Annals of Internal MedicineMajor Update: Masks for Prevention of SARS-CoV-2 in Health Care and Community Settings—Final Update of a Living, Rapid Review

Let’s delve into the complexity of mask effectiveness against SARS-CoV-2 in diverse settings.

Debate rages on about optimal mask use for COVID-19 prevention. This trial takes a fresh look at the issue. It evaluates N95, surgical, and cloth masks in preventing SARS-CoV-2 infections.

The team sourced data from MEDLINE, EMBASE, and medRxiv. They also scanned relevant reference lists. They selected randomized trials and observational studies. These studies increased mask use and controlled for confounding factors in assessing SARS-CoV-2 infection risk.

Two investigators carried out the data extraction process. They carefully abstracted data from each study and evaluated its quality. Their efforts resulted in the inclusion of three randomized trials and 21 observational studies.

Evidence from two trials and seven studies points to a possible reduction in SARS-CoV-2 infection risk through mask use in community settings. Despite this, observational studies failed to provide sufficient evidence for other mask comparisons due to methodological inconsistencies.

In routine patient care settings, one new trial and four studies indicated comparable infection risk between surgical masks and N95 respirators. However, the study couldn’t disregard the potential beneficial effects of N95 respirators.

Yet, several limitations cloud these findings. These include a limited number of randomized trials, methodological imprecision, and suboptimal adherence in trials. Limited evidence on potential harms, concerns about applicability to the Omicron variant era, and English language restriction also restricted the study.

In conclusion, masks may slightly reduce SARS-CoV-2 infection risk in community settings. Surgical masks and N95 respirators may offer similar protection in routine patient care settings. Nevertheless, N95 respirators’ potential benefits cannot be dismissed outright.

Editorial on the Study
Getting to the Truth About the Effectiveness of Masks in Preventing COVID-19

Opinion on the Study
For Patient Safety, It Is Not Time to Take Off Masks in Health Care Settings