Inhaled aerosols: Their role in COVID-19 transmission, including biophysical interactions in the lungs

Estimated relative potential for airborne SARS-CoV-2 transmission in a day care centre

We estimated the hourly probability of airborne severe acute respiratory coronavirus 2 (SARS-CoV-2) transmission and further the estimated number of persons at transmission risk in a day care centre by calculating the inhaled dose for airborne pathogens based on their concentration, exposure time and activity. Information about the occupancy and activity of the rooms was collected from day care centre personnel and building characteristics were obtained from the design values. The generation rate of pathogens was calculated as a product of viral load of the respiratory fluids and the emission of the exhaled airborne particles, considering the prevalence of the disease and the activity of the individuals. A well-mixed model was used in the estimation of the concentration of pathogens in the air. The Wells-Riley model was used for infection probability. The approach presented in this study was utilised in the identification of hot spots and critical events in the day care centre. Large variation in the infection probabilities and estimated number of persons at transmission risk was observed when modelling a normal day at the centre. The estimated hourly infection probabilities between the worst hour in the worst room and the best hour in the best room varied in the ratio of 100:1. Similarly, the number of persons at transmission risk between the worst and best cases varied in the ratio 1000:1. Although there are uncertainties in the input values affecting the absolute risk estimates the model proved to be useful in ranking and identifying the hot spots and events in the building and implementing effective control measures.

Polyhexamethylene guanidine accelerates the macrophage foamy formation mediated pulmonary fibrosis

Polyhexamethylene guanidine (PHMG) is manufactured and applied extensively due to its superior disinfectant capabilities. However, the inhalatory exposure to PHMG aerosols is increasingly recognized as a potential instigator of pulmonary fibrosis, prompting an urgent call for elucidation of the underlying pathophysiological mechanisms. Within this context, alveolar macrophages play a pivotal role in the primary immune defense in the respiratory tract. Dysregulated lipid metabolism within alveolar macrophages leads to the accumulation of foam cells, a process that is intimately linked with the pathogenesis of pulmonary fibrosis. Therefore, this study examines PHMG's effects on alveolar macrophage foaminess and its underlying mechanisms. We conducted a 3-week inhalation exposure followed by a 3-week recovery period in C57BL/6 J mice using a whole-body exposure system equipped with a disinfection aerosol generator (WESDAG). The presence of lipid-laden alveolar macrophages and downregulation of pulmonary tissue lipid transport proteins ABCA1 and ABCG1 were observed in mice. In cell culture models involving lipid-loaded macrophages, we demonstrated that PHMG promotes foam cell formation by inhibiting lipid efflux in mouse alveolar macrophages. Furthermore, PHMG-induced foam cells were found to promote an increase in the release of TGF-β1, fibronectin deposition, and collagen remodeling. In vivo interventions were subsequently implemented on mice exposed to PHMG aerosols, aiming to restore macrophage lipid efflux function. Remarkably, this intervention demonstrated the potential to retard the progression of pulmonary fibrosis. In conclusion, this study underscores the pivotal role of macrophage foaming in the pathogenesis of PHMG disinfectants-induced pulmonary fibrosis. Moreover, it provides compelling evidence to suggest that the regulation of macrophage efflux function holds promise for mitigating the progression of pulmonary fibrosis, thereby offering novel insights into the mechanisms underlying inhaled PHMG disinfectants-induced pulmonary fibrosis.

The impact of actuator nozzle and surroundings condition on drug delivery using pressurized-metered dose inhalers

The most commonly used method to deliver aerosolized drugs to the lung is with pressurized metered-dose inhalers (pMDIs). The spray actuator is a critical component of pMDI, since it controls the atomization process by forming aerosol plumes and determining droplet size distribution. Through computational fluid dynamics (CFD) simulations, this study investigated the effect of two different nozzle types (single conventional and twin nozzles) on drug deposition in the mouth-throat (MT) region. We also studied the behavior of aerosol plumes in both an open-air environment and the MT geometry. Our study revealed that spray aerosol generated in an unconfined, open-air environment with no airflow behaves distinctly from spray introduced into the MT geometry in the presence of airflow. In addition, the actuator structure significantly impacts the device's efficacy. In the real MT model, we found that the twin nozzle increases drug deposition in the MT region, and its higher aerosol velocity negatively affects its efficiency.

