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Annals of Internal Medicine Jun 2023Optimal use of masks for preventing COVID-19 is unclear. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Optimal use of masks for preventing COVID-19 is unclear.
PURPOSE
To update an evidence synthesis on N95, surgical, and cloth mask effectiveness in community and health care settings for preventing SARS-CoV-2 infection.
DATA SOURCES
MEDLINE, EMBASE, medRxiv (3 June 2022 to 2 January 2023), and reference lists.
STUDY SELECTION
Randomized trials of interventions to increase mask use and risk for SARS-CoV-2 infection and observational studies of mask use that controlled for potential confounders.
DATA EXTRACTION
Two investigators sequentially abstracted study data and rated quality.
DATA SYNTHESIS
Three randomized trials and 21 observational studies were included. In community settings, mask use may be associated with a small reduced risk for SARS-CoV-2 infection versus no mask use, on the basis of 2 randomized trials and 7 observational studies. In routine patient care settings, surgical masks and N95 respirators may be associated with similar risk for SARS-CoV-2 infection, on the basis of 1 new randomized trial with some imprecision and 4 observational studies. Evidence from observational studies was insufficient to evaluate other mask comparisons due to methodological limitations and inconsistency.
LIMITATION
Few randomized trials, studies had methodological limitations and some imprecision, suboptimal adherence and pragmatic aspects of randomized trials potentially attenuated benefits, very limited evidence on harms, uncertain applicability to Omicron variant predominant era, meta-analysis not done due to heterogeneity, unable to formally assess for publication bias, and restricted to English-language articles.
CONCLUSION
Updated evidence suggests that masks may be associated with a small reduction in risk for SARS-CoV-2 infection in community settings. Surgical masks and N95 respirators may be associated with similar infection risk in routine patient care settings, but a beneficial effect of N95 respirators cannot be ruled out.
PRIMARY FUNDING SOURCE
None.
Topics: Humans; SARS-CoV-2; COVID-19; Masks; Delivery of Health Care
PubMed: 37186920
DOI: 10.7326/M23-0570 -
Enfermedades Infecciosas Y... Nov 2021The global health emergency caused by the current COVID-19 pandemic is resulting in a huge challenge at all levels. The use of masks may reduce the spread of the... (Review)
Review
INTRODUCTION
The global health emergency caused by the current COVID-19 pandemic is resulting in a huge challenge at all levels. The use of masks may reduce the spread of the infection by minimising the excretion of Flügge droplets. The objective of this study was to compile the evidence available on the use of masks in relation to respiratory infections.
METHODOLOGY
An umbrella review (review of systematic reviews) was conducted. Two reviewers independently carried out the screening process, data extraction and data analysis. Discrepancies were resolved with a third reviewer, and the assessment of the risk of bias of the studies was carried out using the AMSTAR 2 tool. The Rayyan QCRI program was used for the screening process.
RESULTS
A total of eight systematic reviews were included. The studies analysed the use of masks in the general population, in long-term care facilities, in hospitals and at mass gatherings, and compared the effectiveness thereof in preventing infection. The results of this review revealed that the use of masks is associated with a protective effect against respiratory infections in healthcare facilities, in long-term care facilities and at mass gatherings.
CONCLUSIONS
In light of the results, it seems reasonable to recommend the use of masks to the general population, but this use should be accompanied by a training programme to improve compliance, as not using them properly may increase the risk of infection.
Topics: COVID-19; Humans; Masks; Pandemics; Respiratory Tract Infections; SARS-CoV-2; Systematic Reviews as Topic
PubMed: 34446392
DOI: 10.1016/j.eimce.2021.08.002 -
Medicina 2021The COVID-19 pandemic has had an impact on public health and the global economy. The objective of this document was to update, according to the available evidence, the...
The COVID-19 pandemic has had an impact on public health and the global economy. The objective of this document was to update, according to the available evidence, the management of some basic elements in the Infection Control Programs (PCI) and the daily care of patients. As a result: 1. The routine use of the N95 masks is not recommended for the care of suspected or confirmed COVID-19 patients. Available data indicates that SARS-CoV-2 has spread primarily like most other common respiratory viruses, through droplet and contact transmission. In certain situations, personto-person transmission is described through the airway, observed in poorly ventilated environments, and while the individual carried out actions of greater potential transmission 2. The limited reuse and decontamination methods of N95 masks are accepted under safe and effective prot ocols in the context of limited resources. 3. The isolation of patients with COVID-19 can be lifted under a strategy based on the clinic, individual risk factors and time of evolution of the disease. 4. PCR control is not required in confirmed cases to determine epidemiological discharge. 5. Current evidence shows that there is a possibility of reinfection although its diagnosis is difficult. 6. The measurement of antibodies has a specific role in prevalence studies, diagnosis of multisystemic inflammatory syndrome and a picture compatible with negative PCR after the 7th. day.
