A recent study revealed that primary headache deteriorates after COVID-19. De novo primary headache is frequently noted after covid and resolves within one month. Headaches associated with COVID-19 are severe and present as migraine phenotype. Young males infected with coronavirus are more vulnerable to worse headache. Investigators undertook this cross-sectional study to examine headache character in association with COVID-19.

The study recruited 121 adults  (mean age 35.29 + 9.54, 83.5% females) with reverse transcription polymerase chain reaction (RT-PCR)-confirmed COVID-19 who visited the headache clinic within three months following the commencement of infections. The participants were identified as having primary headache disorders as per the International Classification of Headache Disorders. 

The recruited subjects were divided into categories as per having previous or de novo headache. For statistical assessment of the data,  chi-squared test (X2), paired sample t-test, and descriptive data were utilized. Before SARS-CoV-2, 78 (64.5%) had migraine, and 11(9.1%) suffered a tension-type headache. On the other hand, 32 (26.4) had de novo headache following coronavirus infection.

The participants exhibited a substantial rise in headache days post COVID-19 in comparison with headache days prior to COVID-19 infection. Post COVID-19, analgesic use was found to be raised in patients with migraine while the patient with tension-type headache had a considerable rise in the severity and frequency of headache attacks, as shown in Table 1:

Considering de novo headache group, temporal and  bi-frontal headache were the most commonly reported (40.6% each) headache site. After COVID-19, males reported more serious headache than females (8.66 ± 1.15 vs 5.93 ± 2.01) and individuals younger than 40 years had a longer duration of headache attack compared to individuals older than 40 years (18.50 ± 16.44 vs 5.5 ± 9.07). In 65.3% of participants, the de novo headache resolved.

Thus, the post-COVID-19 headaches are considerably more intense and frequent, with migraine-type being the most common. Also, high pain intensity was linked with male gender, younger age and moderate coronavirus infection.