Can Wearing a Face Mask Protect from COVID-19? A Systematic Review

In the outbreak of infectious diseases, non-pharmacological intervention might be the only available protection tools. The aim of this systematic review is to investigate whether it is or is not necessary to wear masks in new corona virus (COVID-19) outbreaks in the community.

On February, 28, 2020, related databases were searched with the following keywords: "COVID-19"; "COVID 19"; 2019-nCoV; 2019-CoV; coronavirus; mask* and facemask. We updated the search in March 13, 2020. A total of 982 relevant reports were identified after removing duplicates. Of these, 71 references were screened based on titles and abstracts. After excluding unrelated studies, 36 studies were included in the full-text review and were assessed for eligibility. Finally, 3 articles met our inclusion criteria.

In three wards of hospital with more exposure to infected patients, wearing the N95 respirator while using regular disinfectants and hand hygiene, was a better way to prevent COVID-19 transmission from patients to nurses and physicians when compared to non-users of masks. Another study on family members with a history of travelling to Wuhan, showed that those who had worn a surgical mask only during the hospital visit, were infected. However, the 7 years old child of the family who wore a surgical mask, was not found to be infected by COVID-19. Finally, none of eleven healthcare workers who had unprotected exposure with confirmed cases were infected.

Due to the newness of the COVID-19 virus, no clinical trials have been found regarding the use of the masks in the prevention of the disease, and the level of evidence were low.