Обзорная статья

Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis

Derek K. ChuDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada; The Research Institute of St Joe's Hamilton, Hamilton, ON, CanadaElie A AklDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; Department of Internal Medicine, American University of Beirut, Beirut, Lebanon; Clinical Research Institute, American University of Beirut, Beirut, LebanonStephanie DudaDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, CanadaKarla SoloDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, CanadaSally YaacoubClinical Research Institute, American University of Beirut, Beirut, LebanonHolger J. SchünemannDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada; Michael G DeGroote Cochrane Canada and GRADE Centres, Hamilton, ON, Canada. Electronic address: [email protected]Elie A. AklDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; Department of Internal Medicine, American University of Beirut, Beirut, Lebanon; Clinical Research Institute, American University of Beirut, Beirut, LebanonAmena El‐HarakehAntonio BognanniTamara LotfiMark LoebMcMaster University [Hamilton, Ontario] (1280 Main Street West Hamilton, Ontario L8S 4L8 - Canada)Anisa HajizadehAnna BąkAriel IzcovichCarlos A. Cuello‐GarcíaChen ChenSamsung (Beijing China 10008 - China)David J. HarrisE BorowiackFatimah ChamseddineFinn SchünemannDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, CanadaGian Paolo MorganoGiovanna E.U. Muti SchünemannGuang ChenHong ZhaoIgnacio NeumannJeffrey Shi Kai ChanJoanne KhabsaLayal HneinyLeila HarrisonMaureen SmithNesrine RizkPaolo Giorgi RossiPierre AbihannaRayane El-KhouryRosa StalteriTejan BaldehThomas PiggottYuan ZhangZahra SaadAssem M. KhamisMarge ReinapStephanie DudaDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada

2020en

ABI

Аннотация

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 and is spread person-to-person through close contact. We aimed to investigate the effects of physical distance, face masks, and eye protection on virus transmission in health-care and non-health-care (eg, community) settings. METHODS: We did a systematic review and meta-analysis to investigate the optimum distance for avoiding person-to-person virus transmission and to assess the use of face masks and eye protection to prevent transmission of viruses. We obtained data for SARS-CoV-2 and the betacoronaviruses that cause severe acute respiratory syndrome, and Middle East respiratory syndrome from 21 standard WHO-specific and COVID-19-specific sources. We searched these data sources from database inception to May 3, 2020, with no restriction by language, for comparative studies and for contextual factors of acceptability, feasibility, resource use, and equity. We screened records, extracted data, and assessed risk of bias in duplicate. We did frequentist and Bayesian meta-analyses and random-effects meta-regressions. We rated the certainty of evidence according to Cochrane methods and the GRADE approach. This study is registered with PROSPERO, CRD42020177047. FINDINGS: =0·090; posterior probability >95%, low certainty). Eye protection also was associated with less infection (n=3713; aOR 0·22, 95% CI 0·12 to 0·39, RD -10·6%, 95% CI -12·5 to -7·7; low certainty). Unadjusted studies and subgroup and sensitivity analyses showed similar findings. INTERPRETATION: The findings of this systematic review and meta-analysis support physical distancing of 1 m or more and provide quantitative estimates for models and contact tracing to inform policy. Optimum use of face masks, respirators, and eye protection in public and health-care settings should be informed by these findings and contextual factors. Robust randomised trials are needed to better inform the evidence for these interventions, but this systematic appraisal of currently best available evidence might inform interim guidance. FUNDING: World Health Organization.

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Идентификаторы

DOI: 10.1016/s0140-6736(20)31142-9

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Цитирований: 4Использованных источников: 0

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