A Review on Headaches Due to COVID-19 Infection

Abstract

Since December 2019, the time when the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was spotted, numerous review studies have been published on COVID-19 and its neuro invasion. A growing number of studies have reported headaches as a common neurological manifestation of COVID-19. Although several hypotheses have been proposed regarding the association between headache and the coronavirus, no solid evidence has been presented for the mechanism and features of headache in COVID-19. Headache also is a common complaint with the omicron variant of the virus. COVID-19 vaccination also is a cause of new-onset headaches or aggravation of the previous headache in migraine or tension headache sufferers. In this review study, the types of headaches reported in previous studies and their possible pathogenic mechanisms are outlined. To accomplish this objective, various types of headaches are classified and their patterns are discussed according to ICHD-3 diagnostic criteria, including, headaches attributed to systemic viral infection, viral meningitis or encephalitis, non-infectious inflammatory intracranial disease, hypoxia and/or hypercapnia, cranial or cervical vascular disorder, increased cerebrospinal fluid (CSF) pressure, refractive error, external-compression headache, and cough headache. Then, their pathogeneses are categorized into three main categories, direct trigeminal involvement, vascular invasion, and inflammatory mediators. Furthermore, persistent headache after recovery and the predictors of intensity is further investigated. Post-vaccination headache is also discussed in this review.

Symptom profiles and vaccination status for COVID‐19 after the adjustment of the dynamic zero‐COVID policy in China: An observational study

“…Over 70% of respondents reported experiencing a headache, fatigue, and myalgia, and more than 20% of respondents considered these three symptoms are severe. Previous studies have shown that headache was the second‐most common symptom after Omicron infection in the acute phase 14 . In the early stages of the Omicron variant, fatigue emerged as one of the predominant symptoms 15 .…”

“…Previous studies have shown that headache was the second-most common symptom after Omicron infection in the acute phase. 14 In the early stages of the Omicron variant, fatigue emerged as one of the predominant symptoms. 15 The severity of fatigue symptoms has shown variation with the evolution of the strain.…”

COVID-19-Related Left-Sided Ptosis

“…Higher morbidity and mortality rates are seen in co-infection with bacterial and viral organisms [ 3 ]. Benign neurological symptoms, like headaches and anosmia, are commonly reported with COVID-19 [ 5 , 6 ]. Patients with more severe infections are likely to develop neurologic manifestations (40%), especially acute cerebrovascular disease [ 7 ].…”

Vaccination efficacy against post-COVID-19 symptoms in Delta and Omicron waves: a prospective cohort in East Indonesia

“…A study assessing the persistent cough in COVID-19 when the original strain was dominant showed that 20.9% of hospitalized patients had a persistent cough after three weeks [26]. The possible mechanisms of chronic headache in COVID-19 are a direct invasion of SARS-COV2 to the nerve and subsequent injury due to pro-inflammatory mediators and cytokines in the central nervous system [27]. In a multicentric study where the wild-type variant was prevalent, 19% of patients experienced headaches for up to three months [28].…”