Impact of COVID-19 on Otorhinolaryngologists in Bulgaria: A Survey of Healthcare Professionals.

Background The COVID-19 pandemic caused significant global social and economic disruption, highlighting the challenges of emerging infectious diseases. It also pushed modern medicine and healthcare systems to the wall. The mode of transmission of the SARS-CoV-2 infection is by aerosolized upper respiratory tract secretions. The otorhinolaryngology specialty seems to be among the riskiest for contracting airborne infections. This is because of the close face-to-face contact with the patients during routine examinations and many specific procedures. This study aimed to evaluate otolaryngologists' self-assessment of their comparative infection risk and the impact of the COVID-19 pandemic on their clinical practice, financial stability, and psychological well-being. Methodology A national cross-sectional survey was conducted among otorhinolaryngologists in Bulgaria by a research team from the Medical University of Varna. The study assessed infection risk perception, changes in practice, psychological stress, and financial effects. Data were collected via Survs.com and analyzed using descriptive statistics, cross-tabulations, and chi-squared tests, with significance set at 0.05 in Jamovi version 2.3.28. Results Of the 241 invited participants, 120 (49.8%) completed the survey. In total, 61 (50.8%) perceived their infection risk as similar to emergency healthcare workers, while 91 (75.8%) likened their exposure to that of dentists. Workplace exposure was identified as the main infection source by 95 (79.1%), with 71 (59.1%) considering outpatient clinics the highest-risk setting. Financially, 47 (39.1%) reported no income change, 31 (25.8%) experienced reductions, and 42 (35.0%) saw increased earnings. A chi-square test revealed a significant association between financial impact and workplace setting (χ² (3) = 11.68, p = 0.0086). Hospital-based otolaryngologists were more frequently affected by income reductions, with 65 (54.2%) reporting financial losses compared to 22 (18.3%) in outpatient settings. The psychological toll was substantial, with 44 (36.6%) reporting high stress, 34 (28.3%) very high stress, and only 3 (2.5%) stating no effect. Significant associations were found between stress levels and workplace setting (χ² (4) = 12.4, p = 0.015) and work experience (χ² (12) = 22.9, p = 0.029). Conclusions The COVID-19 pandemic profoundly affected otorhinolaryngologists' financial stability, work environments, infection risk perception, and mental health. Hospital-based specialists faced greater financial challenges, while stress levels were significantly linked to workplace setting and experience. These findings highlight critical areas for long-term changes in otorhinolaryngological practice.