Associations Between Wearing Masks and Respiratory Viral Infections: A Meta-Analysis and Systematic Review

Abstract

BackgroundRespiratory viral infections (RVIs) are a major health concern, and some previous studies have shown that wearing masks was effective in preventing RVIs, while others failed to show such effect. Therefore, a systematic review and meta-analysis was conducted to investigate the effectiveness of wearing masks.MethodsPubMed, ScienceDirect, Web of Science, the Cochrane Library, EMBASE, MEDLINE, China National Knowledge Infrastructure (CNKI), and Chinese Scientific Journal Database (VIP database) were searched for studies evaluating the effectiveness of wearing masks. The risk ratio (RR) was used to measure the effectiveness of wearing masks in preventing RVIs for randomized controlled trials (RCTs) and cohort studies, and the odds ratio (OR) was used for case-control studies. Forest plots were used to visually assess pooled estimates and corresponding 95% CIs. The I2 test was used to examine the heterogeneity, and subgroup analysis was used to explore the possible explanations for heterogeneity or compare the results between subgroups. Sensitivity analysis was conducted to assess robustness of the synthesized results. Begg's test and Egger's test were used to assess the publications bias.ResultsThirty-one studies (13,329 participants) were eligible for meta-analyses. Overall, the results showed that wearing masks was effective in preventing RVIs. The sensitivity analysis showed that the results of those meta-analyses were robust and reliable. There was no significant publication bias in meta-analysis of case-control studies and most subgroup analyses.ConclusionsWearing masks might be effective in preventing RVIs. To reduce their RVI risk, people should wear masks when they go out in public.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42021296092.

Face mask use to prevent COVID‐19 in clinical practice. Using a review of reviews to improve decision‐making and transparency

“…The main risk of bias across the reviews was due to the times and databases searched, most notably Li et al (2021), Chen et al (2022) and Liang et al (2020) used Chinese as well as Western databases. Because the effect of not accessing Chinese data is not clear, this is considered to be an unclear risk of bias.…”

“…The main risk of bias across the reviews was due to the times and databases searched, most notably Li et al (2021), Chen et al (2022) and Liang et al (2020) used Chinese as well as Western databases.…”

Personal protective measures and settings on the risk of SARS-COV-2 community transmission: a case–control study

“…Consequently, we think that is relevant to investigate the effect of wearing a mask specifically in SARS-CoV-2 on the population. In terms of the optimal type of mask, a meta-analysis, found no benefit between different types of masks, with N95 and cloth masks obtaining similar results ( 17 ).…”

“…Family members and relatives were the main transmission agents of SARS-CoV-2, regardless of whether they shared accommodation with the persons infected (8). However, whilst a systematic review exploring secondary attack rate in different exposure settings highlighted the higher attack rate at homes, social circles, and workplaces (9), most studies focused only on one environment of exposure, such as hospitals or health centers (10)(11)(12)(13)(14)(15), households (16,17), educational centers (18), or public transport (19). Few studies describe the transmission of SARS-CoV-2 related to settings where routine activities such as working, or practicing sports and exercising are carried out, and fewer consider environmental characteristics (ventilation) or factors related to the exposure to the infective agent (exposure time, distancing, etc.…”

“…Wearing a facemask in public settings, maintaining social distance and hand washing are preventive measures and bundles of protective behaviors that had been used for SARS-COV-2 (16,(20)(21)(22), and other similar coronaviruses (23). Recent reviews concluded that the use of the face mask is effective in reducing the likelihood of transmission of respiratory pathogens that could include SARS-CoV-2, although most studies included were unrelated to this virus (16,17). Consequently, we think that is relevant to investigate the effect of wearing a mask specifically in SARS-CoV-2 on the population.…”