Effect of face mask on voice production during COVID-19 pandemic: A systematic review

Background: Evidence is needed on the effectiveness of wearing face masks in the community to prevent SARS-CoV-2 transmission.Methods: Systematic review and meta-analysis to investigate the efficacy and effectiveness of face mask use in a community setting and to predict the effectiveness of wearing a mask. We searched MEDLINE, EMBASE, SCISEARCH, The Cochrane Library, and pre-prints from inception to 22 April 2020 without restriction by language. We rated the certainty of evidence according to Cochrane and GRADE approach.Findings: Our search identified 35 studies, including three randomized controlled trials (RCTs) (4,017 patients), 10 comparative studies (18,984 patients), 13 predictive models, nine laboratory experimental studies. For reducing infection rates, the estimates of cluster-RCTs were in favor of wearing face masks vs. no mask, but not at statistically significant levels (adjusted OR 0.90, 95% CI 0.78–1.05). Similar findings were reported in observational studies. Mathematical models indicated an important decrease in mortality when the population mask coverage is near-universal, regardless of mask efficacy. In the best-case scenario, when the mask efficacy is at 95%, the R0 can fall to 0.99 from an initial value of 16.90. Levels of mask filtration efficiency were heterogeneous, depending on the materials used (surgical mask: 45–97%). One laboratory study suggested a viral load reduction of 0.25 (95% CI 0.09–0.67) in favor of mask vs. no mask.Interpretation: The findings of this systematic review and meta-analysis support the use of face masks in a community setting. Robust randomized trials on face mask effectiveness are needed to inform evidence-based policies.PROSPERO registration: CRD42020184963.

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Efficacy of face mask in preventing respiratory virus transmission: A systematic review and meta-analysis

Travel Medicine and Infectious Disease ◽

10.1016/j.tmaid.2020.101751 ◽

2020 ◽

Vol 36 ◽

pp. 101751 ◽

Cited By ~ 44

Author(s):

Mingming Liang ◽

Liang Gao ◽

Ce Cheng ◽

Qin Zhou ◽

John Patrick Uy ◽

...

Keyword(s):

Systematic Review ◽

Respiratory Virus ◽

Meta Analysis ◽

Virus Transmission ◽

Face Mask

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Face mask use in the Community for Reducing the Spread of COVID-19: a systematic review

10.1101/2020.08.25.20181651 ◽

2020 ◽

Author(s):

Daniela Coclite ◽

Antonello Napoletano ◽

Silvia Gianola ◽

Andrea Del Monaco ◽

Daniela D'Angelo ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Experimental Studies ◽

Community Setting ◽

Face Mask ◽

Cochrane Library ◽

Case Scenario ◽

Materials Used ◽

Randomised Controlled ◽

The Cochrane Library

Background: Evidence is needed on the effectiveness of wearing face masks in the community to prevent SARS-CoV-2 transmission. Methods: Systematic review and meta-analysis to investigate the efficacy and effectiveness of face mask use in a community setting and to predict the effectiveness of wearing a mask. We searched MEDLINE, EMBASE, SCISEARCH, The Cochrane Library and pre-prints from inception to 22 April 2020 without restriction by language. We rated the certainty of evidence according to Cochrane and GRADE approach. Findings: Our search identified 35 studies, including 3 randomised controlled trials (RCTs) (4017 patients), 10 comparative studies (18984 patients), 13 predictive models, 9 laboratory experimental studies. For reducing infection rates, the estimates of cluster-RCTs were in favour of wearing face masks versus no mask, but not at statistically significant levels (adjusted OR 0.90, 95%CI 0.78-1.05). Similar findings were reported in observational studies. Mathematical models indicated an important decrease in mortality when the population mask coverage is near-universal, regardless of mask efficacy. In the best-case scenario, when the mask efficacy is at 95%, the R0 can fall to 0.99 from an initial value of 16.90. Levels of mask filtration efficiency were heterogeneous, depending on the materials used (surgical mask: 45-97%). One laboratory study suggested a viral load reduction of 0.25 (95%CI 0.09-0.67) in favour of mask versus no mask. Interpretation: The findings of this systematic review and meta-analysis support the use of face masks in a community setting. Robust randomised trials on face mask effectiveness are needed to inform evidence-based policies.

