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Abstract：
OBJECTIVE: With the epidemic of coronavirus disease 2019 (COVID-19), the healthcare workers (HCWs) require proper respiratory personal protective equipment (rPPE) against viral respiratory infectious diseases (VRIDs). It is necessary to evaluate which type of mask and manner of wearing is the best suitable rPPE for preventing the VRID.
METHODS: A Bayesian network meta-analysis was performed to comprehensively analyze the protective efficacy of various rPPE.
METHODS: This network meta-analysis protocol was registered in an international prospective register of systematic reviews (CRD42020179489). Electronic databases were searched for cluster randomized control trials (RCTs) of comparing the effectiveness of rPPE and wearing manner in preventing HCWs from VRID. The primary outcome was the incidence of laboratory-confirmed viral respiratory infection reported as an odds ratio (OR) with the associated 95% credibility interval (CrI). The secondary outcome was the incidence of clinical respiratory illness (CRI) reported as an OR with the associated 95% CrI. Surface under the cumulative ranking curve analysis (SUCRA) provided a ranking of each rPPE according to the primary outcome and the secondary outcome as data supplement.
RESULTS: Six studies encompassing 12,265 HCWs were included. In terms of the incidence of laboratory-confirmed viral respiratory infection, the continuous wearing of N95 respirators (network OR, 0.48; 95% CrI: 0.27 to 0.86; SUCRA score, 85.4) showed more effective than the control group. However, in terms of reducing the incidence of CRI, there was no rPPE showing superior protective effectiveness.
CONCLUSIONS: There are significant differences in preventive efficacy among current rPPE. Our result suggests that continuous wearing of N95 respirators on the whole shift can serve as the best preventive rPPE for HCWs from the VRID.
METHODS: A Bayesian network meta-analysis was performed to comprehensively analyze the protective efficacy of various rPPE.
METHODS: This network meta-analysis protocol was registered in an international prospective register of systematic reviews (CRD42020179489). Electronic databases were searched for cluster randomized control trials (RCTs) of comparing the effectiveness of rPPE and wearing manner in preventing HCWs from VRID. The primary outcome was the incidence of laboratory-confirmed viral respiratory infection reported as an odds ratio (OR) with the associated 95% credibility interval (CrI). The secondary outcome was the incidence of clinical respiratory illness (CRI) reported as an OR with the associated 95% CrI. Surface under the cumulative ranking curve analysis (SUCRA) provided a ranking of each rPPE according to the primary outcome and the secondary outcome as data supplement.
RESULTS: Six studies encompassing 12,265 HCWs were included. In terms of the incidence of laboratory-confirmed viral respiratory infection, the continuous wearing of N95 respirators (network OR, 0.48; 95% CrI: 0.27 to 0.86; SUCRA score, 85.4) showed more effective than the control group. However, in terms of reducing the incidence of CRI, there was no rPPE showing superior protective effectiveness.
CONCLUSIONS: There are significant differences in preventive efficacy among current rPPE. Our result suggests that continuous wearing of N95 respirators on the whole shift can serve as the best preventive rPPE for HCWs from the VRID.
摘要：
目标：随着2019年冠状病毒病（COVID-19）的流行，医护人员（HCWs）需要适当的个人呼吸防护设备（rPPE），以防止病毒性呼吸道传染病（VRID）。有必要评估哪种类型的面罩和佩戴方式是最适合防止VRID的rPPE。
方法：进行贝叶斯网络荟萃分析，以综合分析各种rPPE的保护功效。
方法：该网络荟萃分析方案已在国际前瞻性系统评价登记册（CRD42020179489）中注册。在电子数据库中搜索集群随机对照试验（RCT），以比较rPPE和穿着方式预防HCWVRID的有效性。主要结果是实验室确认的病毒性呼吸道感染的发生率，报告为比值比（OR），相关的95％可信区间（CrI）。次要结果是临床呼吸系统疾病（CRI）的发生率，报告为OR，相关的95％CrI。累积排名曲线分析（SUCRA）下的表面根据主要结果和次要结果提供了每个rPPE的排名作为数据补充。
结果：纳入了包括12,265例HCWs的6项研究。就实验室证实的病毒性呼吸道感染的发病率而言，N95呼吸器的连续佩戴(网络或，0.48；95%CrI：0.27至0.86；SUCRA评分，85.4）显示比对照组更有效。然而,在减少CRI的发生率方面，无rPPE表现出优异的保护效果.
结论：目前rPPE的预防效果存在显著差异。我们的结果表明，在整个班次中连续佩戴N95呼吸器可以作为VRID中HCW的最佳预防性rPPE。
方法：进行贝叶斯网络荟萃分析，以综合分析各种rPPE的保护功效。
方法：该网络荟萃分析方案已在国际前瞻性系统评价登记册（CRD42020179489）中注册。在电子数据库中搜索集群随机对照试验（RCT），以比较rPPE和穿着方式预防HCWVRID的有效性。主要结果是实验室确认的病毒性呼吸道感染的发生率，报告为比值比（OR），相关的95％可信区间（CrI）。次要结果是临床呼吸系统疾病（CRI）的发生率，报告为OR，相关的95％CrI。累积排名曲线分析（SUCRA）下的表面根据主要结果和次要结果提供了每个rPPE的排名作为数据补充。
结果：纳入了包括12,265例HCWs的6项研究。就实验室证实的病毒性呼吸道感染的发病率而言，N95呼吸器的连续佩戴(网络或，0.48；95%CrI：0.27至0.86；SUCRA评分，85.4）显示比对照组更有效。然而,在减少CRI的发生率方面，无rPPE表现出优异的保护效果.
结论：目前rPPE的预防效果存在显著差异。我们的结果表明，在整个班次中连续佩戴N95呼吸器可以作为VRID中HCW的最佳预防性rPPE。
