tetano
Editor, Senior Moderator
Influenza Other Respir Viruses. 2020 Apr 4. doi: 10.1111/irv.12745. [Epub ahead of print]
Medical Masks vs N95 Respirators for Preventing COVID-19 in Health Care Workers A Systematic Review and Meta-Analysis of Randomized Trials.
Bartoszko JJ[SUP]1[/SUP], Farooqi MAM[SUP]2[/SUP], Alhazzani W[SUP]1,[/SUP][SUP]3[/SUP], Loeb M[SUP]1,[/SUP][SUP]4[/SUP].
Author information
Abstract
BACKGROUND:
Respiratory protective devices are critical in protecting against infection in health care workers at high risk of novel 2019 coronavirus disease (COVID-19); however, recommendations are conflicting and epidemiological data on their relative effectiveness against COVID-19 are limited.
PURPOSE:
To compare medical masks to N95 respirators in preventing laboratory confirmed viral infection and respiratory illness including coronavirus specifically in health care workers.
DATA SOURCES:
MEDLINE, Embase and CENTRAL from January 1[SUP]st[/SUP] 2014 to March 9[SUP]th[/SUP] 2020. Update of published search conducted from January 1[SUP]st[/SUP] 1990 to December 9[SUP]th[/SUP] 2014.
STUDY SELECTION:
Randomized controlled trials (RCTs) comparing the protective effect of medical masks to N95 respirators in health care workers.
DATA EXTRACTION:
Reviewer pair independently screened, extracted data, and assessed risk of bias and the certainty of the evidence.
DATA SYNTHESIS:
Four RCTs were meta-analysed adjusting for clustering. Compared to N95 respirators; the use of medical masks did not increase laboratory confirmed viral (including coronaviruses) respiratory infection (OR 1.06; 95% CI 0.90-1.25; I[SUP]2[/SUP] =0%; low certainty in the evidence) or clinical respiratory illness (OR 1.49; 95%CI 0.98-2.28; I[SUP]2[/SUP] =78%; very low certainty in the evidence). Only one trial evaluated coronaviruses separately and found no difference between the two groups (p=0.49).
LIMITATIONS:
Indirectness and imprecision of available evidence.
CONCLUSIONS:
Low certainty evidence suggests that medical masks and N95 respirators offer similar protection against viral respiratory infection including coronavirus in health care workers during non-aerosol generating care. Preservation of N95 respirators for high-risk, aerosol generating procedures in this pandemic should be considered when in short supply.
This article is protected by copyright. All rights reserved.
KEYWORDS:
COVID-19; N95 respirators; SARS-CoV-2; coronavirus; masks; meta-analysis; systematic review
PMID:32246890DOI:10.1111/irv.12745
Free full text
Medical Masks vs N95 Respirators for Preventing COVID-19 in Health Care Workers A Systematic Review and Meta-Analysis of Randomized Trials.
Bartoszko JJ[SUP]1[/SUP], Farooqi MAM[SUP]2[/SUP], Alhazzani W[SUP]1,[/SUP][SUP]3[/SUP], Loeb M[SUP]1,[/SUP][SUP]4[/SUP].
Author information
Abstract
BACKGROUND:
Respiratory protective devices are critical in protecting against infection in health care workers at high risk of novel 2019 coronavirus disease (COVID-19); however, recommendations are conflicting and epidemiological data on their relative effectiveness against COVID-19 are limited.
PURPOSE:
To compare medical masks to N95 respirators in preventing laboratory confirmed viral infection and respiratory illness including coronavirus specifically in health care workers.
DATA SOURCES:
MEDLINE, Embase and CENTRAL from January 1[SUP]st[/SUP] 2014 to March 9[SUP]th[/SUP] 2020. Update of published search conducted from January 1[SUP]st[/SUP] 1990 to December 9[SUP]th[/SUP] 2014.
STUDY SELECTION:
Randomized controlled trials (RCTs) comparing the protective effect of medical masks to N95 respirators in health care workers.
DATA EXTRACTION:
Reviewer pair independently screened, extracted data, and assessed risk of bias and the certainty of the evidence.
DATA SYNTHESIS:
Four RCTs were meta-analysed adjusting for clustering. Compared to N95 respirators; the use of medical masks did not increase laboratory confirmed viral (including coronaviruses) respiratory infection (OR 1.06; 95% CI 0.90-1.25; I[SUP]2[/SUP] =0%; low certainty in the evidence) or clinical respiratory illness (OR 1.49; 95%CI 0.98-2.28; I[SUP]2[/SUP] =78%; very low certainty in the evidence). Only one trial evaluated coronaviruses separately and found no difference between the two groups (p=0.49).
LIMITATIONS:
Indirectness and imprecision of available evidence.
CONCLUSIONS:
Low certainty evidence suggests that medical masks and N95 respirators offer similar protection against viral respiratory infection including coronavirus in health care workers during non-aerosol generating care. Preservation of N95 respirators for high-risk, aerosol generating procedures in this pandemic should be considered when in short supply.
This article is protected by copyright. All rights reserved.
KEYWORDS:
COVID-19; N95 respirators; SARS-CoV-2; coronavirus; masks; meta-analysis; systematic review
PMID:32246890DOI:10.1111/irv.12745
Free full text