Under normal circumstances, it would be easy to brush off your pounding headache as a sign of seasonal allergies or skipping your morning cup of coffee. But now, it’s completely understandable to worry that any new symptom—including a headache—could be a sign of the novel coronavirus.
After all, COVID-19 is a respiratory infection, and it’s not uncommon to have a headache with other respiratory viruses like the common cold or influenza. At the same time, headaches are incredibly common in a non-COVID-19 world and have various triggers behind them.
However, research has found a link between headaches and the novel coronavirus, and doctors are seeing this pop up in this patients. “The virus can be associated with a headache, though often it is not the presenting complaint,” says Amit Sachdev, M.D., associate medical director for the department of neurology and ophthalmology at Michigan State University. Here’s what you need to know about the link between headaches and COVID-19.
Is a headache a common symptom of the novel coronavirus?
A fever, cough, and shortness of breath are still the more common signs of COVID-19, but the Centers for Disease Control and Prevention (CDC) recently updated its list of coronavirus symptoms to include a headache.
What’s more, a report from the World Health Organization (WHO) published in February analyzed nearly 56,000 cases of COVID-19 in China, and found that 13.6% of those patients had a headache. That’s well below those that had a fever (87.9%), dry cough (67.7%), and fatigue (38.1%), but about on par with people who experienced a sore throat (13.9%) and muscle aches and pains (14.8%).
Why does the novel coronavirus sometimes cause headaches?
It’s not entirely clear, says Richard Watkins, M.D., infectious disease physician and professor of internal medicine at Northeast Ohio Medical University. “We continue to learn that the coronavirus causes a lot of different symptoms,” he says.
When you have a viral infection, your body mounts an immune response to fight it, explains William Schaffner, M.D., infectious disease specialist and professor at the Vanderbilt University School of Medicine. Your immune cells then release proteins known as cytokines that can cause inflammation and a fever, which can also lead to a headache, he says. Couple that with factors like not sleeping well, not eating enough, and not drinking enough water when you’re sick, and you can end up with a throbbing head.
Another theory: The coronavirus might actually enter the fluid around the brain, which could potentially trigger a headache, Dr. Sachdev says. That said, there’s a lot researchers don’t know about the virus right now and more evidence is needed.
While there’s not a lot of information about what a coronavirus-induced headache is like, Dr. Schaffner says that most viruses tend to cause headaches that get worse in the evening, and that the headaches are often tied to a fever. “It’s not unreasonable to think that would be the case with coronavirus,” he says.
Could a headache be the only sign of COVID-19?
It’s possible, but it’s more likely that you’ll have other symptoms along with your headache, like a fever and cough, Dr. Schaffner says.
Still, if you have a persistent headache that seemingly came out of nowhere and you’re also feeling kind of lousy, Dr. Watkins says it’s not something to brush off. “If a person develops any symptom typically associated with a viral illness, then there needs to be a strong suspicion for COVID-19,” he says.
What can you do to relieve your headache right now?
Back in March, a French health official warned people on Twitter that taking ibuprofen when they have COVID-19 “could be a factor in aggravating the infection.” At the time, there was no evidence to back up his claims.
But the WHO just released the findings of a systematic report that analyzed the effect of non-steroidal anti-inflammatory medications (NSAIDs), like ibuprofen, on people who had viral respiratory infections, including COVID-19. The report confirmed that there was “no evidence” that NSAIDs made the infection worse.
However, if you prefer to play it safe, Dr. Schaffner recommends that you stick to acetaminophen, a.k.a. Tylenol, for pain relief.
When should you call your doctor about a headache?
“There are some indications that COVID-19 might be related to more serious neurological conditions, such as blood clotting, stroke, or infections of the brain,” says Brian Gerhardstein, M.D, Ph.D., associate professor of neurology at Rutgers New Jersey Medical School and Robert Wood Johnson Medical School. “These could also lead to symptoms such as headaches, so you should seek medical attention for any concerning or worsening headaches or other medical or neurological symptoms.”
That means if you ever think your symptoms point to COVID-19, don’t hesitate to call your doctor, Dr. Watkins says. If your headache doesn’t seem to be getting better or comes on with other symptoms, like a fever or cough, he or she should be able to determine if you qualify for a COVID-19 test or give you guidance on how recover at home if your illness is considered mild.
It could be COVID-19 or it could be something else entirely. Either way, you shouldn’t have to try to make that diagnosis on your own.