Introduction COVID-19 pandemic changed healthcare routines and increased occupational stress among workers.

Objectives To analyze the factors associated with mental suffering among frontline healthcare workers (HCW).

Methods National cross-sectional study carried out in May-June 2020 in Brazil. Participants were invited through social media to fill a questionnaire about sociodemographic, occupational, and clinical data. The Swedish Demand-Control-Support Questionnaire was applied to characterize the work psychosocial context. The World Health Organization´ Self-Reporting Questionnaire (SRQ-20) was used to evaluated the mental suffering. A multiple logistic regression was performed to analyze factors associated to the outcome.

Results Data were obtained from 437 workers; their average age was 38.4 years (sd±10.0). Most of them were from nursing team (65.0%), female (71.0%) and working in public services (70.1%). Job strain was reported from 23.8% and 52.9% indicated low social support. The overall prevalence of mental suffering was 61.6% and associated factors were: : females (odds ratio - OR 1.93; 95% confidence interval - 95% CI 1.22–3.07), age < 40 years (OR 1.64; 95% CI 1.07–2.52), weekly workload ≥ 60 hours (OR 1.87; 95% CI 1.15–3.11), job strain (OR 2.45; 95% CI 1.41–4.40) and low social support at work (OR 3.47; 95% CI 2.26–5.38).

Conclusion Individual characteristics and occupational aspects are associated to the suffering in this Brazilian sample of healthcare workers. Policies to improve occupational psychosocial conditions are needed in order to reduce negative mental outcomes, in special during COVID-19 pandemic.