ABSTRACT
Background: Studies show that wearing personal protective equipment (PPE) for long periods of time can lead to discomfort such as headaches, which could affect the performance of healthcare workers. The aim of this study was to determine the prevalence and risk factors of headaches related to PPE in healthcare workers at a COVID-19 referral hospital. Methods: A cross-sectional study was conducted involving 174 healthcare workers in a COVID-19 referral hospital in Bali. We conducted interviews using a questionnaire that consisted of three main parts: characteristics of the subjects, PPE usage, and PPE-associated headaches. A multiple logistic regression was used to analyze the data. Results: The analysis results showed that the PPE-associated headaches had a prevalence of 63.8% and were gradual in onset, pressure-like in quality (46%), and mild in intensity (80.1%). PPE level III-associated headache was the most common type. The majority of the participants had headaches up to 6 hours after using the protective gear, but improving within 15-30 minutes of removal and/or after pharmacotherapy. A Chi-squared analysis showed a statistically significant association between duration of PPE use, working units, and PPE levels (p<0.05). A logistic regression analysis found a significant relationship between PPE level and headache occurrence (OR=4.826;95%CI: 2.433-9.572;p<0.001). Conclusion: The frequency of PPE-associated headache was high and the PPE level was a risk factor of headache among healthcare workers. Better strategies are needed to reduce the duration of PPE exposure so that the work performance and quality of life of healthcare workers are not significantly affected.
ABSTRACT
Background: The outbreak of Coronavirus disease 2019 (COVID-19) has started in China since December 2019 and expanding worldwide rapidly with cases of respiratory tract infection and multiple system involvement. Neurological manifestations are not exempted following the reports from various sources about Ischemic and haemorrhagic stroke related to COVID-19, but the reports about cerebral sinus venous thrombosis (CSVT) are still rare.Case presentation: We would like to report two cases of cerebral sinus venous thrombosis in COVID-19 patients following the respiratory manifestations with profound haematological and coagulation disarrangement triggered by COVID-19 and these are assumed as underlying mechanism. These two cases also have different course of disease and outcome which are interesting.Conclusions: CSVT is one of neurological complication and COVID -19 manifestation that can have grave prognosis, if this involves the brainstem venous drainage. Thrombogenesis and coagulation cascades are prolonged despite successful alteration to negative result of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) reverse transcription polymerase chain reaction (rt-PCR) test. Therefore, monitoring neutrophil to lymphocyte ration (NLR), D-dimer level, fibrinogen and C-reactive protein (CRP) is paramount as well as indicators of poor prognosis.