A headache is a frequently reported symptom of COVID-19, often appearing as one of the earliest signs of infection. For some individuals, a headache may even be the only indication of illness. While many viral infections can cause headaches, the characteristics of a COVID-related headache can be distinct. Understanding these features is helpful for identification, though the experience can vary from person to person.
Characteristics of a COVID Headache
A headache associated with COVID-19 often presents with moderate to severe intensity. Many people describe the sensation as a pressing or tightening feeling across their head. This pain is typically bilateral, meaning it occurs on both sides of the head rather than being confined to one area. The discomfort may be located around the eyes, above the ears, or across the forehead.
Unlike a typical tension headache, which is often milder, a COVID headache is usually more intense. It also differs from a classic migraine, which commonly affects only one side of the head and may be preceded by an aura. While a COVID headache can have migraine-like features such as a throbbing quality, it is less likely to be accompanied by the same degree of light and sound sensitivity that characterizes migraines.
The pain from a COVID headache may worsen with movement, such as coughing or physical activity. It is persistent, lasting for several days throughout the acute phase of the illness. The presence of other COVID-19 symptoms, particularly the loss of taste or smell, can be another indicator that the headache is related to the virus. For those with a history of primary headaches, a COVID infection may trigger more frequent or severe episodes.
Causes and Duration
A headache during a COVID-19 infection is linked to the body’s inflammatory response to the virus. This process involves the release of signaling proteins called cytokines, sometimes referred to as a “cytokine storm” in severe cases. These cytokines can activate the trigeminovascular system, which is involved in transmitting pain signals in the head.
The virus may also have a direct effect on the nervous system. The SARS-CoV-2 virus can irritate the trigeminal nerve, a major nerve that carries sensation from the face to the brain. This irritation leads to the painful sensations characteristic of a COVID headache.
During an acute COVID-19 infection, a headache lasts an average of three to five days, but this can vary. For some, the headache resolves as other symptoms improve, while for others, it may linger. The intensity of the headache during the initial illness may be a predictor of its persistence.
Managing a COVID Headache at Home
For those recovering at home, over-the-counter pain relievers are a common first step. Medications like acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can be effective for pain and fever. It is important to follow dosage instructions and be aware that some multi-symptom cold medications already contain these ingredients.
In addition to medication, several home care strategies can provide relief. Getting adequate rest gives the body resources to fight the infection. Other measures include:
- Resting in a dark, quiet room to reduce stimulation.
- Applying a cool compress to the forehead to alleviate pain.
- Staying well-hydrated, as dehydration can worsen headaches.
- Using a warm shower or humidifier to relieve sinus pressure.
- Gently massaging the neck and shoulders to ease muscle tension.
Persistent Headaches and When to Seek Medical Care
For some, a headache may persist for weeks or months after the initial infection has resolved, a condition known as a “Long COVID” headache. This can be a new daily persistent issue or an exacerbation of a pre-existing headache disorder. If a headache continues long after other symptoms have subsided, consult a healthcare provider for evaluation and management.
Be aware of “red flag” symptoms that could indicate a more serious condition requiring immediate medical attention. A sudden, severe headache that comes on abruptly, often described as a “thunderclap” headache, warrants an urgent medical evaluation. Other warning signs include a headache accompanied by a stiff neck, high fever, confusion, or difficulty speaking.
Seek emergency care if a headache occurs with neurological symptoms such as weakness on one side of the body, seizures, or significant changes in vision. These symptoms are not typical of a COVID-19 headache and could signal a more severe complication, such as a stroke. Prompt medical assessment is necessary in these situations.