Headaches and the use of personal protective equipment in the general population during the COVID-19 pandemic.

INTRODUCTION

Headaches associated with personal protective equipment were reported in health-care workers in previous epidemiological studies.

METHODS

National web-based survey advertised by the Portuguese Headache Society and National Headache and Migraine patient´s organization between September-December 2020 screening for personal protective equipment usage pattern, pre-existing and headaches after the onset of the COVID-19 pandemic, and its relation to personal protective equipment use.

RESULTS

Of 5064 participants, 90.6% (4562/5034) were women, mean age was 37.2 ± 11 years. Most questions had a completion rate above 87% (non-completion rate ranging from 0-12.7%). Twenty percent were health-care professionals (993/5046). Surgical and cloth masks were the most common personal protective equipment type, whereas protective eyewear and FFP2/FFP3 masks were mostly used by health-care professionals. About 97% (1814/1870) of migraine and headache participants reported aggravation of pre-existing headaches with personal protective equipment use, and 56% (2476/4420) had headaches. Participants with headaches had a higher frequency of pre-existing migraine (1118/1226, 91.2% vs 1408/1600, 88%, P = .042), and wore personal protective equipment for longer periods of time (7 ± 2 h 42 vs 6 ± 2 h 54 min per day, P < .001). In multivariate analysis longer mean duration of personal protective equipment use (OR of 1.1, 95% CI 1-1.2) and previous migraine (OR of 1.2, 95% CI 1-1.4) were predictors of developing headaches.

CONCLUSIONS

Almost all participants with pre-existing headache reported worsening of their headaches, and more than half of the study population developed headaches following personal protective equipment use. Duration of personal protective equipment usage and pre-existing migraine were the strongest predictors of headaches.