Headache in Acute and Post-Acute Sequelae of SARS-Cov-2 (PASC) or Long COVID

Headache is a prevalent symptom of COVID-19 and long COVID, and they can be debilitating. If you experience headaches, it is essential to seek medical attention immediately to ensure proper diagnosis and treatment. It has been observed that a considerable proportion of individuals (ranging from 6-45%) diagnosed with COVID-19 and exhibiting symptoms of headache during the acute phase, tend to experience persistent headaches in the post-symptomatic phase. This observation highlights the need for further research into the long-term effects of COVID-19, particularly concerning its neurological impact on patients. It is imperative to conduct more studies to understand the underlying mechanisms and pathophysiology of such headaches in order to provide appropriate treatment and management strategies for those affected. The pathophysiology is not clear. Headaches during COVID-19 can stem from both direct effects of the virus and broader systemic reactions like inflammation and hypoxemia. Key symptoms such as headache, loss of smell, and loss of taste suggest the virus's potential to cause local inflammation early in the infection. Neurological findings, including microhemorrhages in the olfactory bulb, underline the virus's impact on the nervous system. Inflammatory markers are elevated in patients with severe headaches, indicating an inflammatory response. The trigeminovascular system's activation due to olfactory and nasal inflammation, alongside a hypoxic state from reduced oxygen levels, are believed to contribute to headaches. SARS-CoV-2's entry into the central nervous system (CNS), possibly through the olfactory pathway or a compromised BBB, can lead to a range of neurological symptoms, with inflammation and coagulopathy playing roles in headache development. Persistent headaches post-infection suggests a lasting inflammatory response, necessitating further research and clinical attention for management.