To Study Acute Changes in Brain Oxygenation on MRI in Healthcare Workers Using N95 Mask and PPE Kits for Six Hours a Day

Abstract

Background Due to long working hours wearing an N95 mask and PPE kit during the COVID-19 pandemic, the healthcare workers (HCWs) complained of headaches, confusion, and exhaustion. This study was therefore performed to study the changes in brain oxygenation. Aim To compare brain oxygenation in health care workers wearing an N95 mask with a PPE kit versus a three-ply mask during an intensive care setting for 6 hours. Materials and Methods Thirty clinicians and 30 paramedical staff participated in the study. The control (three-ply mask) and subject (N95 mask with PPE) groups included 15 clinicians and 15 paramedical staff. A comparative analysis of brain oxygenation using a 3T magnetic resonance imaging (MRI) machine was performed in these two groups at the beginning and the end of their work shift. Results The mean age of the individuals in the control and subject groups was 30.8 and 30.13 years, respectively. The median value of brain oxygenation in the control and subject groups in the pre-shift was between 33 and 31 and post-shift was 30 and 24. The drop in brain oxygenation in subjects was more than the controls (p = 0.004) in the post-shift assessments. The cerebral blood flow (CBF) in the bilateral middle cerebral artery (MCA) using arterial spin labeling (ASL) showed a rise in CBF in both groups post-shift as compared with the pre-shift values. The median values of the right and left MCA in the control and subject groups pre-shift were 82.75/83.45 and 89.75/106.65. The post-shift median values of both MCAs of the control and subject groups were 115.65/115.55 and 109.60/119.49. Conclusion MRI-BOLD imaging revealed a significant drop in brain oxygenation in the subject group as compared with the control group. Multiphasic-ASL showed a compensatory rise in CBF in both groups.

WITHDRAWN: Physio-metabolic and clinical consequences of wearing face masks -Systematic review with meta-analysis and comprehensive evaluation

“…In patients with aneurysms or brain tumours this phenomenon could be deleterious. Another study showed a pathologic and altered brain metabolism while wearing a N95 mask for 6 hours 11 . The MRI imaging revealed a significant drop in brain oxygenation.…”

“…retention of bacteria during surgical wound care and operations, at present the question needs to be addressed as to the long-term effects widespread mask wearing may have on normal breathing. It is noteworthy that the compulsory wearing of masks for the entire population provided good research conditions and consequently numerous publications dealing with the adverse effects of mask wearing [4][5][6][7][8][9][10][11] . Various volatile metabolites are produced from in vivo biochemical and metabolic pathways and their concentrations in exhaled breath provide immediate physiological 12,13 , metabolic 14,15 and pathological 16,17 magnitudes with the possibility of monitoring various processes and interventions including therapies 18,19 .…”

The effect of mask usage of the health personnel on blood gas analysis and cognitive strengthening during COVID-19 pandemic

“…Headache was the most common symptom in both groups in their study. In addition, clinical symptoms such as nausea, vomiting, dizziness, blurred vision, drowsiness and fatigue were observed more frequently in N95 group, but also in the group using both types of masks [14].…”

“…The most remarkable study among the studies conducted to date is the study of Vakharia et al on sixty volunteers [14]. The authors conducted two groups, the three-ply mask and N95 mask group in which brain oxygenation was evaluated with cerebral blood oxygenation level dependent magnetic resonance imaging (BOLD MR) at the beginning of the shift and at the end of the six-hour shift.…”

“…These regions manage the compensation mechanism for cognitive functions. The clinical mechanism of confusion was also explained in the study of Vakharia et al by the demonstration of insu cient blood redistribution and compensation using BOLD MR in seven subjects [14,15,18]. However, it is seen that there is still no consensus on what and how to use the de nition of "intermittent hypoxia" [10,11].…”