• Ophir Bar-On, Yulia Gendler, Patrick Stafler, Hagit Levine, Guy Steuer, Einat Shmueli, Dario Prais, and Meir Mei-Zahav.
• From the Pulmonary Institute, Schneider Children's Medical Center of Israel, Petach Tikva, Israel (OB-O, YG, PS, HL, GS, ES, DP, MM-Z); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (PS, HL, DP, MM-Z); The Department of Nursing, Ariel University, Ariel, Israel (YG).
• J Am Board Fam Med. 2021 Jul 1; 34 (4): 798801798-801.

BackgroundDuring the Coronavirus disease 2019 (COVID-19) pandemic, wearing facemasks became obligatory worldwide.ObjectivesThe objective of this study was to evaluate the effects of facemasks on gas exchange.MethodsHealthy adults were assessed at rest and during slow and brisk 5-minute walks, with and without masks. We monitored O2 saturation, end-tidal carbon dioxide (EtCO2), and heart and respiratory rates. Participants graded their subjective difficulty and completed individual sensations questionnaires.ResultsTwenty-one participants with a median age of 38 years (range, 29-57 years) were recruited. At rest, all vital signs remained normal, without and with masks. However, during slow and brisk walks, EtCO2 increased; the rise was significantly higher while wearing masks: slow walk, mean EtCO2 (mmHg) change +4.5 ± 2.4 versus +2.9 ± 2.3, P = .004; brisk walk EtCO2 change +8.4 ± 3.0 versus +6.2 ± 4.0, P = .009, with and without masks, respectively. Wearing masks was also associated with higher proportions of participant hypercarbia (EtCO2 range, 46-49 mmHg) compared with walking without masks, though this was only partially significant. Mean O2-saturation remained stable (98%) while walking without masks but decreased by 1.2 % ± 2.2 while walking briskly with a mask (P = .01). Mild desaturation (O2 range, 93% to 96%) was noted during brisk walks among 43% of participants with masks, compared with only 14% without masks (P = .08). Borg's scale significantly increased while walking with a mask, for both slow and brisk walks (P < .001). Sensations of difficulty breathing and shortness of breath were more common while walking with masks.ConclusionWhile important to prevent viral spread, wearing facemasks during brisk 5-minute walks might be associated with mild hypercarbia and desaturation. The clinical significance of these minor gas exchange abnormalities is unclear and should be further investigated.© Copyright 2021 by the American Board of Family Medicine.

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