Abstract:
This rapid systematic review of evidence asks whether (i) wearing a face mask, (ii) one type of mask over another and (iii) mandatory mask policies can reduce the transmission of SARS-CoV-2 infection, either in community-based or healthcare settings. A search of studies published 1 January 2020-27 January 2023 yielded 5185 unique records. Due to a paucity of randomized controlled trials (RCTs), observational studies were included in the analysis. We analysed 35 studies in community settings (three RCTs and 32 observational) and 40 in healthcare settings (one RCT and 39 observational). Ninety-five per cent of studies included were conducted before highly transmissible Omicron variants emerged. Ninety-one per cent of observational studies were at \'critical\' risk of bias (ROB) in at least one domain, often failing to separate the effects of masks from concurrent interventions. More studies found that masks (n = 39/47; 83%) and mask mandates (n = 16/18; 89%) reduced infection than found no effect (n = 8/65; 12%) or favoured controls (n = 1/65; 2%). Seven observational studies found that respirators were more protective than surgical masks, while five found no statistically significant difference between the two mask types. Despite the ROB, and allowing for uncertain and variable efficacy, we conclude that wearing masks, wearing higher quality masks (respirators), and mask mandates generally reduced SARS-CoV-2 transmission in these study populations. This article is part of the theme issue \'The effectiveness of non-pharmaceutical interventions on the COVID-19 pandemic: the evidence\'.
摘要:
这种对证据的快速系统审查询问(i)是否戴口罩,(ii)一种口罩胜过另一种口罩,(iii)强制性口罩政策可以减少SARS-CoV-2感染的传播,在社区或医疗保健环境中。对2020年1月1日至2023年1月27日发表的研究进行搜索,得出5185条独特记录。由于缺乏随机对照试验(RCT),观察性研究纳入分析.我们分析了社区环境中的35项研究(3项RCT和32项观察性研究)和医疗保健环境中的40项研究(1项RCT和39项观察性研究)。包括的研究中有95%是在高度传播的Omicron变体出现之前进行的。91%的观察性研究在至少一个领域处于“关键”偏倚风险(ROB),通常无法将口罩的影响与并发干预措施分开。更多的研究发现,口罩(n=39/47;83%)和口罩要求(n=16/18;89%)比没有效果(n=8/65;12%)或偏爱对照(n=1/65;2%)减少了感染。七项观察性研究发现,呼吸器比外科口罩更具保护性,而五个发现两种面罩类型之间没有统计学上的显著差异。尽管有ROB,考虑到不确定和可变的功效,我们得出的结论是戴着面具,戴更高质量的口罩(呼吸器),在这些研究人群中,口罩的要求通常会减少SARS-CoV-2的传播。本文是“非药物干预对COVID-19大流行的有效性:证据”主题的一部分。