From the Guidelines
The percentage of patients experiencing daily headaches after COVID-19 infection is not explicitly stated in the provided evidence, but based on the available data, it can be estimated that around 7% of patients may experience headaches, although this is not necessarily equivalent to daily headaches. Post-COVID headaches can manifest as a new headache disorder or as a worsening of pre-existing headaches, with some patients developing persistent daily headaches that may last for months after the initial infection. These headaches often present as tension-type or migraine-like pain and can be part of the constellation of symptoms known as long COVID or post-acute sequelae of SARS-CoV-2 infection (PASC) 1. Management typically involves standard headache treatments including NSAIDs like ibuprofen (400-600mg every 6-8 hours) or naproxen (500mg twice daily), as well as migraine-specific medications such as triptans for acute episodes. For persistent headaches, preventive treatments might include amitriptyline (10-25mg nightly), propranolol (40-160mg daily), or topiramate (25-100mg daily). The mechanism behind post-COVID headaches likely involves neuroinflammation, direct viral effects on the nervous system, immune dysregulation, and vascular changes 1. Patients with post-COVID headaches should maintain adequate hydration, regular sleep patterns, and stress management techniques while avoiding known headache triggers.
Some key points to consider in the management of post-COVID headaches include:
- Neurological and cognitive symptoms are a major feature of long COVID, including sensorimotor symptoms, memory loss, cognitive impairment, paresthesia, dizziness and balance issues, sensitivity to light and noise, loss of (or phantom) smell or taste, and autonomic dysfunction 1
- Fatigue was found in 32% and cognitive impairment was found in 22% of patients with COVID-19 at 12 weeks after infection 1
- Cognitive impairments in long COVID are debilitating, at the same magnitude as intoxication at the UK drink driving limit or 10 years of cognitive ageing, and may increase over time 1
- The percentage of patients experiencing headaches during the acute phase of COVID-19 infection is around 7% 1
It is essential to note that the provided evidence does not explicitly state the percentage of patients experiencing daily headaches after COVID-19 infection. However, based on the available data, it can be estimated that around 7% of patients may experience headaches, although this is not necessarily equivalent to daily headaches. Therefore, it is crucial to prioritize the management of post-COVID headaches and consider the potential long-term effects of COVID-19 on neurological and cognitive function.
From the Research
Headache Frequency in COVID-19 Patients
- The frequency of headaches in COVID-19 patients is a significant concern, with various studies investigating the phenomenon 2, 3.
- A study published in 2024 found that 93% of patients required acute medication for COVID-19-related headaches, with 75% requiring preventive treatment 2.
- However, the studies do not provide a clear percentage of patients experiencing daily headaches after COVID-19.
Treatment and Management of COVID-19-Related Headaches
- Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are commonly used to manage COVID-19 symptoms, including headaches 4, 5.
- Amitriptyline has also been found to be effective in reducing headache days per month in patients with post-COVID headache 3.
- The use of corticosteroids during active COVID-19 infection is generally avoided due to concerns of prolonged viral shedding and lack of survival benefit 5.
Patient Experience and Symptom Manifestation
- A qualitative study published in 2022 explored the experience of outpatients with COVID-19, including the symptomatic experience and its impact on daily life 6.
- The study found that symptom type, severity, duration, and time of onset varied by patient, and that symptoms affected all aspects of daily life.
- However, the study does not provide specific information on the percentage of patients experiencing daily headaches after COVID-19.