Headache characteristics attribute to acute infections in Republic of Moldova: prospective multicentric study.

Abstract

Introduction. Headache is a frequent symptom associated with acute infections; however, data regarding its characteristics and the risk of chronification remain limited, particularly outside the context of COVID-19 infection.
Materials and methods. The national cohort from the Republic of Moldova included 40 patients with headache attributed to acute infections, within the framework of the international INFECT-Head study. Evaluation was performed using a standardized questionnaire, and statistical analysis employed χ² tests, Mann-Whitney test, and logistic regression. Results. The mean age of patients was 47.4±15.5 years, with 60% being female. Current headache was severe in 72.5% of cases, predominantly bilateral, with pressing or pulsating quality, and an average duration of 8.2±7.9 hours. Common associated symptoms included vertigo (60%), photophobia (40%), and myalgia (42.5%). Headache intensity was not correlated with fever or clinical markers. Persistence beyond two weeks and intermittent evolution with attacks
were associated with an increased risk of chronification (p<0.05).

Discussion. The phenotype of post-infectious headache is heterogeneous and influenced by a history of primary headache. The identified risk factors for chronification suggest increased vulnerability in a subset of patients; however, the small sample size limits the generalizability of results.
Conclusions. Headache in acute infections shows significant clinical variability and may persist long-term. Persistence
>2 weeks and intermittent evolution may represent risk factors for chronification, highlighting the importance of careful monitoring and early intervention.