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Effect of face mask use on cardioventilatoryand performance parameters: a systematic review

10.25242/8868113820212411 ◽

2021 ◽

Author(s):

Mayara Jeronymo Uébe Mansur ◽

Bárbara Vieira Bolckau Miranda ◽

Paloma Priscila Porreca ◽

Victor Paes Dias Gonçalves ◽

Anderson Pontes Morales ◽

...

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Face Mask ◽

Performance Parameters ◽

Public Places ◽

Surgical Masks ◽

Significant Difference ◽

Physiological Impact ◽

And Performance ◽

The Impact

The main way to combat and prevent the spread of COVID-19 is through the use of face masksin all situations, whether in public places or workspaces and also during physical activity or exercise. However, recommendations for the use of face masks during exercise vary globally and the physiological impact of using tissue or surgical masks duringthis activity is not well understood. Thus, the objective of this work is to carry out a systematic review to investigate the impact of using a mask during physical activity or exercise in the parameters: ventilatory, physiological, and performance. A structured search was performed following the guidelines of the Preferred Reporting Items for Systematic Review (PRISMA) in the Medline / PubMed and Web of Science, Scopus and Bireme / Lilacs / BVS databases until May 2021. Seven published studies were included in the systematic review. All studies were randomized controlled and crossover clinical trials, seven studies used a surgical mask in their analysis, three studies used a P95 mask, and two studies used a cloth mask. When analyzing the results, four studies showed no significant difference in the use of surgical masks in relation to performance, ventilatory and hemodynamic function parameters; three studies showed a significant worsening with the condition of using a mask in ventilatory, cardiorespiratoryand performance parameters. It was concluded that the findings of the evaluated studies showed divergences in ventilatory, physiological and performance parameters. It is believed that it may be related to the types of exercise protocols used in the assessment. In addition, the study methods had a low risk of bia

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Rapid systematic review of neonatal COVID-19 including a case of presumed vertical transmission

BMJ Paediatrics Open ◽

10.1136/bmjpo-2020-000718 ◽

2020 ◽

Vol 4 (1) ◽

pp. e000718 ◽

Cited By ~ 4

Author(s):

Morris Gordon ◽

Taher Kagalwala ◽

Karim Rezk ◽

Chris Rawlingson ◽

M Idris Ahmed ◽

...

Keyword(s):

Systematic Review ◽

Vertical Transmission ◽

Systematic Reviews ◽

Neonatal Infection ◽

Face Mask ◽

Premature Baby ◽

Risk Of Bias ◽

Teaching Hospitals ◽

Rt Pcr ◽

Ongoing Research

ObjectiveTo carry out a systematic review of the available studies on COVID-19 (coronavirus disease 2019) in neonates seen globally since the onset of the COVID-19 global pandemic in 2020. The paper also describes a premature baby with reverse transcription (RT)-PCR-positive COVID-19 seen at the Blackpool Teaching Hospitals NHS Foundation Trust, UK.DesignWe conducted a multifaceted search of the Cumulative Index to Nursing and Allied Health Literature, Embase, Medline and PubMed from 1 December 2019 to 12 May 2020 to harvest articles from medical journals and publications reporting cases of COVID-19 in neonates from anywhere in the world. Additional searches were also done so as not to miss any important publications. Write-up was in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, the protocol for the review was registered with International Prospective Register of Systematic Reviews (PROSPERO), and risk of bias was analysed with the Newcastle-Ottawa tool. Additionally, the preterm neonate with COVID-19 from our hospital is also reported.ResultsThe systematic review has revealed eight studies where neonates have been described to have confirmed COVID-19, with low risk of bias. Of the 10 reported cases elsewhere, only three are likely to be vertically transmitted, while seven occurred in the postperinatal period and are likely to have been postnatally acquired. All neonates had a mild course, recovered fully and were negative on retesting. Our case of COVID-19 in a 32-week premature baby from the UK was delivered by emergency caesarean section, with the mother wearing a face mask and the family having no contact with the neonate, suggesting vertical transmission. On day 33, the neonate was asymptomatic but was still RT-PCR-positive on nasopharyngeal airway swab.ConclusionsNeonatal infection is uncommon, with only two previously reported cases likely to be of vertical transmission. The case we report is still RT-PCR-positive on day 28 and is asymptomatic. Ongoing research is needed to ascertain the epidemiology of COVID-19 in neonates.

