Comparative effectiveness of N95, surgical or medical, and non-medical facemasks in protection against respiratory virus infection: A systematic review and network meta-analysisYonsei Univ, South Korea.
Yonsei Univ, South Korea.
Sejong Univ, South Korea; Sungkyunkwan Univ, South Korea.
Kyung Hee Univ, South Korea.
Yonsei Univ, South Korea.
Yonsei Univ, South Korea; Yonsei Univ, South Korea.
Univ Ottawa, Canada; Ottawa Hosp, Canada; Univ Ottawa, Canada; Univ Ottawa, Canada.
Univ Barcelona, Spain; ICREA, Spain; Inst Salud Carlos III, Spain.
Univ Barcelona, Spain; Univ Versailles St Quentin En Yvelines, France.
Univ Cambridge, England.
Tunis El Manar Univ, Tunisia.
Univ Piemonte Orientale, Italy.
Univ Piemonte Orientale, Italy.
Yonsei Univ Hlth Syst, South Korea.
Case Western Reserve Univ, OH USA.
CIBERSAM, Spain; Kings Coll London, England; Karolinska Inst, Sweden.
Univ Southern Calif, CA USA.
Univ Clin Marburg, Germany.
Dana Farber Harvard Canc Ctr, MA USA; Harvard TH Chan Sch Publ Hlth, MA USA; Harvard Med Sch, MA 02115 USA; Broad Inst MIT & Harvard, MA 02142 USA.
Harvard TH Chan Sch Publ Hlth, MA USA; Brigham & Womens Hosp, MA 02115 USA; Harvard Med Sch, MA 02115 USA.
Harvard TH Chan Sch Publ Hlth, MA USA; Harvard TH Chan Sch Publ Hlth, MA USA.
Anglia Ruskin Univ, England.
Anglia Ruskin Univ, England.
Nottingham Trent Univ, England.
Queen Elizabeth Hosp Fdn Trust, England.
Yonsei Univ, South Korea; Yonsei Univ, South Korea.
Anglia Ruskin Univ, England.
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2022 (English)In: Reviews in Medical Virology, ISSN 1052-9276, E-ISSN 1099-1654, Vol. 32, no 5, article id e2336Article, review/survey (Refereed) Published
Abstract [en]
The aim of this systematic review and network meta-analysis is to evaluate the comparative effectiveness of N95, surgical/medical and non-medical facemasks as personal protective equipment against respiratory virus infection. The study incorporated 35 published and unpublished randomized controlled trials and observational studies investigating specific mask effectiveness against influenza virus, SARS-CoV, MERS-CoV and SARS-CoV-2. We searched PubMed, Google Scholar and medRxiv databases for studies published up to 5 February 2021 (PROSPERO registration: CRD42020214729). The primary outcome of interest was the rate of respiratory viral infection. The quality of evidence was estimated using the GRADE approach. High compliance to mask-wearing conferred a significantly better protection (odds ratio [OR], 0.43; 95% confidence interval [CI], 0.23-0.82) than low compliance. N95 or equivalent masks were the most effective in providing protection against coronavirus infections (OR, 0.30; CI, 0.20-0.44) consistently across subgroup analyses of causative viruses and clinical settings. Evidence supporting the use of medical or surgical masks against influenza or coronavirus infections (SARS, MERS and COVID-19) was weak. Our study confirmed that the use of facemasks provides protection against respiratory viral infections in general; however, the effectiveness may vary according to the type of facemask used. Our findings encourage the use of N95 respirators or their equivalents (e.g., P2) for best personal protection in healthcare settings until more evidence on surgical and medical masks is accrued. This study highlights a substantial lack of evidence on the comparative effectiveness of mask types in community settings.
Place, publisher, year, edition, pages
WILEY , 2022. Vol. 32, no 5, article id e2336
Keywords [en]
coronavirus; COVID-19; facemask; influenza virus; network meta-analysis
National Category
Microbiology in the medical area
Identifiers
URN: urn:nbn:se:liu:diva-183569DOI: 10.1002/rmv.2336ISI: 000761237100001PubMedID: 35218279Scopus ID: 2-s2.0-85125220122OAI: oai:DiVA.org:liu-183569DiVA, id: diva2:1645408
2022-03-172022-03-172023-03-31Bibliographically approved