Comparative efficacy of respiratory personal protective equipment
against viral respiratory infectious diseases in healthcare workers: A
network meta-analysis
Abstract
Background: With the epidemic of COVID-19, the health care workers
(HCWs) require proper respiratory personal protective equipment (rPPE)
against viral respiratory infectious diseases. However, there is little
published evidence comparing their efficacy. Therefore, we conducted a
network meta-analysis (NMA) to compare the efficacy of rPPEs and the
wearing manner preventing from the viral respiratory infectious diseases
(VRID). Methods: This NMA protocol was registered in PROSPERO
(CRD42020179489). PubMed, the Cochrane Library, Web of Science, and
EMBASE were searched by computer to collect cluster randomized control
trials of comparing the effectiveness of rPPEs and wearing manner in
preventing HCWs from VRID. The primary outcome was the incidence of
laboratory-confirmed viral respiratory infection. The secondary outcome
was the incidence of CRI. The Bayesian NMA was conducted to use the
control group as the comparison group. Incidence of the VRID and CRI
were reported as network odds ratio (network OR) and 95% credibility
interval (CrI). Results: Six studies encompassed 11,828 HCWs and seven
interventions were included. In terms of the incidence of
laboratory-confirmed viral respiratory infection, the continuous wearing
of N95 respirator (network OR, 0.48; 95% CrI 0.27 to 0.86; SUCRA score,
85.4) showed more effective than the control group. In terms of the
incidence of CRI, there are no interventions that showed more effective
than the control group. Conclusion: There are significant differences in
preventive efficacy among current rPPEs. Our result suggests that
continuous wearing of N95 respirator can serve as the best preventive
rPPE for HCWs from the VRID.