The COVID-19 headache is a common neurological symptom associated with the viral infection, often appearing early in the disease course. Approximately half of all individuals diagnosed with COVID-19 report experiencing a headache. For many people, this headache is one of the first indications of illness, sometimes preceding symptoms like fever or cough. Its duration and severity vary widely from person to person.
Defining the Acute COVID Headache Experience
The headache experienced during the active COVID-19 infection is frequently described as moderate to severe in intensity, often feeling like a throbbing, pulsing, or pressing sensation. While the pain can sometimes resemble a tension-type headache, feeling like a tight band around the head, it may also present with migraine-like features. This pain is typically felt across both sides of the head, particularly in the frontal or temporal regions, though it can also be localized. For the majority of individuals, the headache has a sudden onset and tends to worsen gradually throughout the day.
A key feature of this pain is that it is often resistant to common over-the-counter pain relievers and may be aggravated by physical activity or coughing. This acute headache usually resolves relatively quickly, often clearing up within a few days to a week. The typical duration is between 7 and 14 days, generally coinciding with the resolution of other viral symptoms. Studies suggest the average duration is around four days.
Persistent Headaches and Long COVID Duration
In a subset of cases, the headache extends well beyond the acute infection phase, becoming a symptom of what is commonly known as Long COVID. A headache is considered persistent or a Long COVID symptom if it lasts for 30 days or more following the initial infection. Estimates suggest that the headache can persist for up to 60 days in a significant number of people, and for 90 days in others. This chronic condition is frequently linked to a neurological phenomenon known as “new daily persistent headache” (NDPH), where a headache begins abruptly and continues daily for months. The persistent pain may shift in its characteristics, sometimes evolving into a chronic migraine or a chronic tension-type headache.
For some individuals, the headache may be a de novo symptom, meaning they had no history of headaches before the COVID-19 infection. The duration of these chronic headaches is highly variable, often lasting for months and sometimes for over a year. Studies note that a small percentage of patients continue to experience headaches even 9 months after their initial illness. The persistence of a headache is often associated with other Long COVID symptoms, such as debilitating fatigue, cognitive difficulties, and sleep disturbances.
Practical Steps for Relief and When to Worry
Managing a COVID-19 headache often involves general headache relief strategies, as a specific treatment for this type of pain does not exist. Over-the-counter medications like acetaminophen or ibuprofen can be used to help reduce the pain and inflammation. Staying well-hydrated is important because dehydration can contribute to headache pain by causing tissues to contract.
Other non-pharmacological methods can also provide comfort, such as applying a cold compress to the forehead or temples to numb the pain. Minimizing exposure to bright lights and loud noises can create a more restful environment, as these factors often aggravate headache symptoms. Ensuring adequate sleep and avoiding skipped meals helps prevent common triggers that can worsen headache intensity.
You should seek urgent care if you experience the “worst headache of your life,” as this could signal a severe, potentially life-threatening condition. Other serious symptoms include a headache accompanied by a stiff neck, sudden confusion, difficulty speaking, or any changes in vision. A headache that continually worsens or does not respond to standard pain medication, particularly when lying down, is also a red flag.