Updated 15 April 2020

Is my headache a symptom of Covid-19?

If you are prone to headaches, you might wonder when it's a symptom of Covid-19 and when it’s just a 'regular' headache. This is what we currently know about headaches and Covid-19.

Since the news of Covid-19, the disease caused by the new coronavirus, broke in January, guidelines around the world have been listing the main symptoms as a fever, a cough and breathlessness.

As the virus progresses, symptoms don't remain as cut-and-dry. Some people experience little to no symptoms at all, others experience gastrointestinal symptoms, and some even display neurological symptoms.

But what about the classic pounding headache? From anecdotal evidence, a lot of people who test positive, experience a “sinus-like” headache.

According to a report from the World Health Organization (WHO), a headache isn’t the most common symptom of Covid-19 and is experienced by only about 14% of patients. However, those who do experience headaches report they are quite significant and intense.

When is headache a symptom?

If you regularly experience headaches, whether they are sinus headaches, tension headaches or a migraine, you will be familiar with the agony it can cause.

But why would a respiratory disease cause a headache? Some reports mention that a small number of patients experience neurological ailments such as seizure, confusion, severe lethargy and headaches.

A paper published in the Journal of Medical Virology reports that the virus is not only confined to the respiratory system and can therefore affect the neurological system, which explains symptoms such as headaches and vomiting.

Covid-19 also tends to mimic some symptoms of "regular" influenza – therefore headache and congestion may be experienced.

If you suffer from the odd headache, but don’t have any other symptoms, especially fever, it’s probably not Covid-19-related.

What are the mechanics behind a headache?

Primary headaches can be caused by contraction of your neck muscles, leading to a common tension headache. This can be exacerbated by stress and anxiety, bad posture and bad ergonomics in your work area.

Migraine, which has an important vascular component, makes up the other large group of primary headaches – affecting 5% to 10% of the population.

Secondary headaches are those headaches caused by underlying conditions and inflammation such as a sinus infection, cold or flu.

For some people, headaches, especially migraines, are often triggered by certain foods, smells, chemicals or even medication.

Not drinking enough water can also worsen headaches.

When should you never ignore a headache?

If you often suffer from headaches, you most likely know what triggers them and what medication provides relief. Just because a headache is not Covid-19 related, you should not ignore a medical emergency. Here are some signs that your headache might have a serious underlying cause:

  • It is accompanied by fever.
  • It’s a “first time” experience or a kind of headache you’ve never experienced before.
  • You feel dizzy, confused and nauseous.
  • You experience slurred speech.
  • Your sight is suddenly blurry.
  • Your headache is accompanied by sudden muscular weakness, gait disturbance or sensory loss.
  • You are experiencing a stiff neck, fever and vomiting.

How to avoid headaches

There might be several factors that could be causing your headaches. Here are some basic tips to keep them at bay:

  • Stress and anxiety, especially during these uncertain times, may cause tension headaches. Make a conscious effort to relax your shoulders and neck and to unclench your jaw. Put 15 minutes a day aside just to focus on relaxation.
  • If you are suddenly working from home, your workstation may not be ergonomically sound. Ensure that you are able to sit upright, with your laptop at least 50cm away from your eyes.
  • Ensure that there is proper ventilation in your work area.
  • Avoid dehydration by keeping a bottle of water at your desk or work station and taking regular sips. 
  • Even when your routine is upset, it's important to get proper sleep – not too much and not too little – as fatigue can also cause headaches.

READ | 10 new weapons in the war on migraines

READ | Here's when a headache can be an emergency

READ | Neurological ailment in some coronavirus patients - what could this mean?

Image credit: iStock

Ask the Expert

Headache expert

Dr Elliot Shevel is a South African migraine surgery pioneer and the founder and medical director of The Headache Clinic in Johannesburg, Durban and Cape Town, South Africa. The Headache Clinic is a multidisciplinary practice dedicated to the diagnosis and treatment of Primary Headaches and Migraines. Dr Shevel is also the main author of all scientific publications generated by his team. He recently won a high level science debate in which he was able to prove that the current migraine diagnosis and classification is not based on data. Tertiary Education - Dr Shevel holds both Dental and Medical degrees, and practises as a specialist Maxillo-facial and Oral Surgeon. Follow the Headache Clinic on Twitter@HeadacheClinic.

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