For some people with COVID-19, the pain in their skull is so severe that they are considering a trip to the emergency department.
For others, it may appear in pulsating waves or feel like constant mild pain; it may disappear within minutes of taking painkillers or still be there months later.
“My head felt like it was going to explode and no medication was enough to improve it,” said Ananda Pires, who fell ill in late December.
After two days in which she could barely move from her bed, the Guelph woman, Ont., Said her headache was mostly gone, with only mild pain and sensitivity to light in the following days.
While loss of odor, fever, and dry cough may be more prominent symptoms of COVID-19, headaches are also common. And two years after the pandemic, patients and doctors are beginning to realize that for some it may be the worst symptom – and one that persists after others have disappeared.
That’s why there was a boost from researchers, including the US National Institutes of Healthto investigate the little-understood long-term neurological symptoms reported in some patients with acute COVID-19, which may include headache, inflammation of the brain, and damage to cerebral blood vessels.
While in some people the headache disappears with the disease, other patients cannot shake it – even long after their other COVID symptoms have disappeared.
Some people with COVID headaches find relief with over-the-counter painkillers. Others say the drugs do not relieve their pain. (Ryan Remiorz / Canadian Press)
Dr. Neely Kaplan-Meert tested positive for COVID in early April. The Ottawa family doctor is now well enough to resume taking patients, but she still has a constant headache, which she describes as “a vice.”
“It’s like wearing a hat that’s too small,” Kaplan-Meer told CBC News. “It’s a dull pain that’s always there.”
For Scott Schmid, the COVID headache “was like living underwater for a few weeks” with constant pressure behind his eyes.
“I was like, I just can’t get rid of this headache for the rest of my life. I’m used to it. Honestly, I just started spending my day with a headache,” said Schmid, a journalist with Medicine Hat, Alta.
“Just a headache” – or is it COVID?
Headaches are common in viral infections, including colds and flu. They are often one of the earliest symptoms of COVID-19, which doctors have noticed may make it difficult to tell whether it is just a headache or a sign of a developing disease.
Dr. Sumon Chakrabarti, an infectious disease specialist in Mississauga, Ontario, says he has seen patients present in the emergency department with severe headaches and then a positive COVID test.
But others may get rid of a mild headache and not realize they are infected.
Headache may be an early sign of COVID infection. Infectious Diseases Specialist Dr. Sumon Chakrabarti says it’s worth doing a quick test, like the one filmed in Vancouver on April 10, during a high-level public broadcast. (David Horemans / CBC)
So many people come and tell you, “You know what? It was so weird, I had a little headache, a little sore throat, I just thought I drank too much wine, but I was positive. “
Chakrabarti said that if someone develops a new headache in the middle of a growing wave of COVID, it is worth doing a quick test.
He also points out that sudden, severe headaches may be indicative of other medical emergencies, such as cerebral hemorrhage, stroke or viral meningitis – some symptoms of which may be similar to those of COVID.
“If you have a severe headache and fever, it’s also a good idea to go to the emergency room [room]. If you have a severe headache and vomiting that doesn’t stop, come in. “
A headache that just won’t go away
For some people, the headache just won’t go away – long after they’re no longer infected. Exactly why it is still not well understood.
“There are a lot of opportunities right now, and I don’t think we’ve done well yet,” said Dr. Jennifer Frontera, a professor of neurology at NYU Grossman School of Medicine who is studying post-COVID conditions.
Some of these possibilities, she says, include complications from severe COVID, autoimmune conditions, high blood pressure affecting blood vessels in the brain, or even pandemic stress, which leads to tension headaches.
Given the number of potential causes, she says, “it’s worth going to a clinician and seeing what the treatment strategies are.”
The good news is that most long-term patients with COVID respond to existing treatments for headaches and migraines, says Dr. Angela Cheung, a long-time COVID researcher based at the University of Toronto Health Network.
Dr. Angela Cheung, a senior clinician at the University Health Network in Toronto, is studying the effects of long-term COVID. (Evan Mitsui / CBC)
These treatments may include prescription drugs, massage and attention, depending on the diagnosis.
Cheung also reminds patients who are frustrated by their long-term COVID symptoms that “this does not mean you will have it forever.”
Her advice: “Try to deal with what you are experiencing right now, step by step, because we learn so much every day with COVID.
Headache and other infection
Although Kaplan-Myrt is still struggling with her daily headache, the Ottawa doctor has another concern: if she becomes infected again in the future, will the headache return?
“The fear of getting COVID again and going through it again, especially when I don’t go back to baseline like it is, is just like, I don’t think I’m going to make it,” she said.
This is a concern shared by Schmid, whose COVID headache finally disappeared after about three weeks.
“Now I actually live in only a small part of fear … I used to be careful because I pay attention and people told me to be careful,” she said. “I’m careful now because I’m actually legally concerned about myself.”
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