Evaluation of the effectiveness of four alternative approaches for the classical cough test during a urodynamic study in the context of the COVID-19 global pandemic

BACKGROUD

To evaluate four different alternatives to the classical cough test during a urodynamic study in the context of the COVID-19 pandemic.

METHODS

Patients who needed to undergo a urodynamic study (UDS) at the West China Hospital of Sichuan University between April 2021 and May 2021 were randomly selected according to the inclusion and exclusion criteria. During the UDS process, we used four alternative methods to the "cough test": 1) quickly pressing the bladder area, 2) performing the Valsalva maneuver, 3) performing the Kegel maneuver, and 4) letting the patient close their mouth while performing the cough test. The "cough" waveform amplitudes and characteristics of the graphics were obtained and compared with the classical cough test.

RESULTS

A total of 120 patients (89 men, 31 women) were included in the study. There was no significant difference between the cough waveform amplitude induced by the Valsalva maneuver compared with the classical cough test (P = 0.182); there was no significant difference between the cough waveform amplitude induced by the cough test with the mouth closed and the classical cough test (P = 0.342); there was no significant difference between pressing quickly on the bladder area and the classical method (P = 0.076); and there was a significant difference between the data obtained by the Kegel maneuver and the classical method (P < 0.05). The average "cough" amplitudes obtained were 73.14 ± 22.48 cm H2O, 66.17 ± 17.12 cm H2O, 82.93 ± 18.95 cm H2O, 26.50 ± 8.68 cm H2O, and 68.90 ± 20.32 cm H2O by the classical cough test, by quickly pressing the bladder area, by the Valsalva maneuver, by the Kegel maneuver, and by coughing with a closed mouth, respectively.

CONCLUSION

Quickly pressing the bladder area, performing the Valsalva maneuver, and letting the patient close their mouth while performing the cough test can all provide effective cough waveforms and amplitudes.

TRIAL REGISTRATION

No. 2021-183.

COVID infection in 4 steps: Thermodynamic considerations reveal how viral mucosal diffusion, target receptor affinity and furin cleavage act in concert to drive the nature and degree of infection in human COVID-19 disease

We have developed a mechanistic model of SARS-CoV-2 and SARS-CoV infection, exploring the relationship between the viral diffusion in the mucosa and viral affinity for the angiotensin converting enzyme 2 (ACE2) target. Utilising the structural similarity of SARS-CoV and SARS-CoV-2 and a shared viral target receptor (ACE2), but a dramatic difference in upper or lower respiratory tract infectivity, we were able to generate insights into the linkage of mucosal diffusion and target receptor affinity in determining the pathophysiological pathways of these two viruses. Our analysis reveals that for SARS-CoV-2 the higher affinity of ACE2 binding, the faster and more complete the mucosal diffusion in its transport from the upper airway to the region of the ACE2 target on the epithelium. This diffusional process is essential for the presentation of this virus to the furin catalysed highly efficient entry and infection process in the upper respiratory tract epithelial cells. A failure of SARS-CoV to follow this path is associated with lower respiratory tract infection and decreased infectivity. Thus, our analysis supports the view that through tropism SARS-CoV-2 has evolved a highly efficient membrane entry process that can act in concert with a high binding affinity of this virus and its variants for its ACE2 which in turn promotes enhanced movement of the virus from airway to epithelium. In this way ongoing mutations yielding higher affinities of SARS-CoV-2 for the ACE2 target becomes the basis for higher upper respiratory tract infectivity and greater viral spread. It is concluded that SARS-CoV-2 is constrained in the extent of its activities by the fundamental laws of physics and thermodynamics. Laws that describe diffusion and molecular binding. Moreover it can be speculated that the very earliest contact of this virus with the human mucosa defines the pathogenesis of this infection.

