Effect of Universal Masking on Non-Severe Acute Respiratory Syndrome Coronavirus 2 Healthcare-Associated Respiratory Viral Infections

Satish Munigala, Patrick R. Ching, Helen Wood, R. J. Waken, Josephine Fox, Heather Gasama, Robert Russell, Melanie L. Yarbrough, David K. Warren

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Respiratory viral infections are common and are a major cause of morbidity and mortality. We evaluated the impact of universal masking implemented during the coronavirus disease 2019 (COVID-19) pandemic on other healthcare-associated respiratory viral infections (HA-RIs) in an academic medical center. Methods: A retrospective cohort study was performed among all inpatients aged ≥18 years admitted between 1 May 2019 and 30 June 2022. Universal masking was implemented in May 2020 at our hospital and state-level mask mandates had been lifted by May 2021. We evaluated and compared the HA-RI rates, adjusted for monthly community-onset viral infections, during the premasking period, universal masking period, and post-community mandate period. Results: We identified 3015 patients (median age, 58 years; 48.0% males) with a positive respiratory viral test within 14 days prior to, or during, their hospitalization; 441 (14.6%) patients had an HA-RI. Rhinovirus/enterovirus (51.0%), parainfluenza virus (14.3%), coronaviruses (229E, OC43, HKU1, and NL63; 13.2%) and influenza (10.0%) were the predominant HA-RI viruses detected. The monthly HA-RI rate decreased 34.9% (95% confidence interval, 8.8%-51.8%) after the implementation of universal masking (0.71 premasking period vs 0.19 universal masking period vs 0.35 infections per 1000 patient-days in the post-community mandate period) while accounting for a drop in the community-onset respiratory viral infections using a structural time-series model analysis (P <. 001), with no significant change in HA-RI rates with the relaxation of community masking mandate. Conclusions: Implementation of universal masking at our hospital was associated with a significantly reduced incidence of HA-RIs.

Original languageEnglish
Article numberofae617
JournalOpen Forum Infectious Diseases
Volume11
Issue number10
DOIs
StatePublished - Oct 1 2024

Keywords

  • COVID-19 pandemic
  • healthcare setting
  • healthcare-associated respiratory viral infections
  • medical face mask
  • respiratory viral infections

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