N95 Respirators vs Medical Masks for Preventing Influenza Among Health Care Personnel

Radonovich, Lewis J.; Simberkoff, Michael S.; Bessesen, Mary; Brown, Alexandria C.; Cummings, Derek A. T.; Gaydos, Charlotte A.; Los, Jenna; Krosche, Amanda; Gibert, Cynthia L.; Gorse, Geoffrey J.; Nyquist, Ann Christine; Reich, Nicholas G.; Rodriguez‐Barradas, Maria C.; Price, Connie S.; Perl, Trish M.

doi:10.1001/jama.2019.11645

Cited by 456 publications

(467 citation statements)

References 33 publications

(56 reference statements)

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“…A randomized clinical trial has reported that the N95 respirators vs medical masks resulted in no significant difference in the incidence of laboratory confirmed influenza [4]. In our study, we observed that the N95 respirators, disinfection and hand washing appeared to help reduce the infectious risk of 2019-nCoV in doctors and nurses.…”

mentioning

confidence: 44%

Association between 2019-nCoV transmission and N95 respirator use

Wang

Pan

Cheng

2020

Journal of Hospital Infection

187

152

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University. Medical staff (doctors and nurses) followed differential routines of occupational protection: (a) staff at the Departments of Respiratory Medicine, ICU, and Infectious Disease (mainly quarantined area) wore N95 respirators, and disinfected and cleaned their hands frequently (the N95 group); (b) medical staff in the other three departments wore no medical masks, and disinfected and cleaned their hands only occasionally (the no-mask group). The difference was because the latter departments were not considered to be high risk in the early days of the outbreak.Suspected cases of 2019-nCoV infection was investigated by chest CT, and confirmed by molecular diagnosis. In total, 28 and 58 patients had confirmed and suspicious 2019-nCov-infection. Patient exposure was significantly higher for the N95 group compared to no-mask group (for confirmed patients: difference: 733%; exposure odds ratio: 8.33, Table I).Among the 493 medical staff, none of 278 (56 doctors and 222 nurses) in the N95 group became infected, compared with 10 of 213 (77 doctors and 136 nurses) from the no-mask group were confirmed infected ( Table I). Regardless of their lower risk of exposure, the 2019-nCoV infection rate for medical staff was significantly increased in the no-mask group compared with the N95 respirator group (difference: 4.65%, [95% CI: 1.75%-infinite]; P<2.2e-16) (adjusted odds ratio (OR): 464.82, [95% CI: 97.73-infinite]; P<2.2e-16). Likewise, we analyzed the medical staff infection data from Huangmei People's Hospital (12 confirmed patients) and Qichun People's Hospital (11 confirmed patients), and have observed the similar phenomenon. No medical staff wearing the N95 respirators and following routines of frequent disinfection and hand washing were infected by 2019-nCoV up until 22 nd January 2020.A randomized clinical trial has reported that the N95 respirators vs medical masks resulted in no significant difference in the incidence of laboratory confirmed influenza 4 . In our study, we observed that the N95 respirators, disinfection and hand washing appear to help reduce the infectious risk of 2019-nCoV in doctors and nurses.Interestingly, departments with a high proportion of male doctors seemed to have a higher risk of infection. Our results emphasize the need for strict occupational protection measures in fighting COVID-19.

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mentioning

confidence: 44%

Association between 2019-nCoV transmission and N95 respirator use

Wang

Pan

Cheng

2020

Journal of Hospital Infection

187

152

View full text Add to dashboard Cite

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“…A randomized clinical trial has reported N95 respirators vs medical masks as worn by participants in this trial resulted in no significant difference in the incidence of laboratory confirmed influenza. 4 In our study, we found N95 respirators, disinfection and hand washing can help to reduce the risk of 2019-nCoV infection in medical staffs. Interestingly, department with a high proportion of male doctors seem to have a higher risk of infection.…”

Section: Suspicious Cases Of 2019-ncov Infection Wasmentioning

confidence: 63%

Association between 2019-nCoV transmission and N95 respirator use

Wang

Pan

Cheng

2020

Preprint

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“…RCTs comparing N95 respirators to medical masks in health care personnel working in outpatient and ward settings have not shown significant differences in protection from laboratory-confirmed influenza or other RVIs [72,73]. The relevance of these observations to the ICU setting is uncertain, given the frequent use of aerosol-generating procedures in critically ill patients.…”

Section: Infection Prevention and Controlmentioning

confidence: 99%

Critical care management of adults with community-acquired severe respiratory viral infection

2020

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With the expanding use of molecular assays, viral pathogens are increasingly recognized among critically ill adult patients with community-acquired severe respiratory illness; studies have detected respiratory viral infections (RVIs) in 17-53% of such patients. In addition, novel pathogens including zoonotic coronaviruses like the agents causing Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS) and the 2019 novel coronavirus (2019 nCoV) are still being identified. Patients with severe RVIs requiring ICU care present typically with hypoxemic respiratory failure. Oseltamivir is the most widely used neuraminidase inhibitor for treatment of influenza; data suggest that early use is associated with reduced mortality in critically ill patients with influenza. At present, there are no antiviral therapies of proven efficacy for other severe RVIs. Several adjunctive pharmacologic interventions have been studied for their immunomodulatory effects, including macrolides, corticosteroids, cyclooxygenase-2 inhibitors, sirolimus, statins, anti-influenza immune plasma, and vitamin C, but none is recommended at present in severe RVIs. Evidence-based supportive care is the mainstay for management of severe respiratory viral infection. Non-invasive ventilation in patients with severe RVI causing acute hypoxemic respiratory failure and pneumonia is associated with a high likelihood of transition to invasive ventilation. Limited existing knowledge highlights the need for data regarding supportive care and adjunctive pharmacologic therapy that is specific for critically ill patients with severe RVI. There is a need for more pragmatic and efficient designs to test different therapeutics both individually and in combination.

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N95 Respirators vs Medical Masks for Preventing Influenza Among Health Care Personnel

Cited by 456 publications

References 33 publications

Association between 2019-nCoV transmission and N95 respirator use

Association between 2019-nCoV transmission and N95 respirator use

Association between 2019-nCoV transmission and N95 respirator use

Critical care management of adults with community-acquired severe respiratory viral infection

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