Hi there- so sorry you have been presented with a stubborn migraine that is unresponsive to your normal course of treatment. I wouldn't get too concerned just yet about whether or not COVID has any bearings on this experience since it's only happened once. Migraine on its own can evolve over time and change in presentation both in terms of triggers, symptoms, severity, and frequency. This is a well-known part of the disease and is one of the most frustrating things about it. It makes it feel like a moving target to treat and means we often have to revisit and alter our treatment strategy as we go along. While we're not medical professionals here and cannot offer medical advice, I have had migraine for 45 years and the condition has evolved greatly for me over the years. I would encourage you to continue keeping a diary about your attacks (or start to do so, if you don't already) to share with your doctor at your next appointment to discuss whether or not a change in treatment strategy may be called for. Hope this helps. Warmly- Holly -migraine.com team.