A headache is a recognized symptom of COVID-19 and can be one of the first indicators of a SARS-CoV-2 infection. While fever, cough, and fatigue are often cited as the most common signs, head pain occurs frequently enough to be considered a significant part of the illness. Understanding the nature of this headache and how it compares to other common types of head pain can help guide individuals during a potential infection.
Headache Prevalence and Mechanism in COVID-19
Headaches are a common neurological symptom of COVID-19. Studies estimate that the prevalence of headache in COVID-19 cases ranges widely, with some reports suggesting it affects nearly half of patients in the acute phase of the illness. Headaches are more prevalent in COVID-19 patients compared to those with other respiratory viral infections, suggesting a specific link to the SARS-CoV-2 virus.
The underlying biological mechanism is linked to the body’s systemic inflammatory response. When the immune system detects the virus, it releases signaling proteins called cytokines as part of the defense process. This inflammatory state activates pain-sensitive nerves, particularly the trigeminal nerve system, which carries sensations between the face and brain, resulting in the headache.
Defining Characteristics of a COVID-Related Headache
The acute headache linked to COVID-19 often shares features with both tension-type headaches and migraines. It is typically described as moderate to severe in intensity. The pain often affects both sides of the head (bilateral presentation) or can be diffuse across the entire head.
Patients frequently report the sensation as a pressing, tightening, or throbbing pain. This head pain is often one of the first symptoms to appear, sometimes even before typical signs like fever or cough. The pain may be exacerbated by movement, physical activity, or coughing. While many headaches resolve within a few days, a COVID-related headache can sometimes persist for weeks or months after other acute symptoms have vanished.
How COVID Headaches Differ from Other Common Headaches
COVID-19 headaches are classified as secondary headaches, meaning they are a symptom of the underlying viral infection. Unlike a typical primary headache disorder, such as a migraine or tension headache, the COVID-19 headache rarely presents in isolation. It is frequently accompanied by other systemic symptoms like fever, body aches (myalgia), and fatigue.
A classic migraine is often characterized by unilateral (one-sided) throbbing pain that may be preceded by an aura and includes light and sound sensitivity or nausea. While some COVID headaches can resemble migraines, they often lack the full array of associated symptoms like severe light sensitivity or vomiting. Unlike a common tension headache, which is typically mild to moderate, the head pain from a SARS-CoV-2 infection is often reported as intense and can be poorly responsive to standard over-the-counter pain relievers.
Action Steps and Symptom Management
If a new, severe headache appears alongside other symptoms like fever, body aches, or loss of taste or smell, testing for COVID-19 is necessary. For most mild to moderate cases, management of the headache is similar to that of other viral illnesses. Staying well-hydrated is important, as dehydration can trigger or worsen head pain.
Resting in a dark, quiet room can help alleviate discomfort. Over-the-counter medications, such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, can be used to manage the pain and inflammation, provided they are medically safe for the individual. If the headache is the worst you have ever experienced, includes neurological changes, or persists for more than a couple of weeks after the acute illness, consult a healthcare professional to rule out other causes.