PT - JOURNAL ARTICLE AU - Mapelli, Massimo AU - Salvioni, Elisabetta AU - De Martino, Fabiana AU - Mattavelli, Irene AU - Gugliandolo, Paola AU - Vignati, Carlo AU - Farina, Stefania AU - Palermo, Pietro AU - Campodonico, Jeness AU - Maragna, Riccardo AU - Lo Russo, Gerardo AU - Bonomi, Alice AU - Sciomer, Susanna AU - Agostoni, Piergiuseppe TI - “You can leave your mask on”: effects on cardiopulmonary parameters of different airway protection masks at rest and during maximal exercise AID - 10.1183/13993003.04473-2020 DP - 2021 Jan 01 TA - European Respiratory Journal PG - 2004473 4099 - https://publications.ersnet.org//content/early/2021/02/04/13993003.04473-2020.short 4100 - https://publications.ersnet.org//content/early/2021/02/04/13993003.04473-2020.full AB - Background During the COVID-19 pandemic, the use of protection masks is essential to reduce contagions. However, public opinion reports an associated subjective shortness of breath. We evaluated cardiorespiratory parameters at rest and during maximal exertion to highlight any differences with the use of protection masks.Methods Twelve healthy subjects underwent three cardiopulmonary exercise tests: without wearing protection mask, with surgical and with FFP2 mask. Dyspnea was assessed by Borg Scale. Standard pulmonary function tests were also performed.Results All the subjects (40.8±12.4 years; 6 males) completed the protocol with no adverse event. At spirometry, from no mask to surgical to FFP2, a progressive reduction of FEV1 and FVC was observed (3.94±0.91 l, 3.23±0.81 l, 2.94±0.98 l and 4.70±1.21 l, 3.77±1.02 l, 3.52±1.21 l, respectively, p<0.001). Rest ventilation, O2 uptake (V̇O2) and CO2 production (VCO2) were progressively lower with a reduction of respiratory rate. At peak exercise, subjects revealed a progressively higher Borg scale when wearing surgical and FFP2. Accordingly, at peak exercise, V̇O2 (31.0±23.4, 27.5±6.9, 28.2±8.8 ml/kg/min, p=0.001), ventilation (92±26, 76±22, 72±21 l, p=0.003), respiratory rate (42±8, 38±5, 37±4, p=0.04) and tidal volume (2.28±0.72, 2.05±0.60, 1.96±0.65 l, p=0.001) were gradually lower. We did not observed a significant difference in oxygen saturation.Conclusions Protection masks are associated with significant but modest worsening of spirometry and cardiorespiratory parameters at rest and peak exercise. The effect is driven by a ventilation reduction due to an increased airflow resistance. However, since exercise ventilatory limitation is far from being reached, their use is safe even during maximal exercise, with a slight reduction in performance.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Mapelli has nothing to disclose.Conflict of interest: Dr. Salvioni has nothing to disclose.Conflict of interest: Dr. De Martino has nothing to disclose.Conflict of interest: Dr. Mattavelli has nothing to disclose.Conflict of interest: Dr. Gugliandolo has nothing to disclose.Conflict of interest: Dr. Vignati has nothing to disclose.Conflict of interest: Dr. Farina has nothing to disclose.Conflict of interest: Dr. Palermo has nothing to disclose.Conflict of interest: Dr. Campodonico has nothing to disclose.Conflict of interest: Dr. Maragna has nothing to disclose.Conflict of interest: Dr. Lo Russo has nothing to disclose.Conflict of interest: Dr. Bonomi has nothing to disclose.Conflict of interest: Dr. Sciomer has nothing to disclose.Conflict of interest: Dr. Agostoni reports non-financial support from Menarini, grants from Daiichi Sankyo, non-financial support from Novartis, non-financial support from Boeringer, grants and non-financial support from Actelion, grants from Bayer, outside the submitted work.