Topics: COVID-19; Humans; Masks; Pandemics; SARS-CoV-2
PubMed: 33906143
DOI: No ID Found -
PloS One 2022Motivated by several possible differences in Covid-19 virus strains, age demographics, and face mask wearing between continents and countries, we focussed on changes in...
Motivated by several possible differences in Covid-19 virus strains, age demographics, and face mask wearing between continents and countries, we focussed on changes in Covid death rates in 2020. We have extended our Covid-19 multicompartment model (Khan et al., 2020) to fit cumulative case and death data for 49 European countries and 52 US states and territories during the recent pandemic, and found that the case mortality rate had decreased by at least 80% in most of the US and at least 90% in most of Europe. We found that death rate decreases do not have strong correlations to other model parameters (such as contact rate) or other standard state/national metrics such as population density, GDP, and median age. Almost all the decreases occurred between mid-April and mid-June 2020, which corresponds to the time when many state and national lockdowns were relaxed resulting in surges of new cases. We examine here several plausible causes for this drop-improvements in treatment, face mask wearing, new virus strains, testing, potentially changing demographics of infected patients, and changes in data collection and reporting-but none of their effects are as significant as the death rate changes suggest. In conclusion, this work shows that a two death rate model is effective in quantifying the reported drop in death rates.
Topics: COVID-19; Communicable Disease Control; Humans; Masks; Pandemics; SARS-CoV-2
PubMed: 35976910
DOI: 10.1371/journal.pone.0268332 -
Sensors (Basel, Switzerland) Aug 2022Filter face masks are Respiratory Protective Equipment designed to protect the wearer from various hazards, suit various health situations, and match the specific...
Filter face masks are Respiratory Protective Equipment designed to protect the wearer from various hazards, suit various health situations, and match the specific requirements of the wearer. Current traditional face masks have several limitations. In this paper, we present (ME)2, the Monitoring Equipment Mask Environment: an innovative reusable 3D-printed eco-sustainable mask with an interchangeable filter. (ME)2 is equipped with multiple vital sensors on board, connected to a system-on-a-chip micro-controller with computational capabilities, Bluetooth communication, and a rechargeable battery that allows continuous monitoring of the wearer's vital signs. It monitors body temperature, heart rate, and oxygen saturation in a non-invasive, strategically positioned way. (ME)2 is accompanied by a mobile application that provides users' health information. Furthermore, through Edge Computing Artificial Intelligence (Edge AI) modules, it is possible to detect an abnormal and early symptoms linked to possible pathologies, possibly linked to the respiratory or cardiovascular tract, and therefore perform predictive analysis, launch alerts, and recommendations. To validate the feasibility of embedded in-app Edge AI modules, we tested a machine learning model able to distinguish COVID-19 versus seasonal influenza using only vital signs. By generating new synthetic data, we confirm the highly reliable performances of such a model, with an accuracy of 94.80%.
Topics: Artificial Intelligence; COVID-19; Humans; Influenza, Human; Masks
PubMed: 36080824
DOI: 10.3390/s22176365 -
Revista Paulista de Pediatria : Orgao... 2022To identify and synthesize scientific evidence that the use of face protection masks by children, in the community and at home, is a way of preventing communicable...
OBJECTIVE
To identify and synthesize scientific evidence that the use of face protection masks by children, in the community and at home, is a way of preventing communicable diseases.
DATA SOURCE
A scoping review was made using the Joana Briggs Institute method and PRISMA-ScR. A research was carried out in five electronic databases, at the Cochrane Library and on seven websites of governmental and non-governmental institutions. The data were organized in a spreadsheet and submitted to narrative analysis.