A review on indoor airborne transmission of COVID-19– modelling and mitigation approaches

In the past few years, significant efforts have been made to investigate the transmission of COVID-19. This paper provides a review of the COVID-19 airborne transmission modeling and mitigation strategies. The simulation models here are classified into airborne transmission infectious risk models and numerical approaches for spatiotemporal airborne transmissions. Mathematical descriptions and assumptions on which these models have been based are discussed. Input data used in previous simulation studies to assess the dispersion of COVID-19 are extracted and reported. Moreover, measurements performed to study the COVID-19 airborne transmission within indoor environments are introduced to support validations for anticipated future modeling studies. Transmission mitigation strategies recommended in recent studies have been classified to include modifying occupancy and ventilation operations, using filters and air purifiers, installing ultraviolet (UV) air disinfection systems, and personal protection compliance, such as wearing masks and social distancing. The application of mitigation strategies to various building types, such as educational, office, public, residential, and hospital, is reviewed. Recommendations for future works are also discussed based on the current apparent knowledge gaps covering both modeling and mitigation approaches. Our findings show that different transmission mitigation measures were recommended for various indoor environments; however, there is no conclusive work reporting their combined effects on the level of mitigation that may be achieved. Moreover, further studies should be conducted to understand better the balance between approaches to mitigating the viral transmissions in buildings and building energy consumption.

A cost-effectiveness assessment of the operational parameters of central HVAC systems during pandemics

The present study develops a cost-effectiveness assessment model to analyze the performance of major operational parameters of central HVAC systems in terms of airborne transmission risk, energy consumption, and medical and social cost. A typical multi-zone building model with a central HVAC system is built numerically, and the effect of outdoor air (OA) ratio (from 30% to 100%) and filtration level (MERV 13, MERV 16, and HEPA) are assessed under the conditions of five climate zones in China. Compared with the baseline case with 30% OA and MERV 13 filtration, the airborne transmission risk in zones without infector is negligibly reduced with the increase in OA ratio and the upgrade of filtration level, owing to their slight modification on the equivalent ventilation rate of virus-free air. However, depending on climate zone, a 10% increase in OA ratio results in 12.5%-78.6% and 0.1%-8.6% increase in heating and cooling energy consumption, respectively, while an upgrade of filtration level to MERV 16 and HEPA results in an increase of 0.08%-0.2% and 1.4%-2.6%, respectively. Overall, when compared to the use of 100% OA ratio and HEPA filtration, the application of 30% or 40% OA ratio and MERV 13 filtration would save annually an energy and facility related cost of $29.4 billion in China, though giving an increase of approximately $0.1 billion on medical and social cost from the increased number of confirmed cases. This study provides basic method and information for the formulation of cost-effective operational strategies of HVAC systems coping with the airborne transmission, especially in resource-limited regions.

SARS-CoV-2 in brief: from virus to prevention

The recent outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), ahighly transmissible virus with a likely animal origin, has posed major and unprecedentedchallenges to millions of lives across the affected nations of the world. This outbreak firstoccurred in China, and despite massive regional and global attempts shortly thereafter, itspread to other countries and caused millions of deaths worldwide. This review presents keyinformation about the characteristics of SARS-CoV-2 and its associated disease (namely,coronavirus disease 2019) and briefly discusses the origin of the virus. Herein, we also brieflysummarize the strategies used against viral spread and transmission.

Association Between Weather Parameters and SARS-CoV-2 Confirmed Cases in Two South African Cities

Several approaches have been used in the race against time to mitigate the spread and impact of COVID-19. In this study, we investigated the role of temperature, relative humidity, and particulate matter in the spread of COVID-19 cases within two densely populated cities of South Africa-Pretoria and Cape Town. The role of different levels of COVID-19 restrictions in the air pollution levels, obtained from the Purple Air Network, of the two cities were also considered. Our results suggest that 26.73% and 43.66% reduction in PM2.5 levels were observed in Cape Town and Pretoria respectively for no lockdown (Level 0) to the strictest lockdown level (Level 5). Furthermore, our results showed a significant relationship between particulate matter and COVID-19 in the two cities. Particulate matter was found to be a good predictor, based on the significance of causality test, of COVID-19 cases in Pretoria with a lag of 7 days and more. This suggests that the effect of particulate matter on the number of cases can be felt after 7 days and beyond in Pretoria.

