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World J Clin Cases. Apr 6, 2021; 9(10): 2170-2180
Published online Apr 6, 2021. doi: 10.12998/wjcc.v9.i10.2170
SARS-CoV-2, surgeons and surgical masks
Mohammad Ibrahim Khalil, Gouri Rani Banik, Sarab Mansoor, Amani S Alqahtani, Harunor Rashid
Mohammad Ibrahim Khalil, Department of Surgery, Dhaka Medical College Hospital, Dhaka 1000, Bangladesh
Gouri Rani Banik, Clinical Research Unit, The Department of Medicine, University of New South Wales, Sydney 2217, New South Wales, Australia
Gouri Rani Banik, National Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead and the University of Sydney, Westmead 2145, New South Wales, Australia
Sarab Mansoor, The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, New South Wales, Australia
Amani S Alqahtani, Research Department, Saudi Food and Drug Authority, Riyadh 13312, Saudi Arabia
Harunor Rashid, National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, and the University of Sydney, Westmead 2145, New South Wales, Australia
Harunor Rashid, Discipline of Child and Adolescent Health, the Faculty of Medicine and Health, The University of Sydney, Sydney 2145, New South Wales, Australia
Harunor Rashid, Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Biological Sciences and Sydney Medical School, The University of Sydney, Westmead 2145, New South Wales, Australia
Author contributions: Khalil MI and Rashid H conceived the idea; Banik GR and Rashid H conducted literature search; Mansoor S, Banik GR, Alqahtani AS and Rashid H sifted the titles, identified full texts, created the content; Khalil MI, Banik GR and Rashid H abstracted the data; Rashid H and Banik GR conducted data synthesis and formal analysis; Mansoor S crafted the background; Rashid H prepared the Figure 1; all authors contributed to writing the original draft, review and editing.
Conflict-of-interest statement: There is none to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Harunor Rashid, MD, Associate Professor, National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, and the University of Sydney, Cnr Hawkesbury Road and Hainsworth Street, Locked Bag 4001, Westmead 2145, New South Wales, Australia. harunor.rashid@health.nsw.gov.au
Received: December 1, 2020
Peer-review started: December 1, 2020
First decision: December 13, 2020
Revised: December 25, 2020
Accepted: February 12, 2021
Article in press: February 12, 2021
Published online: April 6, 2021
Processing time: 119 Days and 0.6 Hours
Abstract

The exact risk association of coronavirus disease 2019 (COVID-19) for surgeons is not quantified which may be affected by their risk of exposure and individual factors. The objective of this review is to quantify the risk of COVID-19 among surgeons, and explore whether facemask can minimise the risk of COVID-19 among surgeons. A systematised review was carried out by searching MEDLINE to locate items on severe acute respiratory syndrome coronavirus 2 or COVID-19 in relation to health care workers (HCWs) especially those work in surgical specialities including surgical nurses and intensivists. Additionally, systematic reviews that assessed the effectiveness of facemask against viral respiratory infections, including COVID-19, among HCWs were identified. Data from identified articles were abstracted, synthesised and summarised. Fourteen primary studies that provided data on severe acute respiratory syndrome coronavirus 2 infection or experience among surgeons and 11 systematic reviews that provided evidence of the effectiveness of facemask (and other personal protective equipment) were summarised. Although the risk of COVID-19 could not be quantified precisely among surgeons, about 14% of HCWs including surgeons had COVID-19, there could be variations depending on settings. Facemask was found to be somewhat protective against COVID-19, but the HCWs’ compliance was highly variable ranging from zero to 100%. Echoing surgical societies’ guidelines we continue to recommend facemask use among surgeons to prevent COVID-19.

Keywords: COVID-19; Health care worker; Personal protective equipment; SARS-CoV-2; Surgeon; Surgical mask

Core Tip: The risk of coronavirus disease 2019 (COVID-19) among surgeons is unknown. By searching Medline we identified 14 primary studies that provided data on severe acute respiratory syndrome coronavirus infection among surgeons and identified 11 systematic reviews that provided evidence on the role of facemask against respiratory viral infection among health professionals. About 14% of health professionals including surgeons had COVID-19, and facemask was found to be somewhat protective against COVID-19, but the health professionals’ compliance was highly variable ranging from zero to 100%. In line with other guidelines we continue to recommend facemask use among surgeons to prevent COVID-19.