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COVID-19 & New-Onset Migraine and Tension-Type Headaches

Medically reviewed by Susan Kerrigan, MD and Marianne Madsen on February 4, 2023

A 2021 study published in The Journal of Headache and Pain has aimed to examine the relationship between headaches and COVID-19. The researchers have aimed to develop a better definition of COVID-19 related headache and attempt to define its characteristics and evolution.


According to research, patients infected with SARS-CoV-2, the virus that causes COVID-19, can experience a wide range of clinical manifestations, from no symptoms to critical illness. Around 33% of patients who become infected with SARS-CoV-2 will never develop symptoms. For those that do, the most common symptoms of COVID-19 include fever, cough, myalgia, and fatigue. The CDC has also included headaches as one of the main symptoms of COVID-19.


The new cross-sectional study was conducted at Ibn Sina Hospital in Kuwait. The researchers used data from 121 patients who had COVID-19, as confirmed by reverse transcription polymerase chain reaction technique, and presented to the headache clinic within three months of the onset of COVID-19 infection. Participants were grouped into categories based on whether they had experienced headaches previously or if the headaches were new. Before their infection, 64.5% of patients suffered migraines, 9.1% had tension-type headaches, and 26.4% had no previous history of headaches.


The study results revealed that 41.2% of migraine patients reported an increase in attack severity and average daily use per month of analgesics post COVID-19. 36.5% reported an increase in monthly headache frequency. For patients with tension-type headaches, two-thirds reported an increase in attack severity. Around 55% cited an increase in both monthly attack frequency and the average number of days per month they used analgesics. Of the patients who developed headaches post COVID-19, most resolved within one month. 62.5% of patients who developed headaches had migraine phenotype.


In their conclusion, the researchers write, “the present study showed that COVID-19 has a significant negative impact on patients with pre-existing primary headache disorder either migraine or tension type headache. De novo primary headache is frequent post COVID-19”. The research team recommends that “when seeing patients presenting with these characters of headache, physicians should consider SARS-CoV-2 infection as a differential diagnosis to avoid delayed diagnosis or misdiagnosis and prevention of transmission. Physicians should pay more attention to neurological symptoms of COVID-19 in order to avoid chronicization.” The authors also feel that physicians should consider headaches during COVID-19 as a possible prognostic factor for symptom severity.


Written by Chaim Ford

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