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dc.contributor.author Chu, Derek K.
dc.contributor.author Akl, Elie A.
dc.contributor.author Duda, Stephanie
dc.contributor.author Solo, Karla
dc.contributor.author Yaacoub, Sally
dc.contributor.author Schünemann, Holger J.
dc.contributor.author El-harakeh, Amena
dc.contributor.author Bognanni, Antonio
dc.contributor.author Lotfi, Tamara
dc.contributor.author Loeb, Mark
dc.contributor.author Hajizadeh, Anisa
dc.contributor.author Bak, Anna
dc.contributor.author Izcovich, Ariel
dc.contributor.author Cuello-Garcia, Carlos A.
dc.contributor.author Chen, Chen
dc.contributor.author Harris, David J.
dc.contributor.author Borowiack, Ewa
dc.contributor.author Chamseddine, Fatimah
dc.contributor.author Schünemann, Finn
dc.contributor.author Morgano, Gian Paolo
dc.contributor.author Muti Schünemann, Giovanna E.U.
dc.contributor.author Chen, Guang
dc.contributor.author Zhao, Hong
dc.contributor.author Neumann, Ignacio
dc.contributor.author Chan, Jeffrey
dc.contributor.author Khabsa, Joanne
dc.contributor.author Hneiny, Layal
dc.contributor.author Harrison, Leila
dc.contributor.author Smith, Maureen
dc.contributor.author Rizk, Nesrine
dc.contributor.author Giorgi Rossi, Paolo
dc.contributor.author AbiHanna, Pierre
dc.contributor.author El-khoury, Rayane
dc.contributor.author Stalteri, Rosa
dc.contributor.author Baldeh, Tejan
dc.contributor.author Piggott, Thomas
dc.contributor.author Zhang, Yuan
dc.contributor.author Saad, Zahra
dc.contributor.author Khamis, Assem
dc.contributor.author Reinap, Marge
dc.date.accessioned 2024-09-26T00:31:02Z
dc.date.available 2024-09-26T00:31:02Z
dc.date.issued 2020-06-27
dc.identifier.issn 0140-6736
dc.identifier.uri https://repositorio.uss.cl/handle/uss/12430
dc.description Publisher Copyright: © 2020 World Health Organization
dc.description.abstract 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: Our search identified 172 observational studies across 16 countries and six continents, with no randomised controlled trials and 44 relevant comparative studies in health-care and non-health-care settings (n=25 697 patients). Transmission of viruses was lower with physical distancing of 1 m or more, compared with a distance of less than 1 m (n=10 736, pooled adjusted odds ratio [aOR] 0·18, 95% CI 0·09 to 0·38; risk difference [RD] −10·2%, 95% CI −11·5 to −7·5; moderate certainty); protection was increased as distance was lengthened (change in relative risk [RR] 2·02 per m; pinteraction=0·041; moderate certainty). Face mask use could result in a large reduction in risk of infection (n=2647; aOR 0·15, 95% CI 0·07 to 0·34, RD −14·3%, −15·9 to −10·7; low certainty), with stronger associations with N95 or similar respirators compared with disposable surgical masks or similar (eg, reusable 12–16-layer cotton masks; pinteraction=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. en
dc.language.iso eng
dc.relation.ispartof vol. 395 Issue: no. 10242 Pages: 1973-1987
dc.source The Lancet
dc.title 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 en
dc.type Artículo
dc.identifier.doi 10.1016/S0140-6736(20)31142-9
dc.publisher.department Facultad de Medicina y Ciencia


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