Research is ongoing, and we continue to learn more. Here we’ll discuss the latest research findings on migraines and COVID-19, as well as how the virus could affect your medications and treatment schedule.
Migraine and COVID-19 Risk
Having a history of migraines does not appear to put you at higher risk of contracting COVID-19. However, people with a history of migraines may be more at risk for developing headaches during a COVID-19 infection, as well as for experiencing other negative outcomes related to the pandemic’s emotional toll.
Exposure Risk
The more time you spend in public places with other people, the more likely you are to be exposed to the virus. If you need to seek medical treatment at a hospital for your migraine management, you may be at higher risk of coming into contact with the virus. This could include a trip to the emergency department because of a severe migraine or a scheduled appointment with your healthcare provider for Botox injections to prevent migraines.
You can mitigate this risk by taking preventive measures, such as getting vaccinated and wearing a mask when you are somewhere with people from outside your household, especially in crowded indoor settings.
Risk of Worsening Pain
Headache is a common symptom of COVID-19, and having a history of migraines may put you at greater risk of developing a headache during an active infection with the virus.
A 2020 survey of patients who experienced headaches during the COVID-19 pandemic found that 36% of respondents experienced migraines and 55% were diagnosed with tension headaches. Of the patients who experienced headaches with COVID-19, individuals with a history of previous headaches were more likely to experience pulsating pain with their COVID headache.
A study published in 2021 found that COVID-19 infection seemed to worsen existing migraine or tension-type headaches. People in the study, on average, had more headache days per month after a COVID infection (11 vs. 8) and said they used pain medications more frequently to treat their headaches.
About a quarter of people in the study also reported experiencing new headaches after having COVID. Their symptoms were most often described as migraine-like. These headaches typically resolved within a month after the infection.
However, daily or occasional new headaches are also a commonly reported feature of long COVID, a yet poorly understood syndrome that may persist for weeks, months, or longer after a COVID infection. The headaches are often accompanied by loss of smell and may be migraine- or tension-type.
Complications of Migraine and COVID-19
There are special considerations for people with migraines who are diagnosed with COVID-19.
Cardiovascular Risk
If you typically experience an aura with your migraine, you may be at higher risk for complications from COVID-19. Studies have shown that people who have an aura with their migraines tend to be more at risk for cardiovascular diseases such as hypertension or atherosclerosis. Because cardiovascular disease is a risk factor for serious disease with COVID-19, it is best to stay in close contact with your healthcare provider, especially if you have recently begun experiencing an aura.
Gastrointestinal Symptoms
We have learned that people with a history of migraines may be more at risk of experiencing headaches with COVID-19. Research shows that people who report COVID-19 headaches are more likely to experience loss of taste and smell, as well as gastrointestinal symptoms like nausea and diarrhea during the infection. In fact, it’s estimated that up to 71% of patients who experienced headaches with COVID-19 also experienced nausea.
New Headache Symptoms
If you experience a headache during a coronavirus infection, you may notice that it feels different from your typical migraines. A COVID-19 headache is usually moderate to severe in pain intensity and has a pulsating or pressing quality to it.
Patients often report it in the front of their head, and the headaches often don’t respond to over-the-counter pain medications like acetaminophen or ibuprofen. Patients who experienced headaches with COVID-19 reported that the headaches came on rapidly, as opposed to migraines, which may be more gradual.
Stress
Living through a global pandemic brings on new stressors for everyone, and if you have a history of migraines, the stress may contribute to more frequent headaches. People with a history of migraines may be impacted by the pandemic for a variety of reasons. Increased stress, social isolation, changes in routine, and sleep disruptions can all contribute to migraine attacks.
In a 2020 survey of people living with migraines in Kuwait, 60% of respondents reported increased migraine frequency during the pandemic. Participants also experienced more painful migraines, with 64% reporting an increase in migraine severity.
It’s helpful to keep in mind that the majority of the respondents were not in communication with their healthcare providers during the lockdown period. Of the participants who tested positive for COVID-19 during the study, 63% reported that their migraines were worse during their illness.
The social aspects of the pandemic greatly affected participants. About 78% experienced sleep disturbances, and 80% reported feelings of anxiety or depression. The majority of patients stated that they increased their screen time and decreased their activity time during quarantine.
Fortunately, 16% of respondents reported fewer migraines during the pandemic. The study authors believed this was due to less work stress because participants were working from home.
Migraine Treatments and COVID-19
If you are living with migraines, you have most likely wondered how your treatment could be affected by the COVID-19 pandemic.
Barriers to Treatment
Medical care for migraines has been impacted by the pandemic. A 2020 study found that patients with migraines had less interaction with their healthcare provider and a harder time obtaining prescription migraine medications during the pandemic. This was due to fewer available appointments and fear of visiting a clinic or hospital due to the risk of exposure to the virus.
Medications for Migraine Management
The American Headache Society recommends a combination of nonsteroidal anti-inflammatory drugs (NSAIDs), triptans, and antiemetics to treat acute migraines, and these medications can be continued throughout an infection with COVID-19.
At the start of the pandemic, there was a concern that NSAIDs may be dangerous during an active coronavirus infection. In March 2020, the Food and Drug Administration (FDA) released a statement saying that there was no known evidence connecting NSAIDs with poorer COVID outcomes.
Opioid medications such as oxycodone or morphine are not recommended for migraine use, even during a coronavirus infection. Opioids can lead to rebound headaches and make getting your migraines under control much more challenging.
Lifestyle Factors
In addition to prescription medications and medical procedures, stress reduction techniques can help you prevent and manage your migraines.
A headache program in Italy implemented daily phone calls and mindfulness teaching as a way to support their patients from home during the pandemic. The program leaders asked patients to keep a daily log of their pain and medication use, as well as lifestyle factors like sleep and diet.
Program leaders found that patients were very satisfied with the telehealth program and regularly attended the calls. Patients who took part in the program reported an improvement in migraine symptoms.
Migraine Prevention
Utilize strategies to help you prevent as many migraines as you can, especially during this stressful time. Sticking to a regular sleep schedule, staying active, eating a healthy diet, and keeping yourself hydrated can all contribute to better migraine management.
Do your best to limit screen time, and find ways to stay connected with your social support system. Talk with your healthcare provider about a home plan for when you feel a migraine coming on. Be sure to keep your prescriptions filled and talk with your healthcare provider if a medication is unavailable at the pharmacy.
Telehealth appointments are becoming more common and may provide a convenient way for you to receive the care you need. Ask your neurologist or a headache specialist if they are offering telehealth visits during the pandemic. To learn more about the latest telemedicine policy changes, the American Academy of Neurology has launched a website with details about each state’s coverage.
It’s important to stay in communication with your healthcare provider if you develop a headache during your illness. If the head pain is out of control, consider seeking emergency medical treatment.
A Word From Verywell
If you are living with migraines, you have probably been concerned about how COVID-19 could affect you. Fortunately, it does not appear that a history of migraines puts you at higher risk for the virus.
If you have noticed an increase in migraine frequency or severity during the pandemic, know that you are not alone. Talk with your healthcare provider about new ways to better manage your migraines, and take measures to promote your health and well-being during this stressful time.
The information in this article is current as of the date listed. As new research becomes available, we’ll update this article. For the latest on COVID-19, visit our coronavirus news page.
