Activation of the trigeminal system as a likely target of SARS-CoV-2 may contribute to anosmia in COVID-19

Cephalalgia. 2022 Feb;42(2):176-180. doi: 10.1177/03331024211036665. Epub 2021 Aug 18.

Abstract

Clinical publications show consistently that headache is a common symptom in the coronavirus disease of 2019 (COVID-19). Several studies specifically investigated headache symptomatology and associated features in patients with COVID-19. The headache is frequently debilitating with manifold characters including migraine-like characteristics. Studies suggested that COVID-19 patients with headache vs. those without headache are more likely to have anosmia. We present a pathophysiological hypothesis which may explain this phenomenon, discuss current hypotheses about how the coronavirus SARS-CoV-2 enters the central nervous system and suggest that activation of the trigeminal nerve may contribute to both headache and anosmia in COVID-19.

Keywords: Coronavirus disease; anosmia; headache; olfactory; trigeminal.

MeSH terms

  • Anosmia
  • COVID-19*
  • Headache / etiology
  • Humans
  • Migraine Disorders*
  • Olfaction Disorders*
  • SARS-CoV-2