TY - JOUR
T1 - Major Update
T2 - Masks for Prevention of SARS-CoV-2 in Health Care and Community Settings-Final Update of a Living, Rapid Review
AU - Chou, Roger
AU - Dana, Tracy
PY - 2023/6/1
Y1 - 2023/6/1
N2 - 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.None.
AB - 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.None.
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U2 - 10.7326/M23-0570
DO - 10.7326/M23-0570
M3 - Article
C2 - 37186920
AN - SCOPUS:85163921384
SN - 0003-4819
VL - 176
SP - 827
EP - 835
JO - Annals of internal medicine
JF - Annals of internal medicine
IS - 6
ER -