longitudinal cohort study. Lancet. 2021; 398: 747-758
Image credit: ©stock.adobe.com/au/ink drop
2SLGBTQ+ lobby group head speaks on the trauma of conversion therapy
Although conversion therapy has now been outlawed in Canada, many are still victims causing them to go through a lot of trauma in the process.
According to Jordan Sullivan, Project Coordinator of Conversion Therapy Survivors Support and Survivors of Sexual Orientation and Gender Identity and Expression Change Efforts (SOGIECE), survivors of conversion therapy identify the need for a variety of supports including education and increased awareness about SOGIECE and conversion practices.
Also needed is access to affirming therapists experienced with SOGIECE, trauma (including religious trauma), safe spaces and networks, and access to affirming healthcare practitioners who are aware of conversion therapy or SOGIECE and equipped to support survivors.
“In January of 2021 when I was asked to be the project coordinator, I was hesitant because I wasn’t sure that my experience could be classified as SOGIECE or conversion therapy. I never attended a formalized conversion therapy program or camp run by a religious organization. Healthcare practitioners misdiagnosed me or refused me access to care.
In reality, I spent 27 years internalizing conversion therapy practices through prayer, the study of religious texts, disassociation from my body, and suppression or denial of my sexual and gender identities. I spent six years in counselling and change attempts using conversion therapy practices. I came out as a lesbian at age 33, and as a Trans man at age 51. I am now 61 and Queerly Heterosexual, but I spent decades of my life hiding in shame and fear and struggled with suicidal ideation until my mid-30s.
At times I wanted to crawl away and hide, be distracted by anything that silenced the emptiness, the pain, the wounds deep inside. I realized that in some ways, I am still more comfortable in shame, silence, and disassociation, than in any other way of being and living, but I was also filled with wonderment at the resiliency and courage of every single one of the participants.
However, many of us did not survive, choosing to end the pain and shame through suicide. Many of us are still victims in one way or another, still silenced by the shame, still afraid of being seen as we are. Still, many of us are survivors, and while it has not been an easy road, many of us are thrivers too,” said Jordan.
In addition, Jordan said conversion practices and programs are not easily defined or identified, and often capture only a fragment of pressures and messages that could be considered SOGIECE.
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