Recomendações quanto ao uso de máscaras/ respiradores de proteção por profissionais de saúde em risco de exposição ao SARS-CoV-2: scoping review

Abstract

Introduction: Health professionals are one of the groups at risk of contamination by SARS-CoV-2. The use of surgical masks and particulate respirators has been problematized since the beginning of the pandemic by SARS-CoV-2, with the dissemination of conflicting recommendations in scientific studies, national and international health agencies. Objective: To analyze governmental recommendations and scientific evidence regarding the use of respiratory protectors by health professionals in the context of the SARS-CoV-2 pandemic. Method: Scoping Review (scope review), followed by the protocol model proposed by the Joanna Briggs Institute (JBI), Version 2020. The PCC strategy (Population, Concept and Context) was used to formulate the research question, and established the guiding question: What are the recommendations regarding the use of respiratory protection masks / respirators by health professionals in view of the risk of contamination by SARS-CoV-2? Searches were carried out in six international databases and in the gray literature and on government websites in different countries, from July to August 2020. Results: 3,655 studies were identified in the databases, 14 studies identified in the complementary reading (references of articles already included in the sample), and 12 works from the gray literature; 61 documents were eligible for full reading, which resulted in a final sample of 20 studies published in 2020. On the methodology of the studies, 1 (5%) descriptive study, 1 (5%) narrative review, 2 (10%) review systematic with meta-analysis, 2 systematic reviews (10%), 8 (40%) literature review and 6 (30%) technical report. The show brings conflicting recommendations regarding the use of surgical masks and particulate respirators, with indication of different types of surgical masks and particulate respirators, there is also disagreement as to the scenario for using these PPE's and as to the social distance, which varies from 1 to 2 meters in the sample. Conclusion: The results presented show that there are divergences as to: type of respiratory protection in routine care, when there is no generation of aerosols, with studies that indicate the use of surgical masks and others that recommend the use of a particulate respirator; there is an indication of different particulate respirators of varying degrees of protection, for the same scenario of clinical exposure, and there is conflict regarding the scenario of greater exposure for health professionals, in disagreement of which procedures generate aerosols. This review stresses the need for primary studies with methodological rigor to produce more robust evidence on the protective effect of surgical masks and particulate respirators specifically with respect to SARS-CoV-2.