Physiological characteristics, geochemical properties and hydrological variables influencing pathogen migration in subsurface system: What we know or not?

The global outbreak of coronavirus infectious disease-2019 (COVID-19) draws attentions in the transport and spread of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in aerosols, wastewater, surface water and solid wastes. As pathogens eventually enter the subsurface system, e.g., soils in the vadose zone and groundwater in the aquifers, they might survive for a prolonged period of time owing to the uniqueness of subsurface environment. In addition, pathogens can transport in groundwater and contaminate surrounding drinking water sources, possessing long-term and concealed risks to human society. This work critically reviews the influential factors of pathogen migration, unravelling the impacts of pathogenic characteristics, vadose zone physiochemical properties and hydrological variables on the migration of typical pathogens in subsurface system. An assessment algorithm and two rating/weighting schemes are proposed to evaluate the migration abilities and risks of pathogens in subsurface environment. As there is still no evidence about the presence and distribution of SARS-CoV-2 in the vadose zones and aquifers, this study also discusses the migration potential and behavior of SARS-CoV-2 viruses in subsurface environment, offering prospective clues and suggestions for its potential risks in drinking water and effective prevention and control from hydrogeological points of view.

Polymeric Nanoparticles for Inhaled Vaccines

Many recent studies focus on the pulmonary delivery of vaccines as it is needle-free, safe, and effective. Inhaled vaccines enhance systemic and mucosal immunization but still faces many limitations that can be resolved using polymeric nanoparticles (PNPs). This review focuses on the use of properties of PNPs, specifically chitosan and PLGA to be used in the delivery of vaccines by inhalation. It also aims to highlight that PNPs have adjuvant properties by themselves that induce cellular and humeral immunogenicity. Further, different factors influence the behavior of PNP in vivo such as size, morphology, and charge are discussed. Finally, some of the primary challenges facing PNPs are reviewed including formulation instability, reproducibility, device-related factors, patient-related factors, and industrial-level scale-up. Herein, the most important variables of PNPs that shall be defined in any PNPs to be used for pulmonary delivery are defined. Further, this study focuses on the most popular polymers used for this purpose.

Evaluating the Impact of Hydrophobic Silicon Dioxide in the Interfacial Properties of Lung Surfactant Films

The interaction of hydrophobic silicon dioxide particles (fumed silicon dioxide), as model air pollutants, and Langmuir monolayers of a porcine lung surfactant extract has been studied in order to try to shed light on the physicochemical bases underlying the potential adverse effects associated with pollutant inhalation. The surface pressure-area isotherms of lung surfactant (LS) films including increasing amounts of particles revealed that particle incorporation into LS monolayers modifies the organization of the molecules at the water/vapor interface, which alters the mechanical resistance of the interfacial films, hindering the ability of LS layers for reducing the surface tension, and reestablishing the interface upon compression. This influences the normal physiological function of LS as is inferred from the analysis of the response of the Langmuir films upon the incorporation of particles against harmonic changes of the interfacial area (successive compression-expansion cycles). These experiments evidenced that particles alter the relaxation mechanisms of LS films, which may be correlated to a modification of the transport of material within the interface and between the interface and the adjacent fluid during the respiratory cycle.

