Headache in SARS-CoV-2 infection

Takeaway

  • Headache in COVID-19 usually appears as an early symptom and is associated with a more benign disease course. Headache features were typical of an acute headache attributed to systemic viral infection.

Why this matters

  • Headache is an established symptom of COVID-19, reported in 13–74.6% of patients.

  • The neuroinvasive potential of SARS-CoV-2 is unclear. SARS-CoV-2 binds to ACE2 receptors which are not believed to be expressed in the central nervous system (CNS); however, key symptoms including headache, anosmia and ageusia, as well as the finding of SARS-CoV-2 in the cerebrospinal fluid in some patients, suggest the virus may nonetheless enter the CNS.

  • Many systemic viral infections are associated with headache, but it is possible that the headache seen in SARS-CoV-2 infection is distinct.