Objective: To systematically assess the evidence comparing directly the effectiveness of surgical facemasks to respirators in the prevention of COVID-19 infection in Health care Workers (HCWs) providing non-Aerosol Generating Procedure (AGP) care to Covid-19 patients.

Methods: We performed a systematic review of literature databases. This was prospectively registered.

Results: We identified only one relevant study which reported no significant difference in COVID-19 infection rates amongst HCWs wearing surgical facemasks as compared to FFP2 respirators. That was observational with substantial methodological deficiencies.

Conclusions: There is lack of evidence to support the use of either fluid resistant surgical masks or FFP respirators when providing non-AGP care to Covid-19 patients. Until high quality evidence is available, and given that inadequate mask use may increase the risk of nosocomial infection amongst patients and HCWs, we recommend respirators for non-AGP care of Covid-19 patients.