An Update on Advancements and Challenges in Inhalational Drug Delivery for Pulmonary Arterial Hypertension

A lethal condition at the arterial–alveolar juncture caused the exhaustive remodeling of pulmonary arterioles and persistent vasoconstriction, followed by a cumulative augmentation of resistance at the pulmonary vascular and, consequently, right-heart collapse. The selective dilation of the pulmonary endothelium and remodeled vasculature can be achieved by using targeted drug delivery in PAH. Although 12 therapeutics were approved by the FDA for PAH, because of traditional non-specific targeting, they suffered from inconsistent drug release. Despite available inhalation delivery platforms, drug particle deposition into the microenvironment of the pulmonary vasculature and the consequent efficacy of molecules are influenced by pathophysiological conditions, the characteristics of aerosolized mist, and formulations. Uncertainty exists in peripheral hemodynamics outside the pulmonary vasculature and extra-pulmonary side effects, which may be further exacerbated by underlying disease states. The speedy improvement of arterial pressure is possible via the inhalation route because it has direct access to pulmonary arterioles. Additionally, closed particle deposition and accumulation in diseased tissues benefit the restoration of remolded arterioles by reducing fallacious drug deposition in other organs. This review is designed to decipher the pathological changes that should be taken into account when targeting the underlying pulmonary endothelial vasculature, especially with regard to inhaled particle deposition in the alveolar vasculature and characteristic formulations.

Impact of Polymer Nanoparticles on DPPC Monolayer Properties

The application of surface rheology and Brewster angle microscopy on mixed monolayers of DPPC and polymeric nanoparticles (cationic and anionic) showed that the sign of the particle charge affects the dynamic properties of the monolayers less than the nanoparticles’ ability to aggregate. Under almost physiological conditions, the effect of nanoparticles on the elasticity of DPPC monolayer is insignificant. However, the particles prevent the surface tension from decreasing to extremely low values. This effect could affect the functionality of pulmonary surfactants.

Impact of natural ventilation on exposure to SARS-CoV 2 in indoor/semi-indoor terraces using CO2 concentrations as a proxy

Nowadays, it is necessary a better airborne transmission understanding of respiratory diseases in shared indoor and semi-indoor environments with natural ventilation in order to adopt effective people's health protection measures. The aim of this work is to evaluate the relative exposure to SARS-CoV 2 in a set of virtual scenarios representing enclosed and semi-enclosed terraces under different outdoor meteorological conditions. For this purpose, indoor CO₂ concentration is used as a proxy for the risk assessment. Airflow and people exhaled CO₂ in different scenarios are simulated through Computational Fluid Dynamics (CFD) modelling with Unsteady Reynolds-Averaged Navier-Stokes (URANS) approach. Both spatial average concentrations and local concentrations are analyzed. In general, spatial average concentrations decrease as ventilation increases, however, depending on the people arrangement inside the terrace, spatial average concentrations and local concentrations can be very different. Therefore, for assessing the relative exposure to SARS-CoV 2 it is necessary to consider the indoor flow patterns between infectors and susceptibles. This research provides detailed information about CO₂ dispersion in enclosed/semi-enclosed scenarios, which can be very useful for reducing the transmission risk through better natural ventilation designs and improving the classic risk models since it allows to check their hypotheses in real-world scenarios. Although CFD ventilation studies in indoor/semi-indoor environments have been already addressed in the literature, this research is focused on restaurant terraces, scenarios scarcely investigated. Likewise, one of the novelties of this study is to take into account the outdoor meteorological conditions to appropriately simulate natural ventilation.

Fluid Films as Models for Understanding the Impact of Inhaled Particles in Lung Surfactant Layers

Pollution is currently a public health problem associated with different cardiovascular and respiratory diseases. These are commonly originated as a result of the pollutant transport to the alveolar cavity after their inhalation. Once pollutants enter the alveolar cavity, they are deposited on the lung surfactant (LS) film, altering their mechanical performance which increases the respiratory work and can induce a premature alveolar collapse. Furthermore, the interactions of pollutants with LS can induce the formation of an LS corona decorating the pollutant surface, favoring their penetration into the bloodstream and distribution along different organs. Therefore, it is necessary to understand the most fundamental aspects of the interaction of particulate pollutants with LS to mitigate their effects, and design therapeutic strategies. However, the use of animal models is often invasive, and requires a careful examination of different bioethics aspects. This makes it necessary to design in vitro models mimicking some physico-chemical aspects with relevance for LS performance, which can be done by exploiting the tools provided by the science and technology of interfaces to shed light on the most fundamental physico-chemical bases governing the interaction between LS and particulate matter. This review provides an updated perspective of the use of fluid films of LS models for shedding light on the potential impact of particulate matter in the performance of LS film. It should be noted that even though the used model systems cannot account for some physiological aspects, it is expected that the information contained in this review can contribute on the understanding of the potential toxicological effects of air pollution.