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Systematic Review of Capnography with Mask Ventilation during Cardiopulmonary Resuscitation Maneuvers

Journal of Clinical Medicine ◽

10.3390/jcm8030358 ◽

2019 ◽

Vol 8 (3) ◽

pp. 358 ◽

Cited By ~ 1

Author(s):

Francisco Cereceda-Sánchez ◽

Jesús Molina-Mula

Keyword(s):

Systematic Review ◽

Cardiopulmonary Resuscitation ◽

Randomized Clinical Trials ◽

Face Mask ◽

Cochrane Library ◽

Mask Ventilation ◽

Airway Patency ◽

Lung Aeration ◽

Adults And Children ◽

Different Sources

The latest guidelines identify capnography as an instrument used to assess bag-valve-mask ventilation during cardiopulmonary resuscitation (CPR). In this review, we analyzed the feasibility and reliability of capnography use with face mask ventilation during CPR maneuvers in adults and children. This systematic review was completed in December 2018; data for the study were obtained from the following databases: EBSCOhost, SCOPUS, PubMed, Índice Bibliográfico Español en Ciencias de la Salud (IBECS), TESEO, and Cochrane Library Plus. Two reviewers independently assessed the eligibility of the articles; we analyzed publications from different sources and identified studies that focused on the use of capnography with a face mask during CPR maneuvers in order to describe the capnometry value and its correlation with resuscitation outcomes and the assistance of professionals. A total of 888 papers were collected, and 17 papers were included that provided objective values for the use of capnography with a mask for ventilation. Four were randomized clinical trials (RCT) and the rest were observational studies. Four studies were completed in adults and 13 were completed in newborns. After the analysis of the papers, we recommended a capnographic level of C in adults and B in newborns. Despite the little evidence obtained, capnography has been demonstrated to facilitate the advanced clinical practice of mask ventilation in cardiopulmonary resuscitation, to be reliable in the early detection of heart rate increase in newborns, and to asses in-airway patency and lung aeration during newborn resuscitation.

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Face masks to prevent transmission of respiratory diseases: Systematic review and meta-analysis of randomized controlled trials*

10.1101/2020.07.31.20166116 ◽

2020 ◽

Cited By ~ 1

Author(s):

Hanna M. Ollila ◽

Markku Partinen ◽

Jukka Koskela ◽

Riikka Savolainen ◽

Anna Rotkirch ◽

...

Keyword(s):

Systematic Review ◽

Randomized Controlled Trials ◽

Respiratory Infections ◽

Meta Analysis ◽

Age Groups ◽

Face Mask ◽

Controlled Trials ◽

Randomized Controlled ◽

The Face ◽

Intent To Treat

AbstractObjectiveTo examine the effect of face mask intervention in respiratory infections across different exposure settings and age groups.DesignSystematic review and meta-analysis.Data sourcesPubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science were searched for randomized controlled trials investigating the effect of face masks on respiratory infections published by November 18th 2020. Our reporting follows the PRISMA guidelines.Eligibility criteria for selecting studiesRandomized controlled trials investigating the effect of face masks in respiratory infections and influenza-like illness across different exposure settings and age groups. Two reviewers independently performed the search, extracted the data, and assessed the risk of bias. A random effects meta-analysis with risk ratio, risk difference, and number needed to treat were performed. Findings in exposure settings, age groups, and role of non-compliance were examined using a subgroup analysis.ResultsTotal of 17 studies were included, with N = 11, 601 individuals in intervention and N = 10, 286 in the control group with follow-up duration from 4 days to 19 months). 14 trials included adults (and children) and 3 included children only. 12 studies suffered from non-compliance in the treatment arm and 11 in the control arm. All studies were intent-to-treat analyses, and, thus, non-compliance can bias individual intent-to-treat estimates towards zero. Four out of seventeen studies supported use of face masks. A meta-analysis of all 17 studies found no association between face mask intervention and respiratory infections (RR = 0.9046 [0.777 - 1.053], p = 0.196, p fixed effect = 0.0006). However, a meta-analysis using odds ratios adjusted for age, sex, and vaccination (when available) suggests protective effect of the face mask intervention (17 studies, OR = 0.850 [0.736 - 0.982], p=0.027). A subgroup meta-analysis among adults with (unadjusted) risk ratios found a decrease in respiratory infections (14 studies, RR = 0.859 [0.750 - 0.983], p = 0.026, and 4 studies with a combined face masks and hand hygiene intervention RR = 0.782 [0.696 - 0.879], p < 0.0001). Finally, the face mask use is also supported by a meta-regression adjusting the effect estimates for non-compliance in the controls (17 studies RR = 0.87 [0.780 - 0.980], p = 0.017).ConclusionOur findings support the use of face masks to prevent respiratory infections.

