Migraine symptoms and association of triggers, coping strategies and clinical characteristics with COVID-19 diagnosis among university students in Peninsular Malaysia: A cross-sectional study.

Introduction: Differentiating between migraine and COVID-19 headaches is essential for better treatment. Evidence-based research during the COVID-19 pandemic has found that university students are more likely to experience migraine. Migraine can affect academic performance, sleep pattern, social and emotional well-being if left untreated or misdiagnosed. This study aimed to determine the prevalence of migraine symptoms and the association of triggers, coping strategies and clinical characteristics with COVID-19 diagnosis. Methods: This cross-sectional study was conducted across higher educational institutions in Peninsular Malaysia. Convenience sampling was applied to recruit full-time university students. A reliable and validated instrument was used to evaluate demographic data, migraine symptoms, triggers, coping strategies and clinical characteristics of migraine (frequency, intensity, severity and duration) during COVID-19 diagnosis. Results: The response rate was 98.3%, where 485 out of 493 responses were analysed. The prevalence of migraine was 35.9% (n=174). None of the triggers, coping strategies and clinical characteristics of migraine were significantly associated with COVID-19 diagnosis. Conclusion: The university students in Peninsular Malaysia showed a considerable prevalence of migraine symptoms. During the pandemic, the common triggers for existing symptoms were stress and a lack of sleep (combined triggers). The coping strategy adopted by most of the university students was lifestyle changes and in the COVID-19 positive group maladaptive coping strategies were adopted indicating the need for further investigation.