한빛사 논문
Min Seo Kim1 | Dawon Seong2 | Han Li3 | Seo Kyoung Chung4 | Youngjoo Park2 | Minho Lee2 | Seung Won Lee5,6 | Dong Keon Yon7 | Jae Han Kim2 | Keum Hwa Lee2,8 | Marco Solmi9,10,11,12 | Elena Dragioti13 | Ai Koyanagi14,15,16 | Louis Jacob14,17 | Andreas Kronbichler18 | Kalthoum Tizaoui19 | Sarah Cargnin20 | Salvatore Terrazzino20 | Sung Hwi Hong21 | Ramy Abou Ghayda22 | Joaquim Radua23,24,25 | Hans Oh26 | Karel Kostev27 | Shuji Ogino28,29,30,31 | I‐Min Lee29,32 | Edward Giovannucci29,33 | Yvonne Barnett34 | Laurie Butler35 | Daragh McDermott36 | Petre‐Cristian Ilie37 | Jae Il Shin2,8 | Lee Smith38
1Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
2College of Medicine, Yonsei University, Seoul, Republic of Korea
3College of Medicine, University of Florida, Gainesville, Florida, USA
4College of Medicine, Ewha Womans University, Seoul, Republic of Korea
5Department of Data Science, Sejong University College of Software Convergence, Seoul, Republic of Korea
6Department of Precision Medicine, Sungkyunkwan University School of medicine, Suwon, Republic of Korea
7Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
8Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
9Department of Psychiatry, University of Ottawa, Ontario, Canada
10Department of Mental Health, The Ottawa Hospital, Ontario, Canada
11Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program University of Ottawa, Ontario, Canada
12School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ontario, Canada
13Pain and Rehabilitation Centre and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
14Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, CIBERSAM, Barcelona, Spain
15ICREA, Barcelona, Spain
16Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
17Faculty of Medicine, University of Versailles Saint‐Quentin‐en‐Yvelines, Montigny‐le‐Bretonneux, France
18Department of Medicine, University of Cambridge, Cambridge, UK
19Department of Basic Sciences, Medicine Faculty of Tunis, Tunis El Manar University, Tunis, Tunisia
20Department of Pharmaceutical Sciences, Interdepartmental Research Center of Pharmacogenetics and Pharmacogenomics (CRIFF), University of Piemonte Orientale, Novara, Italy
21Severance Hospital, Yonsei University Health Systems, Seoul, Republic of Korea
22Urology Institute, University Hospitals System, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
23Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Mental Health Research Networking Center, CIBERSAM, Barcelona, Spain
24Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
25Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Institute, Stockholm, Sweden
26School of Social Work, University of Southern California, California, USA
27University Clinic of Marburg, Marburg, Germany
28Cancer Immunology and Cancer Epidemiology Programs, Dana‐Farber/Harvard Cancer Center, Boston, Massachusetts, USA
29Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
30Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
31Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
32Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
33Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
34School of Life Sciences, Faculty of Science and Engineering, Anglia Ruskin University, East Road, Cambridge, UK
35Faculty of Science and Engineering, Anglia Ruskin University, Cambridge, UK
36NTU Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UK
37Queen Elizabeth Hospital Foundation Trust, King's Lynn, UK
38Center for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
Correspondence Jae Il Shin, D
Abstract
The aim of this systematic review and network meta-analysis is to evaluate the comparative effectiveness of N95, surgical/medical and non-medical facemasks as personal protective equipment against respiratory virus infection. The study incorporated 35 published and unpublished randomized controlled trials and observational studies investigating specific mask effectiveness against influenza virus, SARS-CoV, MERS-CoV and SARS-CoV-2. We searched PubMed, Google Scholar and medRxiv databases for studies published up to 5 February 2021 (PROSPERO registration: CRD42020214729). The primary outcome of interest was the rate of respiratory viral infection. The quality of evidence was estimated using the GRADE approach. High compliance to mask-wearing conferred a significantly better protection (odds ratio [OR], 0.43; 95% confidence interval [CI], 0.23–0.82) than low compliance. N95 or equivalent masks were the most effective in providing protection against coronavirus infections (OR, 0.30; CI, 0.20–0.44) consistently across subgroup analyses of causative viruses and clinical settings. Evidence supporting the use of medical or surgical masks against influenza or coronavirus infections (SARS, MERS and COVID-19) was weak. Our study confirmed that the use of facemasks provides protection against respiratory viral infections in general; however, the effectiveness may vary according to the type of facemask used. Our findings encourage the use of N95 respirators or their equivalents (e.g., P2) for best personal protection in healthcare settings until more evidence on surgical and medical masks is accrued. This study highlights a substantial lack of evidence on the comparative effectiveness of mask types in community settings.
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