Introduction
In December 2019, a new coronavirus, SARS-CoV-2, started an outbreak in the Chinese city of Wuhan. In January 2020 its clinical picture was defined as a disease associated with COVID-19.1 2 This outbreak evolved into a pandemic and on 24 May 2020, 216 countries had been affected, 5 206 614 cases had been confirmed worldwide and 337 736 deaths.3 In Spain, there are 233 037 cases, and 27 940 patients have lost their lives.4 In the region of Extremadura, 3047 cases and 506 deaths have been reported.5
During the increase in cases of COVID-19 in our environment, the health authorities established the mandatory use of Personal Protective Equipment (PPE) by health professionals. This PPE consists of a protective suit, surgical gloves, protective goggles, shield and face mask. In the case of face masks, they must be highly effective, with type FFP2 (filtering face pieces) (in Europe), N95 (USA) and KN95 (China) recommended.6 There are other types of masks (surgical masks or FPP1 among others), of lesser effectiveness, which are used by healthcare personnel who is not in direct contact with COVID-19.7
In ‘front-line’ work, the use of masks can be very prolonged.8 Although, in general, highly effective masks are well tolerated, some problems have been reported, such as: general discomfort; decreased visual, auditory or vocal capacity; excessive heat or humidity; facial pressure; skin lesions; itching; fatigue; anxiety and claustrophobia.9 Another effect described in the 2003 SARS epidemic was headache, whose prevalence reached 37.3% of the health personnel studied.10 This headache can be related to mechanical factors, the presence of hypoxaemia and hypercapnia or to the stress associated with mask use.11 12 Our aim is to demonstrate if there is an association between the appearance of ‘de novo’ headache with the type of mask and its time of use, as well as the impact of this headache on health professionals.