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Nagy A, Czitrovszky A, Lehoczki A, Farkas Á, Füri P, Osán J, Groma V, Kugler S, Micsinai A, Horváth A, Ungvári Z, Müller V. Creating respiratory pathogen-free environments in healthcare and nursing-care settings: a comprehensive review. GeroScience 2024:10.1007/s11357-024-01379-7. [PMID: 39392557 DOI: 10.1007/s11357-024-01379-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Accepted: 10/03/2024] [Indexed: 10/12/2024] Open
Abstract
Hospital- and nursing-care-acquired infections are a growing problem worldwide, especially during epidemics, posing a significant threat to older adults in geriatric settings. Intense research during the COVID-19 pandemic highlighted the prominent role of aerosol transmission of pathogens. Aerosol particles can easily adsorb different airborne pathogens, carrying them for a long time. Understanding the dynamics of airborne pathogen transmission is essential for controlling the spread of many well-known pathogens, like the influenza virus, and emerging ones like SARS-CoV-2. Particles smaller than 50 to 100 µm remain airborne and significantly contribute to pathogen transmission. This review explores the journey of pathogen-carrying particles from formation in the airways, through airborne travel, to deposition in the lungs. The physicochemical properties of emitted particles depend on health status and emission modes, such as breathing, speaking, singing, coughing, sneezing, playing wind instruments, and medical interventions. After emission, sedimentation and evaporation primarily determine particle fate. Lung deposition of inhaled aerosol particles can be studied through in vivo, in vitro, or in silico methods. We discuss several numerical lung models, such as the Human Respiratory Tract Model, the LUng Dose Evaluation Program software (LUDEP), the Stochastic Lung Model, and the Computational Fluid Dynamics (CFD) techniques, and real-time or post-evaluation methods for detecting and characterizing these particles. Various air purification methods, particularly filtration, are reviewed for their effectiveness in healthcare settings. In the discussion, we analyze how this knowledge can help create environments with reduced PM2.5 and pathogen levels, enhancing safety in healthcare and nursing-care settings. This is particularly crucial for protecting older adults, who are more vulnerable to infections due to weaker immune systems and the higher prevalence of chronic conditions. By implementing effective airborne pathogen control measures, we can significantly improve health outcomes in geriatric settings.
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Affiliation(s)
- Attila Nagy
- Department of Applied and Nonlinear Optics, HUN-REN Wigner Research Centre for Physics, Konkoly-Thege Miklós St. 29-33, 1121, Budapest, Hungary.
| | - Aladár Czitrovszky
- Department of Applied and Nonlinear Optics, HUN-REN Wigner Research Centre for Physics, Konkoly-Thege Miklós St. 29-33, 1121, Budapest, Hungary
| | - Andrea Lehoczki
- Doctoral College, Health Sciences Program, Semmelweis University, Budapest, Hungary
- Institute of Preventive Medicine and Public Health, Semmelweis University, Budapest, Hungary
| | - Árpád Farkas
- Environmental Physics Department, HUN-REN Centre for Energy Research, Budapest, Hungary
| | - Péter Füri
- Environmental Physics Department, HUN-REN Centre for Energy Research, Budapest, Hungary
| | - János Osán
- Environmental Physics Department, HUN-REN Centre for Energy Research, Budapest, Hungary
| | - Veronika Groma
- Environmental Physics Department, HUN-REN Centre for Energy Research, Budapest, Hungary
| | - Szilvia Kugler
- Environmental Physics Department, HUN-REN Centre for Energy Research, Budapest, Hungary
| | | | - Alpár Horváth
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Zoltán Ungvári
- Vascular Cognitive Impairment and Neurodegeneration Program, Oklahoma Center for Geroscience and Healthy Brain Aging, Department of Biochemistry & Molecular Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 731042, USA
- Peggy and Charles Stephenson Cancer Center, Oklahoma City, OK, 73104, USA
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Institute of Preventive Medicine and Public Health, Semmelweis University, Budapest, Hungary
| | - Veronika Müller
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
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Fry J, Lee JYH, McAuley JL, Porter JL, Monk IR, Martin ST, Collins DJ, Barbante GJ, Fitzgerald NJ, Stinear TP. Optimization of Reverse Transcription Loop-Mediated Isothermal Amplification for In Situ Detection of SARS-CoV-2 in a Micro-Air-Filtration Device Format. ACS OMEGA 2024; 9:40832-40840. [PMID: 39372017 PMCID: PMC11447726 DOI: 10.1021/acsomega.4c05784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 09/06/2024] [Accepted: 09/11/2024] [Indexed: 10/08/2024]
Abstract
The Coronavirus disease 2019 (COVID-19) pandemic has supercharged innovation in the field of molecular diagnostics and led to the exploration of systems that permit the autonomous identification of airborne infectious agents. Airborne virus detection is an emerging approach for determining exposure risk, although current methods limit intervention timeliness. Here, we explore reverse transcription loop-mediated isothermal amplification (RT-LAMP) assays for one-pot detection of Severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) (SCV2) run on membrane filters suitable for micro-air-filtration of airborne viruses. We use a design of experiments statistical framework to establish the optimal additive composition for running RT-LAMP on membrane filters. Using SCV2 liquid spike-in experiments and fluorescence detection, we show that single-pot RT-LAMP on glass fiber filters reliably detected 0.10 50% tissue culture infectious dose (TCID50) SCV2 per reaction (3600 E-gene copies) and is an order of magnitude more sensitive than conventional RT-LAMP.