Particle Size Analysis in Aerosol-Generating Dental Procedures Using Laser Diffraction Technique

The global outbreak of coronavirus disease 2019 (COVID-19) has raised concerns about the risk of airborne infection during dental treatment. Aerosol-generating dental procedures (AGDP) produce droplets and aerosols, but the details of the risks of COVID-19 transmission in AGDP are not well-understood. By discriminating between droplets and aerosols, we devised a method to measure particle size using laser diffraction analysis and evaluated aerosols generated from dental devices for providing a basis for proper infection control procedures. The droplets and aerosols generated from dental devices were characterized by multimodal properties and a wide range of droplet sizes, with the majority of droplets larger than 50 μm. AGDP emitted few aerosols smaller than 5 μm, which are of concern for pulmonary infections due to airborne transmission. In addition, the use of extraoral suction was found to prevent the spread of aerosols from high-speed dental engines. This study suggests that the risk of aerosol infections is considerably limited in regular dental practice and that current standard precautions, such as mainly focusing on protection against droplet and contact infections, are sufficient. While several cases of airborne transmission of COVID-19 in general clinics and emergency hospitals have been reported, cluster outbreaks in dental clinics have not yet been reported, which may indicate that AGDP does not pose a significant threat in contributing to the spread of SARS-CoV-2.

When Do We Need Massive Computations to Perform Detailed COVID-19 Simulations?

The COVID‐19 pandemic has infected over 250 million people worldwide and killed more than 5 million as of November 2021. Many intervention strategies are utilized (e.g., masks, social distancing, vaccinations), but officials making decisions have a limited time to act. Computer simulations can aid them by predicting future disease outcomes, but they also require significant processing power or time. It is examined whether a machine learning model can be trained on a small subset of simulation runs to inexpensively predict future disease trajectories resembling the original simulation results. Using four previously published agent‐based models (ABMs) for COVID‐19, a decision tree regression for each ABM is built and its predictions are compared to the corresponding ABM. Accurate machine learning meta‐models are generated from ABMs without strong interventions (e.g., vaccines, lockdowns) using small amounts of simulation data: the root‐mean‐square error (RMSE) with 25% of the data is close to the RMSE for the full dataset (0.15 vs 0.14 in one model; 0.07 vs 0.06 in another). However, meta‐models for ABMs employing strong interventions require much more training data (at least 60%) to achieve a similar accuracy. In conclusion, machine learning meta‐models can be used in some scenarios to assist in faster decision‐making.

What is suitable social distancing for people wearing face masks during the COVID-19 pandemic?

COVID-19 has caused the global pandemic and had a serious impact on people's daily lives. The respiratory droplets produced from coughing and talking of an infected patient were possible transmission routes of coronavirus between people. To avoid the infection, the US Centers for Disease Control and Prevention (CDC) advised to wear face masks while maintaining a social distancing of 2 m. Can the social distancing be reduced if people wear masks? To answer this question, we measured the mass of inhaled droplets by a susceptible manikin wearing a mask with different social distances, which was produced by coughing and talking of an index "patient" (human subject) also wearing a mask. We also used the computational fluid dynamics (CFD) technology with a porous media model and particle dispersion model to simulate the transmission of droplets from the patient to the susceptible person with surgical and N95 masks. We compared the CFD results with the measured velocity in the environmental chamber and found that the social distancing could be reduced to 0.5 m when people wearing face masks. In this case, the mass concentration of inhaled particles was less than two people without wearing masks and with a social distancing of 2 m. Hence, when the social distancing was difficult, wearing masks could protect people. We also found that the leakage between the face mask and the human face played an important role in the exhaled airflow pattern and particle dispersion. The verified numerical model can be used for more scenarios with different indoor environments and HVAC systems. The results of this study would make business profitable with reduced social distancing in transportation, education, and entertainment industries, which was beneficial for the reopening of the economy.

