“Prevalence and Associated Factors of Craniocervical and Orofacial
Symptoms Among Healthcare Professionals During the COVID-19 Pandemic:
A Systematic Review and Meta-Analysis”
Headache, Neck Pain, Healthcare Personnel, Temporomandibular Disorder, Risk factors
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.