The role of gowns in preventing nosocomial transmission of respiratory viruses: a systematic review
Orsel, LM Severin, JA Knoester, M Lokate, M Voss, A Haanappel, CP van Kampen, JJA Haagmans, BL Koopmans, MPG Veldkamp, KE
Orsel, LM
Severin, JA
Knoester, M
Lokate, M
Voss, A
Haanappel, CP
van Kampen, JJA
Haagmans, BL
Koopmans, MPG
Veldkamp, KE
Series / Report no.
Open Access
Type
Journal Article
Article
Article
Language
en
Date of publication
2025-06-16
Year of publication
Research Projects
Organizational Units
Journal Issue
Title
The role of gowns in preventing nosocomial transmission of respiratory viruses: a systematic review
Translated Title
Published in
J Hosp Infect 2025; 163:57-71
Abstract
BACKGROUND: During the COVID-19 pandemic, long-sleeved gowns were advocated as personal protective equipment for healthcare workers (HCWs). The purpose of gowns is preventing transmission of infectious agents via the uniform or arms during contact with patients and their surroundings. Gowns, however, entail a substantial burden; in costs, workload for HCWs, and generated waste.
AIM: To evaluate the current knowledge regarding the use of gowns during care of patients with COVID-19 and other respiratory viruses to prevent nosocomial transmission.
METHODS: PRISMA guidelines were used to search five databases (Medline, Embase, Web of Science, Cochrane, Google Scholar) up to April 11, 2023.
FINDINGS: The search identified 2667 potentially relevant studies, of which 30 were selected and divided into four categories. In 12 studies, contamination rates of gowns ranged from 0% to 77.5% (median: 1.43%). Three out of seven studies showed that virus remained infectious the longest on Tyvek coveralls and plastic gowns, and the shortest on cotton and polyester. Two out of seven studies found a protective effect between HCW protective clothing and infection of HCWs. Finally, three out of four studies concluded that short sleeves, cotton gowns, or no gowns provided the same level of protection as standard gowns.
CONCLUSION: Viral RNA can be found on clothing, but it is unclear whether viruses are transmitted to HCWs and/or patients. Evidence for the protective effect of long-sleeved gowns over alternatives is still insufficient. Therefore, well-controlled and adequately powered laboratory transmission experiments that simulate real-life conditions are necessary.