Fatores associados a sintomas craniocervicais e otológicos em profissionais da saúde que atuaram na pandemia da Covid-19: um estudo transversal

Abstract

Introduction: During the COVID-19 pandemic, there was an increase in the use of Personal Protective Equipment (PPE), increased working hours and high rates of psychological disorders in health professionals, which together can lead to acute and chronic health problems. psychic and physical, such as craniocervical complaints, headache, orofacial pain, neck pain and otological symptoms, which can also be influenced due to the anatomical interconnections and nervous communication of the craniocervical structures. Objective: to identify factors associated with craniocervical and otological symptoms in health professionals who worked in the COVID-19 pandemic. Methods: cross-sectional study carried out with health professionals of both sexes, aged 18 years or older, who worked in helping patients infected or suspected of having COVID-19, without restrictions on their work in department or level of care. Data were collected on sociodemographic characteristics, presence of craniocervical symptoms (headache, orofacial pain and neck pain) and otological symptoms (tinnitus, ear fullness, hypoacusis, dizziness and vertigo), pattern of PPE use before and during the pandemic. In addition to medical history, working conditions, life habits, sleep quality and depressive symptoms, through a self-administered online questionnaire. Results: 147 subjects answered the questionnaire, with 79.6% women, mean age 35 ± 9.7 years. The presence of craniocervical symptoms before the pandemic was 32% for headache, 15.6% for orofacial pain, 21.1% for neck pain and 11.6% for otological symptoms. Regarding the worsening of pre-existing symptoms during the pandemic, headaches were identified in 22%, orofacial pain in 8.8%, neck pain in 9.4% and otological symptoms in 6.8%. As for the emergence of new craniocervical symptoms during the pandemic, headache was present in 50.8%, orofacial pain occurred in 39.7%, neck pain in 43.8% and otological symptoms in 54.4%. Headache was the most prevalent symptom before the pandemic and in the worsening of pre-existing symptoms; already the otological symptoms for the emergence of new symptoms. Factors associated with the worsening of pre-existing headache symptoms were: being female (OR = 5.09), not practicing physical activity during the pandemic (OR = 4.48), and using the PFF2 mask during the pandemic (OR = 4.07). As for orofacial pain, it was just working in a ward (OR = 4.74). Regarding the factors associated with the onset of craniocervical symptoms, with regard to headache, we found depressive symptoms present (OR = 3.15) and for the onset of orofacial pain, the presence of neck pain during the pandemic (OR = 2.42) and having otological symptoms during the pandemic (OR = 3.14). Regarding neck pain, having associated symptoms during the pandemic (OR = 3.99) and presenting orofacial pain during the pandemic (OR = 2.45). Regarding the factors associated with the onset of otological symptoms, the use of a surgical mask before the pandemic for more than 4 hours a day (OR = 3.06), use of a face shield during the pandemic for more than 4 hours a day (OR = 2.98, 95% CI 1.07 – 8.24, p = 0.035) and presence of orofacial pain during the pandemic (OR = 3.89). Conclusion: an increase in the frequency of craniocervical and otological symptoms in health professionals during the pandemic was evidenced, with headache being the most prevalent before the pandemic and in the worsening of pre-existing symptoms. It is suggested to carry out epidemiological, longitudinal studies, with the largest sample size, to improve knowledge and repercussions regarding craniocervical and otological complaints, ways to prevent and treat them.