DATA SYNTHESIS
Initially, 658 productions were identified, of which 19 made up the final sample. Studies with higher levels of evidence are scarce. The types of masks identified were professional (surgical and facial respirators with filtration) and non-professional (homemade). The transmissible agents studied were influenza and SARS-CoV-2 viruses, and the evaluated environments were schools, homes and community spaces. The main discomforts reported were heat, shortness of breath, headache and maladjustment to the face. The indication and acceptability of masks change according to the age group and clinical conditions. There is no consensus on the reduction in the transmissibility of infections.
CONCLUSIONS
Children older than five can benefit from the correct use of masks, as long as they are supervised, taught and educated to do so and the masks should be well adjusted to the face. The use of masks show better results when associated with other measures such as physical distancing, keeping places ventilated and frequent hand hygiene.
Topics: COVID-19; Child; Communicable Diseases; Humans; Masks; Physical Distancing; SARS-CoV-2
PubMed: 35858041
DOI: 10.1590/1984-0462/2023/41/2021164 -
The Cochrane Database of Systematic... Apr 2016Surgical face masks were originally developed to contain and filter droplets containing microorganisms expelled from the mouth and nasopharynx of healthcare workers... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Surgical face masks were originally developed to contain and filter droplets containing microorganisms expelled from the mouth and nasopharynx of healthcare workers during surgery, thereby providing protection for the patient. However, there are several ways in which surgical face masks could potentially contribute to contamination of the surgical wound, e.g. by incorrect wear or by leaking air from the side of the mask due to poor string tension.
OBJECTIVES
To determine whether the wearing of disposable surgical face masks by the surgical team during clean surgery reduces postoperative surgical wound infection.
SEARCH METHODS
In December 2015, for this seventh update, we searched: The Cochrane Wounds Specialised Register; The Cochrane Central Register of Controlled Trials; Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE and EBSCO CINAHL. We also searched the bibliographies of all retrieved and relevant publications. There were no restrictions with respect to language, date of publication or study setting.
SELECTION CRITERIA
Randomised controlled trials (RCTs) and quasi-randomised controlled trials comparing the use of disposable surgical masks with the use of no mask.
DATA COLLECTION AND ANALYSIS
Two review authors extracted data independently.
MAIN RESULTS
We included three trials, involving a total of 2106 participants. There was no statistically significant difference in infection rates between the masked and unmasked group in any of the trials. We identified no new trials for this latest update.
AUTHORS' CONCLUSIONS
From the limited results it is unclear whether the wearing of surgical face masks by members of the surgical team has any impact on surgical wound infection rates for patients undergoing clean surgery.
Topics: Disposable Equipment; Humans; Masks; Randomized Controlled Trials as Topic; Surgical Wound Infection
PubMed: 27115326
DOI: 10.1002/14651858.CD002929.pub3 -
Deutsches Arzteblatt International Feb 2021Since the beginning of 2020 the SARS-CoV-2 virus has spread to nearly every country in the world. The mainly airborne pathogen has led to large numbers of deaths,... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Since the beginning of 2020 the SARS-CoV-2 virus has spread to nearly every country in the world. The mainly airborne pathogen has led to large numbers of deaths, principally in elderly and vulnerable segments of the population. Protective vaccines have recently become available, but it is not yet clear whether and when population-wide immunity will be achieved. The existence of evidence for the protective effect of masks covering the mouth and nose is a topic of public debate.
METHODS
A selective literature search was carried out in PubMed. Data from the German Robert Koch Institute and the Centers for Disease Control and Prevention were also taken into account.
RESULTS
When talking, as many as 20 000 droplets ranging in size from 20 to 500 μM are released every second. According to PCR tests, the amount of virus exhaled is highest immediately before the onset of symptoms. No randomized trials have been conducted on the effect of masks covering the mouth and nose. A metaanalysis of 29 studies on infection with SARS-CoV-2, SARS, or MERS revealed that type N-95 masks (corresponding approximately to FFP-2), surgical masks, or similar multilayer cotton masks can greatly reduce the infection risk for the wearers (RR 0.34 [0.26; 0.45], with moderate heterogeneity [I2 = 48%]). Model experiments and case reports suggest that masks covering the mouth and nose afford considerable protection against transmission of SARS-CoV-2 and other airborne diseases by reducing release of and exposure to potentially infectious droplets; in addition, infections that do occur take a milder course. A limitation of the studies analyzed is that in most cases, this effect cannot be viewed in isolation from the protective impact of other measures (distancing, hygiene precautions).
