The impact of facemask on patients with COPD: A systematic review and meta-analysis

• Published in: Frontiers in public health Vol. 10; p. 1027521
• Main Authors: Chen, Xuwen, Zhang, Changqing, Ibrahim, Sani, Tao, Shunyu, Xia, Xiaoli, Li, Yi, Li, Caiyun, Yue, Feiyan, Wang, Xinhua, Bao, Shisan, Fan, Jingchun
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 16.11.2022
• Subjects: chronic obstructive pulmonary disease (COPD); COVID-19; facemasks; Humans; Masks; meta-analysis; Personal Protective Equipment; Public Health; Pulmonary Disease, Chronic Obstructive; Sedentary Behavior; systematic review; COVID-19; meta-analysis; facemasks; systematic review; chronic obstructive pulmonary disease (COPD)
• ISSN: 2296-2565; 2296-2565
• DOI: 10.3389/fpubh.2022.1027521

Since the emergence of COVID-19, mandatory facemask wearing has been implemented around the world to prevent viral transmission, however, the impact of wearing facemasks on patients with COPD was unclear. The current study undertakes a systematic review and meta-analysis of a comprehensive literature retrieval from six databases, based on the pre-determined eligibility criteria, irrespective of language. The risk of bias was assessed using an established instrument. We primarily focused on analyzing ETCO , SpO , and heart and respiratory rates, and also considered the impacts on physiological and exercise performance. A descriptive summary of the data and possible meta-analysis was performed. Forest plots were generated to pool estimates based on each of the study outcomes. Of the 3,751 publications considered, six publications were selected for a systematic review and two publications were included for meta-analysis, however, the quality of these six studies was relatively low overall. In the case of inactivity, the facemask wearing COPD cohort had higher respiratory rates than that of the non-facemask wearing cohort (MD = 1.00 and 95% CI 0.47-1.53, < 0.05). There was no significant difference in ETCO (MD = 0.10 and 95% CI -1.57-1.78, > 0.05) and heart rate (MD = 0.40 and 95% CI -3.59-4.39, > 0.05) nor SpO (MD = -0.40 and 95% CI -0.84-0.04, > 0.05) between the COPD patients with and without facemasks. Furthermore, it was observed that the only significant differences between the COPD patients with and without facemasks undertaking different activities were FEV1 (%) (MD = 3.84 and 95% CI 0.14-7.54, < 0.05), FEV1/FVC (%) (MD = 3.25 and 95% CI 0.71-5.79, < 0.05), and blood lactate (MD = -0.90 and 95% CI -1.73 to -0.07, < 0.05). Wearing facemasks decreased the exercise performance of patients with COPD, however, it had minimal impact on physiological indexes. Further investigations will be performed on the high-quality data from randomized control studies. https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=326265, identifier: CRD42022326265.