Abstract
We investigated the prevalence of mask/PPE associated headache among Bangladeshi physicians during COVID 19 pandemic along with the risk factors and headache characteristics. Headache severity was assessed by the Headache Impact Test (HIT-6). This is a cross-sectional, online Google form based study among 200 physicians from different hospitals in Dhaka conducted from December 2020 to April 2021. We compared characteristics of ‘mask associated headache’ and ‘no headache’ groups as well as of groups with and without previous headache. Independent factors associated with headache occurrence and severity were identified. Majority participants were male (129, 64.5%) with mean (SD) age of 35.4(7.5) years. Filter masks (146, 73%) were mostly used along with other PPE (139, 69.5%). Headache prevalence was 71% and 59.9% developed new onset headache. Doctors with a pre-existing primary headache disorder [OR: 5.40, 95% CI: 2.03-14.41; P=0.001] had the highest risk of developing headache. Headache occurrence was independently associated with working in the COVID unit [OR: 2.47, 95% CI: 1.18-5.18; P=0.017] and combined mask & other PPE usage [OR: 2.35, 95% CI: 1.13-4.84;P=0.021] for ≥ 6months [OR:2.06, 95%CI:1.05-3.99; P=0.036]. Most headaches were dull aching (33.8%), lasted for 1-4 hours (58.5%) & relieved within 1 hour of mask removal (43.6%). Headache Impact Test (HIT-6) score was substantial too severe among the doctors with previous headaches [OR: 2.91, 95%CI: 1.43-5.92; P=0.003] and those having moderate to severe stress levels [OR: 2.56, 95%CI: 1.19-5.55; P=0.017]. Most physicians with previous primary headache develop mask/PPE associated headache with considerable impacts on daily life. Keywords: Headache, Mask, COVID19, Doctors
Highlights
The current Corona virus Disease (COVID-19) pandemic, after starting as an outbreak in Wuhan, China in December 2019, shattered the present world with its high infectivity, diverse and mysterious clinical presentations and alarming mortality [1,2]
Out of 200 participants, 142 (71%) developed mask/Protective Equipment (PPE) associated headache. 85(59.9%) mask/PPE associated headaches were of new onset
Doctors who worked in the COVID unit and used mask and PPE in combination for ≥ 6 months and those who had a preexisting primary headache disorder diagnosis had a greater likelihood of developing mask induced headache
Summary
The current Corona virus Disease (COVID-19) pandemic, after starting as an outbreak in Wuhan, China in December 2019, shattered the present world with its high infectivity, diverse and mysterious clinical presentations and alarming mortality [1,2]. The corona-virus was confirmed to have spread to Bangladesh in March 2020 after which the number of cases were increasing day by day and 15,03,680 cases were officially reported till 1st September 2021 with 26,274 deaths [5]. Still doctors of all levels in the country are serving their best during this deadly pandemic Their works are more stressful and troublesome than those of their counterparts in other countries due to long duty hours in the hot and humid environments of Bangladeshi hospitals. High population and patient density with poor hygiene and insufficient vaccination compelled the physicians to wear protective masks for an
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