Table 1

Key questions (three questions addressing acute physiological, cognitive and psychological outcomes associated with mask use)

Population of interest

  • Adults 18 years and older

Intervention

  • Surgical/medical masks

  • N95 masks/filtering facepiece respirator

  • Military and fire service air-purifying respirators (APR)

  • Cloth mask

Comparison

  • No mask

OutcomesQ1. Acute physiological outcomes

  • Cardiovascular responses

    • Heart rate

    • Cardiac output/stroke volume

    • Blood pressure

  • Ventilatory responses

    • Respiratory rate

    • Minute ventilation

    • Tidal volume

    • VE/VCO2

    • Ventilation equivalent

  • Metabolic response

    • Arterial oxygen saturation

    • Oxygen extraction/muscle oxygenation

    • Carbon dioxide/end-tidal CO2

    • Arterial partial pressure of carbon dioxide

    • Blood lactate

  • Exercise performance

    • Rating of perceived exertion (RPE)

    • Time to exhaustion and perceived exertion

    • Thermal sensation and facial skin temperature


Q2. Cognitive outcomes

  • Mini-Mental State Examination

  • Standardized Mini-Mental State Examination

  • Montreal Cognitive Assessment (MOCA)

  • Mini-Cog

  • Functional Cognitive Assessment Scale

  • Functional Activities Questionnaire

  • Abbreviated Mental Test

  • Six-item Cognitive Impairment Test

    • Distraction, total number of errors, correct responses, response time, self-perceived arousal and ability to concentrate


Q3. Psychological outcomes

  • Anxiety

  • Depression

  • Claustrophobia

Study designs

  • Systematic review and meta-analysis for Q1

  • Comparative individual studies for Q2 and Q3

TimingFrom 2000 to 2023
Subgroup analyses

  • People working in a field with a position description that expects them to wear a face mask (pilots or qualified aircrew including flight attendants, military and public safety professionals)

  • Duration of masking

  • Activity level

    • At rest

    • With exercise (progressive intensity protocol applied the exercise test until exhaustion vs steady exercise state)

Altitude level (when relevant)

  • CO2, carbon dioxide; Q1,2,3, Question 1,2,3; VE/VCO2, minute ventilation/carbon dioxide production.