Efficacy of Face Mask in Preventing Respiratory Virus Transmission

Quick Takes

  • The protective effects of masks against respiratory viral infections were not only significant for both healthcare workers (HCWs) and non-HCWs, but also consistent between populations.
  • Based on available evidence, it makes sense to wear a mask for both HCWs and non-HCWs to contain the COVID-19 pandemic.

Study Questions:

What is the effectiveness of the use of masks to prevent laboratory-confirmed respiratory virus transmission, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)?

Methods:

The investigators performed this systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement methodology. Relevant articles were retrieved from PubMed, Web of Science, ScienceDirect, Cochrane Library, and Chinese National Knowledge Infrastructure (CNKI), VIP (Chinese) database.

Results:

Twenty-one studies met the inclusion criteria. Meta-analyses suggest that mask use provided a significant protective effect (odds ratio [OR], 0.35; 95% confidence interval [CI], 0.24–0.51). Use of masks by healthcare workers (HCWs) and non–healthcare workers (non-HCWs) can reduce the risk of respiratory virus infection by 80% (OR, 0.20; 95% CI, 0.11–0.37) and 47% (OR, 0.53; 95% CI, 0.36–0.79). The protective effect of wearing masks in Asia (OR, 0.31) appeared to be higher than that of Western countries (OR, 0.45). Masks had a protective effect against influenza viruses (OR, 0.55), SARS (OR, 0.26), and SARS-CoV-2 (OR, 0.04). In the subgroups based on different study designs, protective effects of wearing masks were significant in cluster randomized trials and observational studies.

Conclusions:

The authors concluded that this study adds additional evidence of the enhanced protective value of masks as an adjunctive method to contain the coronavirus disease 2019 (COVID-19) outbreak.

Perspective:

This meta-analysis of the 21 studies reports that the protective effects of masks against respiratory viral infections were not only significant for both HCWs and non-HCWs, but also consistent between Asian and Western populations. Of note, well-designed high-quality prospective studies and studies of masking in the general public are still insufficient. Also, other variables such as hand hygiene, age, gender, and culture, may affect the protective effect of masks. While additional evidence is required to better clarify the effectiveness of masks or face coverings in various circumstances, based on available data, it makes sense to wear a mask for both HCWs and non-HCWs to contain the COVID-19 pandemic.

Clinical Topics: Prevention

Keywords: Coronavirus, Coronavirus Infections, COVID-19, Health Personnel, Hand Hygiene, Influenza, Human, Masks, Primary Prevention, Severe Acute Respiratory Syndrome, severe acute respiratory syndrome coronavirus 2, Viral Interference


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