Face masks: benefits and risks during the COVID-19 crisis.


Journal

European journal of medical research
ISSN: 2047-783X
Titre abrégé: Eur J Med Res
Pays: England
ID NLM: 9517857

Informations de publication

Date de publication:
12 Aug 2020
Historique:
received: 18 05 2020
accepted: 21 07 2020
entrez: 14 8 2020
pubmed: 14 8 2020
medline: 22 8 2020
Statut: epublish

Résumé

The German government has made it mandatory to wear respiratory masks covering mouth and nose (MNC) as an effective strategy to fight SARS-CoV-2 infections. In many countries, this directive has been extended on shopping malls or public transportation. The aim of this paper is to critically analyze the statutory regulation to wear protective masks during the COVID-19 crisis from a medical standpoint. We performed an extensive query of the most recent publications addressing the prevention of viral infections including the use of face masks in the community as a method to prevent the spread of the infection. We addressed the issues of practicability, professional use, and acceptability based on the community and the environment where the user resided. Upon our critical review of the available literature, we found only weak evidence for wearing a face mask as an efficient hygienic tool to prevent the spread of a viral infection. However, the use of MNC seems to be linked to relevant protection during close contact scenarios by limiting pathogen-containing aerosol and liquid droplet dissemination. Importantly, we found evidence for significant respiratory compromise in patients with severe obstructive pulmonary disease, secondary to the development of hypercapnia. This could also happen in patients with lung infections, with or without SARS-CoV-2. Epidemiologists currently emphasize that wearing MNC will effectively interrupt airborne infections in the community. The government and the politicians have followed these recommendations and used them to both advise and, in some cases, mandate the general population to wear MNC in public locations. Overall, the results seem to suggest that there are some clinically relevant scenarios where the use of MNC necessitates more defined recommendations. Our critical evaluation of the literature both highlights the protective effects of certain types of face masks in defined risk groups, and emphasizes their potential risks.

Sections du résumé

BACKGROUND BACKGROUND
The German government has made it mandatory to wear respiratory masks covering mouth and nose (MNC) as an effective strategy to fight SARS-CoV-2 infections. In many countries, this directive has been extended on shopping malls or public transportation. The aim of this paper is to critically analyze the statutory regulation to wear protective masks during the COVID-19 crisis from a medical standpoint.
METHODS METHODS
We performed an extensive query of the most recent publications addressing the prevention of viral infections including the use of face masks in the community as a method to prevent the spread of the infection. We addressed the issues of practicability, professional use, and acceptability based on the community and the environment where the user resided.
RESULTS RESULTS
Upon our critical review of the available literature, we found only weak evidence for wearing a face mask as an efficient hygienic tool to prevent the spread of a viral infection. However, the use of MNC seems to be linked to relevant protection during close contact scenarios by limiting pathogen-containing aerosol and liquid droplet dissemination. Importantly, we found evidence for significant respiratory compromise in patients with severe obstructive pulmonary disease, secondary to the development of hypercapnia. This could also happen in patients with lung infections, with or without SARS-CoV-2.
CONCLUSION CONCLUSIONS
Epidemiologists currently emphasize that wearing MNC will effectively interrupt airborne infections in the community. The government and the politicians have followed these recommendations and used them to both advise and, in some cases, mandate the general population to wear MNC in public locations. Overall, the results seem to suggest that there are some clinically relevant scenarios where the use of MNC necessitates more defined recommendations. Our critical evaluation of the literature both highlights the protective effects of certain types of face masks in defined risk groups, and emphasizes their potential risks.

Identifiants

pubmed: 32787926
doi: 10.1186/s40001-020-00430-5
pii: 10.1186/s40001-020-00430-5
pmc: PMC7422455
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

32

Subventions

Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States

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Auteurs

Christiane Matuschek (C)

Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany.

Friedrich Moll (F)

Department of the History, Philosophy and Ethics of Medicine, Heinrich Heine University, Medical Faculty, Dusseldorf, Germany.

Heiner Fangerau (H)

Department of the History, Philosophy and Ethics of Medicine, Heinrich Heine University, Medical Faculty, Dusseldorf, Germany.

Johannes C Fischer (JC)

Institute for Transplant Diagnostics and Cell Therapeutics, Heinrich Heine University, Dusseldorf, Germany.

Kurt Zänker (K)

Center for Biomedical Education and Research (ZBAF), University Witten/Herdecke, Witten, Germany.

Martijn van Griensven (M)

Department cBITE, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, Maastricht, The Netherlands.

Marion Schneider (M)

Department of Experimental Anesthesiology, University of Ulm, Ulm, Germany.

Detlef Kindgen-Milles (D)

Department of Anesthesiology and Intensive Care Medicine, Heinrich Heine University, Dusseldorf, Germany.

Wolfram Trudo Knoefel (WT)

Department for General Visceral and Pediatric Surgery, Heinrich Heine University, Dusseldorf, Germany.

Artur Lichtenberg (A)

Department for Cardiac Surgery, Heinrich Heine University, Dusseldorf, Germany.

Balint Tamaskovics (B)

Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany.

Freddy Joel Djiepmo-Njanang (FJ)

Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany.

Wilfried Budach (W)

Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany.

Stefanie Corradini (S)

Department of Radiation Oncology, University Hospital, LMU Munich, Germany.

Dieter Häussinger (D)

Department of Gastroenterology, Hepatology and Infectious Diseases, Heinrich Heine University, Dusseldorf, Germany.

Torsten Feldt (T)

Department of Gastroenterology, Hepatology and Infectious Diseases, Heinrich Heine University, Dusseldorf, Germany.

Björn Jensen (B)

Department of Gastroenterology, Hepatology and Infectious Diseases, Heinrich Heine University, Dusseldorf, Germany.

Rainer Pelka (R)

Institute for Applied Statistics, Munich, Germany.

Klaus Orth (K)

University of Hannover, Hannover, Germany.

Matthias Peiper (M)

Heinrich-Heine-University, Dusseldorf, Germany.

Olaf Grebe (O)

Department for Cardiology, Rhythmology and Intensive Care Medicine, Evangelic Hospital, Dusseldorf, Germany.

Kitti Maas (K)

Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany.

Peter Arne Gerber (PA)

Heinrich-Heine-University, Dusseldorf, Germany.

Alessia Pedoto (A)

Department of Anesthesiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Edwin Bölke (E)

Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany. boelke@med.uni-duesseldorf.de.

Jan Haussmann (J)

Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany.

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