CONCLUSION
It can plausibly be assumed that consistent use of masks covering the mouth and nose can play an important role in containing the spread of SARSCoV- 2.
Topics: Aged; COVID-19; Humans; Masks; SARS-CoV-2; United States
PubMed: 33785117
DOI: 10.3238/arztebl.m2021.0119 -
Frontiers in Public Health 2022Face coverings and distancing as preventative measures against the spread of the Coronavirus disease 2019 may impact communication in several ways that may...
INTRODUCTION
Face coverings and distancing as preventative measures against the spread of the Coronavirus disease 2019 may impact communication in several ways that may disproportionately affect people with hearing loss. A scoping review was conducted to examine existing literature on the impact of preventative measures on communication and to characterize the clinical implications.
METHOD
A systematic search of three electronic databases (Scopus, PubMed, CINAHL) was conducted yielding 2,158 articles. After removing duplicates and screening to determine inclusion eligibility, key data were extracted from the 50 included articles. Findings are reported following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Extension for Scoping Reviews, including the PRISMA-ScR checklist.
RESULTS
Studies fell into three categories: Studies addressing the impacts of personal protective equipment (PPE) and/or distancing on communication in healthcare contexts ( = 20); studies examining the impact of preventative measures on communication in everyday life ( = 13), and studies measuring the impact of face coverings on speech using acoustic and/or behavioral measures ( = 29). The review revealed that masks disrupt verbal and non-verbal communication, as well as emotional and social wellbeing and they impact people with hearing loss more than those without. These findings are presumably because opaque masks attenuate sound at frequencies above 1 kHz, and conceal the mouth and lips making lipreading impossible, and limit visibility of facial expressions. While surgical masks cause relatively little sound attenuation, transparent masks and face shields are highly attenuating. However, they are preferred by people with hearing loss because they give access to visual cues.
CONCLUSION
Face coverings and social distancing has detrimental effects that extend well beyond verbal and non-verbal communication, by affecting wellbeing and quality of life. As these measures will likely be part of everyday life for the foreseeable future, we propose that it is necessary to support effective communication, especially in healthcare settings and for people with hearing loss.
Topics: COVID-19; Communication; Humans; Masks; Quality of Life; SARS-CoV-2
PubMed: 35419343
DOI: 10.3389/fpubh.2022.815259 -
Asia-Pacific Journal of Ophthalmology... Sep 2022This study aimed to summarize the latest literature on the trends and incidence of ocular trauma during the COVID-19 pandemic. (Meta-Analysis)
Meta-Analysis
PURPOSE
This study aimed to summarize the latest literature on the trends and incidence of ocular trauma during the COVID-19 pandemic.
DESIGN
Systematic review and meta-analysis.
METHODS
A systematic literature search was conducted to identify the relevant literature. The search period was between January 1, 2020, and September 20, 2021. The incidence of overall and various types of ocular trauma during the COVID-19 pandemic and the control period was analyzed. The data from different studies were pooled. The odds ratio (OR) and 95% confidence interval (CI) were calculated.
RESULTS
A total of 32 articles were included. After pooling the data from all included studies, the incidence of total and pediatric ocular trauma during the COVID-19 pandemic was 67.7% and 54.3% of those in the control period, respectively. However, the proportion of ocular trauma in eye emergency visits increased during the pandemic (OR, 95% CI: 1.46, 1.04-2.06). The proportion of domestic ocular trauma increased (OR, 95% CI: 3.42, 1.01-11.62), while ocular trauma related to sports and outdoor activities and occupational ocular trauma decreased (OR, 95% CI: 0.64, 0.09-4.29 and 0.18, 0.10-0.33, respectively). It was also reported that chemical injury caused by alcohol-based sanitizers, photokeratitis caused by ultraviolet lamps, and mechanical eye injury caused by masks increased during the COVID-19 pandemic.
CONCLUSIONS
There was a reduction in overall eye injuries and substantial differences in the spectrum of ocular trauma during the COVID-19 pandemic. Proper health education and supervision should be strengthened to prevent ocular injuries related to COVID-19 preventive interventions.
Topics: COVID-19; Child; Eye Injuries; Humans; Incidence; Masks; Pandemics
PubMed: 36094376
DOI: 10.1097/APO.0000000000000539