What to Know About Migraine and COVID-19

If you’re currently living with migraines, you may be wondering how your condition could be affected by COVID-19. Because headache is a well-known symptom of COVID-19, many individuals prone to migraines fear that the virus could worsen their condition.

Fortunately, we are learning how migraines and their treatment can be affected by COVID-19. Headache is the most common neurological symptom of COVID-19, and initial research has found that people with migraines may be more at risk of experiencing COVID-19 symptoms due to the inflammatory response present in both conditions. This correlation seems to increase with age. 

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. 

Senior businesswoman with mask feeling bad at street

FG Trade / Getty Images

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 doctor for Botox injections to prevent migraines. 

You can mitigate this risk by taking preventive measures, such as avoiding touching any part of your face after coming into contact with communal surfaces like doorknobs; frequent handwashing, especially after going out in public; and wearing a mask when you are somewhere with people from outside your household, especially in 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.

While individuals with a history of migraines are more at risk for developing headaches with COVID-19, the quality of the headache is often different. The majority of individuals who had a history of headaches described the headache they experienced with COVID-19 to be different than their baseline headaches. Patients who experienced headaches with COVID-19 reported the most common headache trigger to be the infection itself, followed by stress.

Of patients with a preexisting migraine diagnosis, 55% reported pulsating pain with headaches experienced during COVID-19 infection. Interestingly, 61% reported that they usually experience pulsating pain with their migraines. While the rate of pulsating pain went down slightly, patients with migraines were much more likely to report pulsating pain than those without a history of headaches.

Having a history of migraines does not mean that you will absolutely experience a COVID-19 headache. Fortunately, 22% of patients with previous headaches in the study did not experience any headache pain during their coronavirus infection.

The study also found that 54% of individuals with a history of migraines did not experience a difference in headache frequency or intensity during the pandemic, and 12% actually reported a decrease in headache frequency. Researchers hypothesized that this decrease may have been related to less stress due to fewer social interactions and obligations.

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 doctor, 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.

If you experience a headache with a high fever, stiff neck, light sensitivity, or vomiting, talk with your doctor to make sure you are not experiencing a more severe infection like meningitis. While this complication is very rare, it is possible and always best to rule it out with a doctor.  

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 doctors 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 doctor 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.

If you receive regular Botox injections for the prevention of migraines, talk with your doctor about how to proceed. Many of these appointments were canceled at the beginning of the pandemic due to national stay-at-home orders.

Caution with Corticosteroids

According to the Centers for Disease Control and Prevention (CDC), corticosteroid use should be avoided during an active coronavirus infection because it could prolong the illness. Talk with your doctor if you regularly take corticosteroids and test positive for COVID-19. Abruptly stopping this medication can lead to side effects, so talk with your doctor about how to slowly taper off. 

Because many migraine medications require prior authorization with your insurance company, work with your provider and pharmacist to stay on top of the requirements. Your doctor’s office may keep medication samples on hand that they could provide while you are waiting for the prescription to be approved by insurance.

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. 

Frequently Asked Questions

Could the Vaccine Cause a Migraine Attack?

The COVID-19 vaccines are recommended for the majority of adults, and there is currently no evidence to suggest that getting the COVID-19 vaccine causes a migraine attack. However, two common side effects of the vaccine are headache and nausea. Talk with your doctor before you receive the vaccine, and make a treatment plan in case you experience a headache or any other side effects. 

Will the Vaccine Affect My Migraine Medication?

At this time, there is no evidence that taking migraine preventive medication affects the efficacy of the COVID-19 vaccine. Physicians are currently recommending that individuals refrain from taking over-the-counter pain medications like ibuprofen and acetaminophen before receiving their vaccine because there is a concern that those medications could affect the vaccine’s effectiveness. However, if you experience a headache or muscle pain after your vaccine, it is safe to take acetaminophen. Talk with your doctor about how to manage a post-vaccine headache if you have questions.

Is COVID-19 More Dangerous for People With Migraines?

At this time, it does not appear that having COVID-19 is more dangerous for people with migraines. It may be more uncomfortable though. Because you may be more at risk of developing a headache with COVID-19 than someone who does not have a history of migraines, talk with your doctor about how to treat your headaches during an infection.

How to Stay Safe

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 doctor about a home plan for when you feel a migraine coming on. Be sure to keep your prescriptions filled and talk with your doctor 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 doctor if you develop a headache during your illness. A rare complication of COVID-19 is an infection of the central nervous system, and the first symptom is often a headache. Schedule a virtual visit with your doctor if you develop a headache. If the head pain is out of control, consider seeking emergency medical treatment. 

In addition to special considerations for migraines, the CDC recommends everyone take the following precautions to stay as safe as possible:

  • Wear a mask that covers your nose and mouth anytime you are out in public or with people you do not live with.
  • Stay 6 feet away from those you do not live with.
  • Get the COVID-19 vaccine as soon as you are eligible.
  • Avoid crowds, especially indoors.
  • Wash your hands with soap and water often; use hand sanitizer if water is not available.

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 doctor 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.

Was this page helpful?
Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Uygun Ö, Ertaş M, Ekizoğlu E, Bolay H, Özge A, Kocasoy Orhan E, Çağatay AA, Baykan B. Headache characteristics in COVID-19 pandemic-a survey study. J Headache Pain. 2020 Oct 13;21(1):121. doi:10.1186/s10194-020-01188-1

  2. Bolay H, Özge A, Uludüz D, Baykan B. Are migraine patients at increased risk for symptomatic coronavirus disease 2019 due to shared comorbidities? Headache. 2020 Nov;60(10):2508-2521. doi:10.1111/head.13998

  3. Bolay H, Gül A, Baykan B. COVID-19 is a real headache! Headache. 2020 Jul;60(7):1415-1421. doi:10.1111/head.13856

  4. Al-Hashel JY, Ismail II. Impact of coronavirus disease 2019 (COVID-19) pandemic on patients with migraine: a web-based survey study. J Headache Pain. 2020 Sep 24;21(1):115. doi:10.1186/s10194-020-01183-6

  5. Pringsheim T, Davenport WJ, Marmura MJ, Schwedt TJ, Silberstein S. How to apply the AHS Evidence Assessment of the acute treatment of migraine in adults to your patient with migraine. Headache. 2016 Jul;56(7):1194-200. doi:10.1111/head.12870

  6. Szperka CL, Ailani J, Barmherzig R, Klein BC, Minen MT, Halker Singh RB, Shapiro RE. Migraine care in the era of COVID-19: clinical pearls and plea to insurers. Headache. 2020 May;60(5):833-842. doi:10.1111/head.13810

  7. Grazzi L, Rizzoli P. The adaptation of management of chronic migraine patients with medication overuse to the suspension of treatment protocols during the COVID-19 pandemic: lessons from a tertiary headache center in Milan, Italy. Headache. 2020 Jul;60(7):1463-1464. doi:10.1111/head.13825

  8. Gelfand AA, Poland G. Migraine treatment and COVID-19 vaccines: no cause for concern. Headache. 2021 Mar;61(3):409-411. doi:10.1111/head.14086

  9. Centers for Disease Control and Prevention. Possible side effects after getting a COVID-19 vaccine.

  10. Centers for Disease Control and Prevention. How to protect yourself & others. Updated March 8, 2020.