Prevalência e fatores associados a sintomas craniocervicais e orofaciais entre profissionais de saúde durante a pandemia da covid-19: uma revisão sistemática e meta-análise

Abstract

Background: the prolonged use of Personal Protective Equipment (PPE) and the increased workload during the COVID-19 pandemic have led to a rise in reports of craniocervical symptoms among healthcare professionals. Both physical and psychological factors play a significant role in the high prevalence of these symptoms. While the association between headache and these factors is well established, other craniocervical symptoms, such as neck pain, orofacial pain, and temporomandibular dysfunction, require further investigation. Objective: to investigate the prevalence of craniocervical and orofacial symptoms among healthcare professionals during the COVID-19 pandemic and identify potential associated factors. Methods: a systematic review with meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with a protocol previously registered in the International Prospective Register of Systematic Reviews (PROSPERO). Observational studies published since 2020 that reported the prevalence or incidence of craniocervical symptoms, such as headache, neck pain, and orofacial pain, among healthcare professionals during the pandemic were included. Searches were performed in the PUBMED, MEDLINE, EMBASE, CINAHL Plus, Web of Science, and SCOPUS databases. The risk of bias in the included studies was assessed using the Quality in Prognosis Studies (QUIPS) tool. Results: a total of 57 studies including 24,605 healthcare professionals were analyzed. The prevalence of headache during the pandemic was 53% (95% CI: 43–61; p < 0.001), while headache related to PPE use reached 55% (95% CI: 47–64%; p < 0.001). The risk of headache was 2.76 times higher during the pandemic (OR: 2.76; 95% CI: 2.26–3.36; p < 0.004). This symptom was associated with individual, medical, and environmental factors. Neck pain was the second most common craniocervical symptom (38%, 95% CI: 27–50%; p < 0.001), followed by orofacial pain (30%, 95% CI: 9–50%; p < 0.001). Conclusion: this review identified a high prevalence of headache among healthcare professionals during the pandemic, significantly exceeding pre-pandemic levels, as well as a frequent occurrence of craniocervical symptoms and psychosomatic factors. The multifactorial etiology of these symptoms underscores the need for multidisciplinary strategies for their management, considering both physical and psychosocial aspects. Early identification of these symptoms is essential to minimize their impact on the quality of life of healthcare professionals.