Background There is insufficient evidence regarding the role of respirators in the prevention of SARS-CoV-2 infection. We analysed the impact of filtering facepiece class 2 (FFP2) versus surgical masks on the risk of SARS-CoV-2 acquisition among Swiss healthcare workers (HCW). Methods Our prospective multicentre cohort enrolled HCW from June to August 2020. Participants were asked about COVID-19 risk exposures/behaviours, including preferentially worn mask type when caring for COVID-19 patients outside of aerosol-generating procedures. The impact of FFP2 on (1) self-reported SARS-CoV-2-positive nasopharyngeal PCR/rapid antigen tests captured during weekly surveys, and (2) SARS-CoV-2 seroconversion between baseline and January/February 2021 was assessed. Results We enrolled 3259 participants from nine healthcare institutions, whereof 716 (22%) preferentially used FFP2. Among these, 81/716 (11%) reported a SARS-CoV-2-positive swab, compared to 352/2543 (14%) surgical mask users; seroconversion was documented in 85/656 (13%) FFP2 and 426/2255 (19%) surgical mask users. Adjusted for baseline characteristics, COVID-19 exposure, and risk behaviour, FFP2 use was non-significantly associated with decreased risk for SARS-CoV-2-positive swab (adjusted hazard ratio [aHR] 0.8, 95% CI 0.6–1.0) and seroconversion (adjusted odds ratio [aOR] 0.7, 95% CI 0.5–1.0); household exposure was the strongest risk factor (aHR 10.1, 95% CI 7.5–13.5; aOR 5.0, 95% CI 3.9–6.5). In subgroup analysis, FFP2 use was clearly protective among those with frequent (> 20 patients) COVID-19 exposure (aHR 0.7 for positive swab, 95% CI 0.5–0.8; aOR 0.6 for seroconversion, 95% CI 0.4–1.0). Conclusions Respirators compared to surgical masks may convey additional protection from SARS-CoV-2 for HCW with frequent exposure to COVID-19 patients. Supplementary Information The online version contains supplementary material available at 10.1186/s13756-022-01070-6.
【저자키워드】 COVID-19, Healthcare workers, aerosol, surgical mask, Respirator, 【초록키워드】 SARS-CoV-2, SARS-COV-2 infection, risk, surgical, risk factor, healthcare worker, Mask, Antigen, Cohort, Seroconversion, nasopharyngeal, healthcare, multicentre, Swab, patients, COVID-19 patients, Protective, Evidence, COVID-19 patient, HCW, aerosol-generating procedures, adjusted odds ratio, supplementary material, 95% CI, adjusted hazard ratio, baseline characteristics, participant, subgroup analysis, positive swab, acquisition, Result, enrolled, reported, nine, analysed, asked, baseline, 【제목키워드】 SARS-CoV-2, surgical, Mask, Cohort, healthcare, Impact, multicentre, acquisition,