COVID Headache

One in 4 people infected with a strain of the COVID-19 virus commonly experience headache as part of their illness. Most COVID headaches last a week or two, although headache may linger for some people, particularly with long COVID.

What Causes It?

COVID headache has been observed in many people who have contracted the recent coronavirus SARS-CoV-2; as such, this head pain is considered a “headache attributed to systemic viral infection” by the International Classification of Headache Disorders-3 (ICHD-3). The headache typically develops close to onset of the infection or worsens during infection, then significantly improves post-infection. 

In some cases, some form of COVID headache may persist as a symptom of “long COVID,” a condition lasting several months after the virus in general has apparently resolved.

What Are the Symptoms?

COVID headaches most commonly present as tension-like head pain; however, around 25% of patients experience migraine-like pain with the infection. Although severity and duration may vary, migraine-like headaches — throbbing or pulsating severe headache, usually on one side of the head — are more prevalent in COVID-19 patients who have a history of migraine or another primary headache disorder. However, they can also be observed in many patients with no prior migraine history as well.

 How Is It Diagnosed?

Since a COVID headache can present with a wide array of characteristics, it’s hard to set clear clinical diagnostic criteria. So, history taking seems to be the best way to arrive at a diagnosis. It’s also important to remember that this headache type can still present itself as a symptom of “long COVID”, a term used to refer to persistent symptoms of this viral infection that can last several months even after the resolution of the virus.

In people who have (or had) COVID-19, bilateral, long-lasting headaches accompanied by nausea and loss of taste and smell, and appearing resistant to analgesics, can generally be linked to the virus.

How Is It Treated?

Headaches resistant to painkillers can be an early warning sign of a COVID-19 infection.

Because COVID and its long-term effects are still being researched, COVID headache treatment (both acute and as part of long COVID) are not yet established. 

Treating COVID headache in the acute phase of infection may be as simple as using over-the-counter (OTC) pain killers as needed. But experts believe that long COVID headache requires a multidisciplinary approach that may include acute and/or preventive pharmacological interventions, as well as some lifestyle modifications. In these cases, it’s recommended that a treatment plan be tailored to the individual, based on their headache type (migraine or tension-like), medical history, and other post COVID-19 symptoms, such as sleep disturbances, mood fluctuations, and brain fog.

Is It Preventable?

The best way to avoid COVID-related headache is to follow COVID-19 safety protocols, like social distancing, proper sanitation, vaccination, and a healthy lifestyle that supports the immune system

For people with a history of primary headache disorders, COVID-19 headache might persist after recovery from other virus symptoms. As soon as they test positive for the virus, it’s recommended that these people work with their healthcare professional immediately to create a preventive and management plan against potential head pain. 

What Causes It?

COVID headache has been observed in many people who have contracted the recent coronavirus SARS-CoV-2; as such, this head pain is considered a “headache attributed to systemic viral infection” by the International Classification of Headache Disorders-3 (ICHD-3). The headache typically develops close to onset of the infection or worsens during infection, then significantly improves post-infection. 

In some cases, some form of COVID headache may persist as a symptom of “long COVID,” a condition lasting several months after the virus in general has apparently resolved.

What Are the Symptoms?

COVID headaches most commonly present as tension-like head pain; however, around 25% of patients experience migraine-like pain with the infection. Although severity and duration may vary, migraine-like headaches — throbbing or pulsating severe headache, usually on one side of the head — are more prevalent in COVID-19 patients who have a history of migraine or another primary headache disorder. However, they can also be observed in many patients with no prior migraine history as well.

 How Is It Diagnosed?

Since a COVID headache can present with a wide array of characteristics, it’s hard to set clear clinical diagnostic criteria. So, history taking seems to be the best way to arrive at a diagnosis. It’s also important to remember that this headache type can still present itself as a symptom of “long COVID”, a term used to refer to persistent symptoms of this viral infection that can last several months even after the resolution of the virus.

In people who have (or had) COVID-19, bilateral, long-lasting headaches accompanied by nausea and loss of taste and smell, and appearing resistant to analgesics, can generally be linked to the virus.

How Is It Treated?

Headaches resistant to painkillers can be an early warning sign of a COVID-19 infection.

Because COVID and its long-term effects are still being researched, COVID headache treatment (both acute and as part of long COVID) are not yet established. 

Treating COVID headache in the acute phase of infection may be as simple as using over-the-counter (OTC) pain killers as needed. But experts believe that long COVID headache requires a multidisciplinary approach that may include acute and/or preventive pharmacological interventions, as well as some lifestyle modifications. In these cases, it’s recommended that a treatment plan be tailored to the individual, based on their headache type (migraine or tension-like), medical history, and other post COVID-19 symptoms, such as sleep disturbances, mood fluctuations, and brain fog.

Is It Preventable?

The best way to avoid COVID-related headache is to follow COVID-19 safety protocols, like social distancing, proper sanitation, vaccination, and a healthy lifestyle that supports the immune system

For people with a history of primary headache disorders, COVID-19 headache might persist after recovery from other virus symptoms. As soon as they test positive for the virus, it’s recommended that these people work with their healthcare professional immediately to create a preventive and management plan against potential head pain. 

Sources

  1. Current Pain and Headache Reports. Headache as a Symptom of COVID-19: Narrative Review of 1-Year Research. Caronna, Edoardo, and Patricia Pozo-Rosich. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8583579/
  2. Headache: The Journal of Head and Face Pain. Headache Associated with COVID‐19: Epidemiology, Characteristics, Pathophysiology, and Management. Sampaio Rocha‐Filho, Pedro Augusto. https://doi.org/10.1111/head.14319
  3. BioMed Central. Long COVID Headache - The Journal of Headache and Pain. Tana, Claudio, et al. https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-022-01450-8

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