Department of Pulmonary Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India


INTRODUCTION: Novel coronavirus is believed to be tiny enough (0.08–0.14 μm) to penetrate
through face mask, thus protection offered by cloth mask may be too low. However, the use of cloth
face mask in community has been recommended by the United States Centre for Disease Control
and Prevention and regulatory bodies of other countries. There is paucity of literature on efficacy of
cloth face mask in preventing SARS‑CoV‑2 infection transmission; thus, this review aims to update
the available most recent evidences on efficacy of cloth face masks in prevention of viral infection
METHODS: We searched MEDLINE, EMBASE, and Clinical Trials Register for identifying studies
related to this review using free‑text terms and MeSH terms. Both experimental and observational
studies on efficacy of cloth masks which were published in English language have been included
in this review except expert opinions, commentaries, editorials, and review articles. Twelve studies
were eligible to be included in review for data extraction and qualitative synthesis was carried out
from extracted data but quantitative analysis (meta‑analysis) could not be performed because of
serious heterogeneity between the studies.
RESULTS: Cloth face masks show minimum efficacy in source control than the medical grade mask.
The efficacy of cloth face masks filtration varies and depends on the type of material used, number
of layers, and degree of moisture in mask and fitting of mask on face.
CONCLUSION: Cloth face masks have limited efficacy in combating viral infection transmission.
However, it may be used in closed, crowded indoor, and outdoor public spaces involving physical
proximity to prevent spread of SARS‑CoV‑2 infection.


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