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Face Mask Use in the Community for Reducing the Spread of COVID-19: A Systematic Review

Coclite, D; Napoletano, A; Gianola, S; Del Monaco, A; D'Angelo, D; Fauci, A; Iacorossi, L; ... Iannone, P; + view all (2021) Face Mask Use in the Community for Reducing the Spread of COVID-19: A Systematic Review. Frontiers in Medicine , 7 , Article 594269. 10.3389/fmed.2020.594269. Green open access

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Abstract

Background: Evidence is needed on the effectiveness of wearing face masks in the community to prevent SARS-CoV-2 transmission. / Methods: Systematic review and meta-analysis to investigate the efficacy and effectiveness of face mask use in a community setting and to predict the effectiveness of wearing a mask. We searched MEDLINE, EMBASE, SCISEARCH, The Cochrane Library, and pre-prints from inception to 22 April 2020 without restriction by language. We rated the certainty of evidence according to Cochrane and GRADE approach. / Findings: Our search identified 35 studies, including three randomized controlled trials (RCTs) (4,017 patients), 10 comparative studies (18,984 patients), 13 predictive models, nine laboratory experimental studies. For reducing infection rates, the estimates of cluster-RCTs were in favor of wearing face masks vs. no mask, but not at statistically significant levels (adjusted OR 0.90, 95% CI 0.78–1.05). Similar findings were reported in observational studies. Mathematical models indicated an important decrease in mortality when the population mask coverage is near-universal, regardless of mask efficacy. In the best-case scenario, when the mask efficacy is at 95%, the R0 can fall to 0.99 from an initial value of 16.90. Levels of mask filtration efficiency were heterogeneous, depending on the materials used (surgical mask: 45–97%). One laboratory study suggested a viral load reduction of 0.25 (95% CI 0.09–0.67) in favor of mask vs. no mask. / Interpretation: The findings of this systematic review and meta-analysis support the use of face masks in a community setting. Robust randomized trials on face mask effectiveness are needed to inform evidence-based policies. / PROSPERO registration: CRD42020184963.

Type: Article
Title: Face Mask Use in the Community for Reducing the Spread of COVID-19: A Systematic Review
Location: Switzerland
Open access status: An open access version is available from UCL Discovery
DOI: 10.3389/fmed.2020.594269
Publisher version: https://doi.org/10.3389/fmed.2020.594269
Language: English
Additional information: Copyright © 2021 Coclite, Napoletano, Gianola, del Monaco, D'Angelo, Fauci, Iacorossi, Latina, Torre, Mastroianni, Renzi, Castellini and Iannone. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (http://creativecommons.org/licenses/by/4.0/). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Keywords: pandemics, face mask, prevention and control [MeSH], SARS—CoV−2, COVID−19, disease outbreaks, community, systematic review
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
URI: https://discovery.ucl.ac.uk/id/eprint/10121624
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