Your browser doesn't support javascript.
Medical Masks Versus N95 Respirators for Preventing COVID-19 Among Health Care Workers : A Randomized Trial.
Loeb, Mark; Bartholomew, Amy; Hashmi, Madiha; Tarhuni, Wadea; Hassany, Mohamed; Youngster, Ilan; Somayaji, Ranjani; Larios, Oscar; Kim, Joseph; Missaghi, Bayan; Vayalumkal, Joseph V; Mertz, Dominik; Chagla, Zain; Cividino, Maureen; Ali, Karim; Mansour, Sarah; Castellucci, Lana A; Frenette, Charles; Parkes, Leighanne; Downing, Mark; Muller, Matthew; Glavin, Verne; Newton, Jennifer; Hookoom, Ravi; Leis, Jerome A; Kinross, James; Smith, Stephanie; Borhan, Sayem; Singh, Pardeep; Pullenayegum, Eleanor; Conly, John.
  • Loeb M; Department of Pathology and Molecular Medicine and Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada (M.L.).
  • Bartholomew A; Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada (A.B., J.N., P.S.).
  • Hashmi M; Ziauddin University, Karachi, Pakistan (M.Hashmi).
  • Tarhuni W; University of Saskatchewan, Saskatoon, Saskatchewan, and Canadian Cardiac Research Centre, Windsor, Ontario, Canada (W.T.).
  • Hassany M; National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt (M.Hassany).
  • Youngster I; Shamir Medical Center, Tzrifin, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel (I.Y.).
  • Somayaji R; Department of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada (R.S., O.L., J.Kim, B.M., J.C.).
  • Larios O; Department of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada (R.S., O.L., J.Kim, B.M., J.C.).
  • Kim J; Department of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada (R.S., O.L., J.Kim, B.M., J.C.).
  • Missaghi B; Department of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada (R.S., O.L., J.Kim, B.M., J.C.).
  • Vayalumkal JV; Department of Pediatrics, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada (J.V.V.).
  • Mertz D; Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada (D.M., R.H.).
  • Chagla Z; Department of Medicine, McMaster University, and St. Joseph's Healthcare, Hamilton, Ontario, Canada (Z.C.).
  • Cividino M; Department of Medicine, McMaster University, and St. Joseph's Healthcare, Hamilton, Ontario, Canada (Z.C.).
  • Ali K; St. Joseph's Healthcare, Hamilton, Ontario, Canada (M.C.); Niagara Health System, Niagara, Ontario, Canada (K.A.).
  • Mansour S; Montfort Hospital, Ottawa, Ontario, Canada (S.M.).
  • Castellucci LA; Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada (L.A.C.).
  • Frenette C; McGill University Health Centre, Montreal, Quebec, Canada (C.F.).
  • Parkes L; Jewish General Hospital, Montreal, Quebec, Canada (L.P.).
  • Downing M; Unity Health-St. Joseph's, Toronto, Ontario, Canada (M.D.).
  • Muller M; Unity Health-St. Michael's, Toronto, Ontario, Canada (M.M.).
  • Glavin V; Brantford Community Health System, Brantford, Ontario, Canada (V.G.).
  • Newton J; Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada (A.B., J.N., P.S.).
  • Hookoom R; Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada (D.M., R.H.).
  • Leis JA; Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada (J.A.L.).
  • Kinross J; Imperial College, London, England (J.Kinross).
  • Smith S; University of Alberta Hospital, Edmonton, Alberta, Canada (S.S.).
  • Borhan S; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada (S.B.).
  • Singh P; Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada (A.B., J.N., P.S.).
  • Pullenayegum E; University of Toronto, Toronto, Ontario, Canada (E.P.).
  • Conly J; Department of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada (R.S., O.L., J.Kim, B.M., J.C.).
Ann Intern Med ; 2022 Nov 29.
Article in English | MEDLINE | ID: covidwho-2203118
ABSTRACT

BACKGROUND:

It is uncertain if medical masks offer similar protection against COVID-19 compared with N95 respirators.

OBJECTIVE:

To determine whether medical masks are noninferior to N95 respirators to prevent COVID-19 in health care workers providing routine care.

DESIGN:

Multicenter, randomized, noninferiority trial. (ClinicalTrials.gov NCT04296643).

SETTING:

29 health care facilities in Canada, Israel, Pakistan, and Egypt from 4 May 2020 to 29 March 2022.

PARTICIPANTS:

1009 health care workers who provided direct care to patients with suspected or confirmed COVID-19. INTERVENTION Use of medical masks versus fit-tested N95 respirators for 10 weeks, plus universal masking, which was the policy implemented at each site. MEASUREMENTS The primary outcome was confirmed COVID-19 on reverse transcriptase polymerase chain reaction (RT-PCR) test.

RESULTS:

In the intention-to-treat analysis, RT-PCR-confirmed COVID-19 occurred in 52 of 497 (10.46%) participants in the medical mask group versus 47 of 507 (9.27%) in the N95 respirator group (hazard ratio [HR], 1.14 [95% CI, 0.77 to 1.69]). An unplanned subgroup analysis by country found that in the medical mask group versus the N95 respirator group RT-PCR-confirmed COVID-19 occurred in 8 of 131 (6.11%) versus 3 of 135 (2.22%) in Canada (HR, 2.83 [CI, 0.75 to 10.72]), 6 of 17 (35.29%) versus 4 of 17 (23.53%) in Israel (HR, 1.54 [CI, 0.43 to 5.49]), 3 of 92 (3.26%) versus 2 of 94 (2.13%) in Pakistan (HR, 1.50 [CI, 0.25 to 8.98]), and 35 of 257 (13.62%) versus 38 of 261 (14.56%) in Egypt (HR, 0.95 [CI, 0.60 to 1.50]). There were 47 (10.8%) adverse events related to the intervention reported in the medical mask group and 59 (13.6%) in the N95 respirator group.

LIMITATION:

Potential acquisition of SARS-CoV-2 through household and community exposure, heterogeneity between countries, uncertainty in the estimates of effect, differences in self-reported adherence, differences in baseline antibodies, and between-country differences in circulating variants and vaccination.

CONCLUSION:

Among health care workers who provided routine care to patients with COVID-19, the overall estimates rule out a doubling in hazard of RT-PCR-confirmed COVID-19 for medical masks when compared with HRs of RT-PCR-confirmed COVID-19 for N95 respirators. The subgroup results varied by country, and the overall estimates may not be applicable to individual countries because of treatment effect heterogeneity. PRIMARY FUNDING SOURCE Canadian Institutes of Health Research, World Health Organization, and Juravinski Research Institute.
Fulltext
Print
XML
PubMed Links
Search on Google

Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Prognostic study / Randomized controlled trials Topics: Vaccines / Variants Language: English Year: 2022 Document Type: Article

Similar

MEDLINE
LILACS
LIS
Fulltext
Print
XML
PubMed Links
Search on Google

Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Prognostic study / Randomized controlled trials Topics: Vaccines / Variants Language: English Year: 2022 Document Type: Article