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Face Masks Use to Avoid Airborne Contamination during COVID-19 Pandemic and Related Conditions: A Systematic Review

Iranian Journal of Public Health ◽

10.18502/ijph.v50i12.7920 ◽

2021 ◽

Author(s):

Danúbia da Cunha De Sá-Caputo ◽

Ana Carolina Coelho-Oliveira ◽

Anelise Sonza ◽

Laisa Liane Paineiras-Domingos ◽

Redha Taiar ◽

...

Keyword(s):

Systematic Review ◽

Observational Studies ◽

English Language ◽

Face Mask ◽

Risk Of Bias ◽

Bacterial Suspension ◽

Level Of Evidence ◽

Airborne Contamination ◽

Different Types ◽

The Face

Background: The facemasks use has been discussed to prevent respiratory disease due airborne contamination. The aim of this study was to perform a systematic review about the face masks use to avoid airborne contamination during COVID-19 pandemic and related conditions, registered (PROSPERO-CRD42020198347) and performed according PRISMA. Methods: PubMed, Embase and Scopus databases were used to collect data. Observational studies, published in 2020, and English language, were included. Two reviewers independently identified records through database search and reference screening and disagreements were resolved by a third reviewer. Six studies were included. Results: The works investigated about the use of masks (different types) to prevent droplets dissemination with virus or bacterial suspension and decrease COVID-19 transmission routes, comfort, or temperature. The studies have moderate to critical risk of bias and the level of evidence is III-2. Conclusion: It is recommended facemask use to prevent droplets from escaping airborne and infecting other people, although there are different percentages of protection and can be possible a discomfort related the use. Further clinical trials to the effectiveness of face mask to avoid airborne contamination during the COVID-19 pandemic and the factors interfering with their effectiveness should be conducted.

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Downsides of face masks and possible mitigation strategies: a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-044364 ◽

2021 ◽

Vol 11 (2) ◽

pp. e044364

Author(s):

Mina Bakhit ◽

Natalia Krzyzaniak ◽

Anna Mae Scott ◽

Justin Clark ◽

Paul Glasziou ◽

...

Keyword(s):

Systematic Review ◽

Data Extraction ◽

Meta Analysis ◽

Face Mask ◽

Open Science ◽

Mitigation Strategies ◽

Clinical Registries ◽

The Face ◽

Randomised Controlled ◽

New Research

ObjectiveTo identify, appraise and synthesise studies evaluating the downsides of wearing face masks in any setting. We also discuss potential strategies to mitigate these downsides.DesignSystematic review and meta-analysis.Data sourcesPubMed, Embase, CENTRAL and EuropePMC were searched (inception–18 May 2020), and clinical registries were searched via CENTRAL. We also did a forward–backward citation search of the included studies.Inclusion criteriaWe included randomised controlled trials and observational studies comparing face mask use to any active intervention or to control.Data extraction and analysisTwo author pairs independently screened articles for inclusion, extracted data and assessed the quality of included studies. The primary outcomes were compliance, discomforts, harms and adverse events of wearing face masks.ResultsWe screened 5471 articles, including 37 (40 references); 11 were meta-analysed. For mask wear adherence, 47% (95% CI 25% to 68%, p<0.0001), more people wore face masks in the face mask group compared with control; adherence was significantly higher (26%, 95% CI 8% to 46%, p<0.01) in the surgical/medical mask group than in N95/P2 group. The largest number of studies reported on the discomfort and irritation outcome (20 studies); fewest reported on the misuse of masks, and none reported on mask contamination or risk compensation behaviour. Risk of bias was generally high for blinding of participants and personnel and low for attrition and reporting biases.ConclusionsThere are insufficient data to quantify all of the adverse effects that might reduce the acceptability, adherence and effectiveness of face masks. New research on face masks should assess and report the harms and downsides. Urgent research is also needed on methods and designs to mitigate the downsides of face mask wearing, particularly the assessment of possible alternatives.Systematic review registrationOpen Science Framework website https://osf.io/sa6kf/ (timestamp 20-05-2020).

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