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.
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.
Authors: Allison E Aiello; Vanessa Perez; Rebecca M Coulborn; Brian M Davis; Monica Uddin; Arnold S Monto Journal: PLoS One Date: 2012-01-25 Impact factor: 3.240
Authors: Choon Ok Kim; Chung Mo Nam; Duk-Chul Lee; Joon Chang; Ji Won Lee Journal: Influenza Other Respir Viruses Date: 2011-12-08 Impact factor: 4.380
Authors: Anna Davies; Katy-Anne Thompson; Karthika Giri; George Kafatos; Jimmy Walker; Allan Bennett Journal: Disaster Med Public Health Prep Date: 2013-08 Impact factor: 1.385
Authors: Calistus N Ngonghala; Enahoro Iboi; Steffen Eikenberry; Matthew Scotch; Chandini Raina MacIntyre; Matthew H Bonds; Abba B Gumel Journal: Math Biosci Date: 2020-05-01 Impact factor: 2.144
Authors: Lloyd A C Chapman; Margot Kushel; Sarah N Cox; Ashley Scarborough; Caroline Cawley; Trang Q Nguyen; Isabel Rodriguez-Barraquer; Bryan Greenhouse; Elizabeth Imbert; Nathan C Lo Journal: BMC Med Date: 2021-05-07 Impact factor: 8.775
Authors: Sahar Motallebi; Rex C Y Cheung; Babak Mohit; Shahram Shahabi; Amir Alishahi Tabriz; Syamak Moattari Journal: Am J Prev Med Date: 2021-11-11 Impact factor: 5.043
Authors: Michał Ginszt; Grzegorz Zieliński; Jacek Szkutnik; Marcin Wójcicki; Michał Baszczowski; Monika Litko-Rola; Ingrid Rózyło-Kalinowska; Piotr Majcher Journal: J Clin Med Date: 2022-01-07 Impact factor: 4.241