Recurrent headache as a post-COVID-19 sequela: A case report

ABSTRACT

@#Post-COVID condition is the presence of new, recurring, or ongoing signs and symptoms for greater than four weeks after a SARS-CoV-2 infection. Persistent headache as a neurologic sequalae of COVID-19 infection is a common prolonged symptom with limited characterization in the literature. This was a case of a 27-year-old female diagnosed with mild COVID-19 who presented with fever, colds, fatigue, headache, decreased hearing, sore throat, dry cough, pleuritic chest pain, anosmia, ageusia, myalgia, and severe low back pain. Headache was described as remitting, frontally located, squeezing and moderate to severe in pain intensity. She was admitted in a tertiary COVID referral hospital for 8 days and was managed supportively. On the 10th day of illness, symptoms had resolved except for an on and off headache. The residual recurrent headache lasted for more than 5 months after being tested negative for SARSCOV2 on repeat reverse transcriptase-polymerase chain reaction (RT-PCR). The possible pathophysiologic mechanisms for neurologic manifestations and prolonged headache were hypoxia, endothelial damage through angiotensin converting enzyme receptor, and cytokine reactions. The characteristics of the symptoms remained unclear despite the proposed mechanisms for prolonged headache among COVID-19 patients.