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recommended for self-isolation with wearing masks, 9, 10, 31 which can be also used in patients after extubation to reduce the risk of contamination in PACU, as a risk of affecting the respiratory system as well. Hypoxemia is one of the most adverse respiratory events in PACU,32 which could increase 1-year postoperative mortality.33 In our study, we did not found that wearing medical 14 masks could reduce oxygen saturation after extubation. No more hypoxemia and SpO2＜95% happened in these patients. According to Fikenzer, ventilation could be reduced by wearing surgical masks during exercise in healthy individuals.34 Furthermore, wearing masks at rest or brisk walking is safe for cardiopulmonary capacity in children.35 Intensifying monitoring and nursing is also essential to prevent hypoxemia in PACU, especially when patients were wearing masks. Generally, wearing masks dose increase the resistance to breathing, resulting an increase in CO2 in the mask's dead zone. Although recent research have demonstrated that short-term moderate-strenuous aerobic physical activity with masks is associated with an increase in EtCO2 15 , variation of PaCO2 has not found in our study. It was useful to reduce dead space by making sure no gaps between the medical mask and face. In the present study, wearing medical masks reduced patient comfort. Clinical study has suggested a consistent and significant increase in negative ratings for all items of discomfort (humidity, heat, breathing resistance, itchiness, tightness, saltiness, feeling unfit, odor, fatigue, and overall discomfort ) from surgical masks to FFP2/N95 masks 34 . Despite discomfort, compliance can still be achieved by understanding the benefits and need, which can be further reduced by effective communication with patients who will have a positive attitude towards personal protection. There are clearly multiple limitations in this study. Firstly, we just compared the data in adult patients, and did not include other patients at high risks (preoperative acute respiratory pathology, BMI＞35kg m -2 , duration of surgery over 3 hours) of postoperative hypoxemia, therefore, we 15 cannot address whether hypoxemia increase in these patients or not. Secondly, headaches, dyspnea, pressure on nose and rash on face variations were not recorded, as these symptoms often occur with wearing masks. Additionally, studies on the prolonged use of surgical masks after general anesthesia and qualitative studies to assess the impact of mask use in children and the aged will have to be undertaken. Conclusions In summary, the median SpO2 we reported in adult surgical patients with medical masks after general anaesthesia did not reduce. Wearing medical masks may be safe without more hypoxemia and adverse respiratory events in PACU during the COVID-19 epidemic. Our report can contribute valuable data to the rational use of masks in perioperative COVID-19 defense. References 1. Cossarizza A, De Biasi S, Guaraldi G, Girardis M, Mussini C, Modena Covid-19 Working Group (MoCo19)#. SARS-CoV-2, the Virus that Causes COVID-19: Cytometry and the New Challenge for Global Health. Cytometry A. 2020. 97(4): 340-343. 2. Deng CX. The global battle against SARS-CoV-2 and COVID-19. Int J Biol Sci. 2020. 16(10): 1676-1677. 3. Wu Y, Ho W, Huang Y, et al. SARS-CoV-2 is an appropriate name for the new coronavirus. Lancet. 2020. 395(10228): 949-950. 4. Organization WH. Weekly epidemiological update - 29 December 2020. 16 https://www.who.int/publications/m/item/weekly-epidemiological-update---29-december-2 020 5. Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun 2020; 109:102433. 6. Adhikari SP, Meng S, Wu YJ, et al. Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: a scoping review. Infect Dis Poverty 2020; 9:29. 7. Bartoszko JJ, Farooqi M, Alhazzani W, Loeb M. Medical Masks vs N95 Respirators for Preventing COVID-19 in Health Care
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