Isothermal amplification and fluorescent detection of SARS-CoV-2 and SARS-CoV-2 variant virus in nasopharyngeal swabs

The COVID-19 pandemic caused by the SARS-CoV-2 is a serious health threat causing worldwide morbidity and mortality. Real-time reverse transcription PCR (RT-qPCR) is currently the standard for SARS-CoV-2 detection. Although various nucleic acid-based assays have been developed to aid the detection of SARS-CoV-2 from COVID-19 patient samples, the objective of this study was to develop a diagnostic test that can be completed in 30 minutes without having to isolate RNA from the samples. Here, we present an RNA amplification detection method performed using reverse transcription loop-mediated isothermal amplification (RT-LAMP) reactions to achieve specific, rapid (30 min), and sensitive (<100 copies) fluorescent detection in real-time of SARS-CoV-2 directly from patient nasopharyngeal swab (NP) samples. When compared to RT-qPCR, positive NP swab samples assayed by fluorescent RT-LAMP had 98% (n = 41/42) concordance and negative NP swab samples assayed by fluorescent RT-LAMP had 87% (n = 59/68) concordance for the same samples. Importantly, the fluorescent RT-LAMP results were obtained without purification of RNA from the NP swab samples in contrast to RT-qPCR. We also show that the fluorescent RT-LAMP assay can specifically detect live virus directly from cultures of both SARS-CoV-2 wild type (WA1/2020), and a SARS-CoV-2 B.1.1.7 (alpha) variant strain with equal sensitivity to RT-qPCR. RT-LAMP has several advantages over RT-qPCR including isothermal amplification, speed (<30 min), reduced costs, and similar sensitivity and specificity.

Peptide-Based Inhibitors for SARS-CoV-2 and SARS-CoV

The COVID‐19 (coronavirus disease) global pandemic, caused by the spread of the SARS‐CoV‐2 (severe acute respiratory syndrome coronavirus 2) virus, currently has limited treatment options which include vaccines, anti‐virals, and repurposed therapeutics. With their high specificity, tunability, and biocompatibility, small molecules like peptides are positioned to act as key players in combating SARS‐CoV‐2, and can be readily modified to match viral mutation rate. A recent expansion of the understanding of the viral structure and entry mechanisms has led to the proliferation of therapeutic viral entry inhibitors. In this comprehensive review, inhibitors of SARS and SARS‐CoV‐2 are investigated and discussed based on therapeutic design, inhibitory mechanistic approaches, and common targets. Peptide therapeutics are highlighted, which have demonstrated in vitro or in vivo efficacy, discuss advantages of peptide therapeutics, and common strategies in identifying targets for viral inhibition.

How to address SARS-CoV-2 airborne transmission to ensure effective protection of healthcare workers? A review of the literature

SARS-CoV-2 mainly infects the respiratory tract, and presents significantly higher active replication in the upper airways. To remain viable and infectious, the SARS-CoV-2 virion must be complete and integral, which is not easily demonstrated in the environment by positive reverse transcriptase PCR results. Real-life conditions in healthcare settings may be conducive to SARS-CoV-2 RNA dissemination in the environment but without evidence of its viability and infectiveness in air. Theoretically, SARS-CoV-2 shedding and dissemination nonetheless appears to be air-mediated, and a distinction between “air” and “droplet” transmission is too schematic to reflect the reality of the respiratory particles emitted by patients, between which a continuum exists. Airborne transmission is influenced by numerous environmental conditions that are not transposable between different viral agents and situations in healthcare settings or in the community. Even though international guidelines on “droplet” versus “air” precautions and personal protective equipment (surgical versus respirator masks) are under discussion, the existing literature underscores the effectiveness of “droplet” precautions as a means of protecting healthcare workers. Differentiation in guidelines between healthcare venues, community settings and, more generally, confined environments is of paramount importance, especially insofar as it underlines the abiding pandemic-related need for systematic mask wearing by the general population.