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Effects of face masks on oxygen saturation and functional measures in patients with connective tissue disorder-associated interstitial lung disease
  1. Anuroopa Vijayan1,2,
  2. Sakir Ahmed3,
  3. Sneha Joseph2,
  4. Aswathy Sukumaran2,
  5. Subin Ahmed4,
  6. Padmanabha Shenoy1,2
  1. 1 Rheumatology, Sree Sudheendra Medical Mission Hospital, Kochi, Kerala, India
  2. 2 Rheumatology, Centre for Arthritis and Rheumatism Excellence, Kochi, India
  3. 3 Clinical Immunology and Rheumatology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
  4. 4 Pulmonary Medicine, Renai Medicity Multi Super Specialty Hospital, Kochi, Kerala, India
  1. Correspondence to Dr Padmanabha Shenoy, Rheumatology, Sree Sudheendra Medical Mission Hospital, Kochi 682018, Kerala, India; drdpshenoy{at}

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Face masks are a first-line defence against the COVID-19 pandemic.1 Concerns about face masks reducing oxygen saturation (SpO2) have been negated by controlled studies in healthy individuals.2 3 Universal masking must be followed without exceptions. However, persons with pre-existing cardiorespiratory diseases like interstitial lung diseases (ILD) have limited functional reserves. We explored the effects of face masks in patients with connective tissue disease (CTD)-associated ILD (CTD-ILD).

Patients between 18 and 75 years of age with high-resolution CT (HRCT)-proven CTD-ILD and with Medical Research Council scale grades 1–3 dyspnoea and forced vital capacity (FVC) of less than 70% were included in this crossover trial. If FVC was >70%, patients were included only if the extent of involvement on HRCT was more than 20% of the lung. Patients requiring oxygen supplementation and with myositis or lower limb pain were excluded. Initial SpO2 was recorded and a standard 6 min walk test (6MWT) was carried out with and then without a standard three-layer surgical face mask. Adequate precautions were taken to prevent the spread of COVID-19 during the tests. Distance covered during the 6MWT was the primary outcome measure. The secondary outcome measures …

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  • Handling editor Josef S Smolen

  • Contributors Conceptualisation: PS. Methodology: PS, SaA,SuA, AV, SJ. Writing-original draft: SaA. Writing-review and editing: all authors. All authors have approved the final manuscript and take full responsibility for the integrity of the data and the content of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.