Headache associated with COVID-19: Frequency, characteristics and association with anosmia and ageusia

Cephalalgia. 2020 Nov;40(13):1443-1451. doi: 10.1177/0333102420966770.


Objectives: To assess the frequency and characteristics of headache in patients with COVID-19 and whether there is an association between headache and anosmia and ageusia.

Methods: This was a cross-sectional study. Consecutive patients admitted to hospital with COVID-19, confirmed by reverse transcription polymerase chain reaction (RT-PCR) technique, were assessed by neurologists.

Results: Seventy-three patients were included in the study, 63% were male; the median age was 58 years (IQR: 47-66). Forty-seven patients (64.4%) reported headaches, which had most frequently begun on the first day of symptoms, were bilateral (94%), presenting severe intensity (53%) and a migraine phenotype (51%). Twelve patients (16.4%) presented with headache triggered by coughing. Eleven (15%) patients reported a continuous headache. Twenty-eight patients (38.4%) presented with anosmia and 29 (39.7%) with ageusia. Patients who reported hyposmia/anosmia and/or hypogeusia/ageusia experienced headache more frequently than those without these symptoms (OR: 5.39; 95% CI:1.66-17.45; logistic regression). Patients with anosmia and ageusia presented headache associated with phonophobia more often compared to those with headache without these complaints (Chi-square test; p < 0.05). Headache associated with COVID-19 presented a migraine phenotype more frequently in those experiencing previous migraine (p < 0.05).

Conclusion: Headaches associated with COVID-19 are frequent, are generally severe, diffuse, present a migraine phenotype and are associated with anosmia and ageusia.

Keywords: COVID-19; Headache; SARS-CoV-2; ageusia; anosmia; olfaction disorders.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Ageusia / epidemiology
  • Ageusia / virology*
  • Betacoronavirus
  • COVID-19
  • Coronavirus Infections / complications*
  • Cross-Sectional Studies
  • Female
  • Headache / epidemiology
  • Headache / virology*
  • Humans
  • Male
  • Middle Aged
  • Olfaction Disorders / epidemiology
  • Olfaction Disorders / virology*
  • Pandemics
  • Pneumonia, Viral / complications*
  • SARS-CoV-2