A headache is a frequently reported symptom associated with a COVID-19 infection, often appearing early in the course of the illness. For many people, a headache may be the first noticeable sign, raising concern about whether the pain indicates a coronavirus infection. The presence of a new or unusually severe headache, especially when combined with other flu-like symptoms, warrants attention and consideration of testing.
Headache Prevalence in COVID-19
Headache is a common manifestation of COVID-19, with studies indicating a significant prevalence rate among infected individuals. Across global studies, the percentage of patients reporting a headache has ranged widely, often affecting about one-quarter of cases overall. Compared to other symptoms, headache often ranks high, sometimes appearing more frequently than a sore throat or congestion.
The likelihood of experiencing a headache may be linked to the severity of the illness. Research has shown that headache is more commonly reported in milder to moderate cases of COVID-19, compared to those with severe disease. This symptom also seems more prevalent in younger patients and those who have a history of primary headache disorders, such as migraines. Furthermore, some analyses suggest it is more common in COVID-19 cases than in other non-COVID respiratory viral infections.
Characteristics of COVID-Related Headaches
The headache associated with a coronavirus infection often presents with specific features. The pain is frequently described as moderate to severe in intensity, sometimes reaching a level that is significantly disruptive to daily life. Many patients liken the sensation to a persistent pressure or a tight band around the head.
COVID-related headaches are typically bilateral, meaning the pain is felt on both sides of the head. The pain is often concentrated in the front of the head, described as diffuse, or even retro-orbital, felt behind the eyes. This pain can feel intense, sometimes exhibiting a pulsating or throbbing quality.
The duration of this symptom can vary, but for many, the headache is persistent and lasts throughout the acute phase of the illness, typically several days to a week. The pain may worsen with physical activity, coughing, or moving the head. A notable characteristic is that the pain can sometimes be resistant to common over-the-counter pain relievers. For a small subset of people, this headache can become a lingering symptom, continuing for weeks or months as part of post-COVID conditions.
Guidance on Testing and Care
If you experience a new headache alongside other symptoms like fever, cough, or fatigue, consider the possibility of a COVID-19 infection. The first step is to seek a diagnostic test, which may include a rapid at-home antigen test or a laboratory-based PCR test. If the test result is positive, or if you suspect infection, self-isolation is recommended to prevent transmission.
For managing the headache itself, rest and maintaining adequate hydration are the primary recommendations, as dehydration can intensify the pain. Over-the-counter medications like acetaminophen and ibuprofen can be used to help relieve the pain and fever, though their effectiveness can vary. It is important to monitor symptoms closely, as most COVID-19 cases can be safely managed at home.
Specific severe symptoms require immediate medical attention and should prompt a call for emergency services. These warning signs include persistent chest pressure or pain, difficulty breathing, new confusion, or an inability to wake up or stay awake. If a headache is severe or accompanied by these signs, seek urgent medical evaluation.