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Affiliation(s)
- Jacob Fry
- ARC
Centre of Excellence in Exciton Science, The School of Chemistry, The University of Melbourne, Masson Rd, Parkville, Victoria 3010, Australia
- Department
of Microbiology and Immunology, The Doherty Institute for Infection
and Immunity, The University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
| | - Jean Y. H. Lee
- Department
of Microbiology and Immunology, The Doherty Institute for Infection
and Immunity, The University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
| | - Julie L. McAuley
- Department
of Microbiology and Immunology, The Doherty Institute for Infection
and Immunity, The University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
| | - Jessica L. Porter
- Department
of Microbiology and Immunology, The Doherty Institute for Infection
and Immunity, The University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
| | - Ian R. Monk
- Department
of Microbiology and Immunology, The Doherty Institute for Infection
and Immunity, The University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
| | - Samuel T. Martin
- Department
of Biomedical Engineering, The University
of Melbourne, Building
261/203 Bouverie St, Carlton, Victoria 3053, Australia
| | - David J. Collins
- Department
of Biomedical Engineering, The University
of Melbourne, Building
261/203 Bouverie St, Carlton, Victoria 3053, Australia
- Graeme
Clarke Institute, The University of Melbourne, Chemical Engineering 2 Building
167, Parkville, Victoria 3010, Australia
| | - Gregory J. Barbante
- Defence
Science and Technology Group, Australian
Department of Defence, 506 Lorimer Street, Fishermans Bend, Victoria 3207, Australia
| | - Nicholas J. Fitzgerald
- Defence
Science and Technology Group, Australian
Department of Defence, 506 Lorimer Street, Fishermans Bend, Victoria 3207, Australia
| | - Timothy P. Stinear
- Department
of Microbiology and Immunology, The Doherty Institute for Infection
and Immunity, The University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
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3
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Tandjaoui-Lambiotte Y, Elabbadi A, Marouane B, Besset S, Roux D, Ebstein N, Pineau P, Marchio A, Bloch-Queyrat C, Lomont A, Alloui CA, Gerber A, Delagrèverie H, Cohen Y, Zahar JR, Voiriot G. Routes of SARS-Cov2 transmission in the intensive care unit: A multicentric prospective study. J Infect Public Health 2024; 17:102454. [PMID: 38936235 DOI: 10.1016/j.jiph.2024.05.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 05/04/2024] [Accepted: 05/15/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND The risk of SARS-CoV-2 transmission to health care workers in intensive care units (ICU) and the contribution of airborne and fomites to SARS-CoV-2 transmission remain unclear. To assess the rate of air and surface contamination and identify risk factors associated with this contamination in patients admitted to the ICU for acute respiratory failure due to SARS-CoV-2 pneumonia. METHODS Prospective multicentric non-interventional study conducted from June 2020 to November 2020 in 3 French ICUs. For each enrolled patient, 3 predefined surfaces were swabbed, 2 air samples at 1 m and 3 m from the patient's mouth and face masks of 3 health care workers (HCW) were collected within the first 48 h of SARS-CoV-2 positive PCR in a respiratory sample. Droplet digital PCR and quantitative PCR were performed on different samples, respectively. RESULTS Among 150 included patients, 5 (3.6%, 95%CI: 1.2% to 8.2%) had positive ddPCR on air samples at 1 m or 3 m. Seventy-one patients (53.3%, CI95%: 44.5% to 62.0%) had at least one surface positive. Face masks worn by HCW were positive in 6 patients (4.4%, CI: 1.6% to 9.4%). The threshold of RT-qPCR of the respiratory sample performed at inclusion (odds ratio, OR= 0.88, 95%CI: 0.83 to 0.93, p < 0.0001) and the presence of diarrhea (OR= 3.28, 95%CI: 1.09 to 9.88, p = 0.037) were significantly associated with the number of contaminated surfaces. CONCLUSION In this study, including patients admitted to the ICU for acute respiratory failure " contact route " of transmission, i.e. through fomites, seems dominant. While presence of SARS-CoV-2 in the air is rare in this specific population, the presence of diarrhea is associated to surface contamination around Covid patients.
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Affiliation(s)
- Yacine Tandjaoui-Lambiotte
- Delafontaine Hospital, Department of Pulmonology and Infectious Diseases, Saint Denis, France; INSERM UMR 1272 Hypoxia & Lung, Bobigny, France; INSERM UMR 1137 IAME, Paris, France.
| | - Alexandre Elabbadi
- Sorbonne Université, Centre de Recherche Saint-Antoine UMRS_938 INSERM, Assistance Publique - Hôpitaux de Paris, Service de Médecine Intensive Réanimation, Hôpital Tenon, Paris, France
| | - Boubaya Marouane
- University Sorbonne Paris Nord, APHP, Avicenne hospital, Clinical Research Unit, Bobigny, France
| | - Sebastien Besset
- University Paris Cité, APHP, Louis Mourier Hospital, DMU ESPRIT, Intensive Care Unit, Colombes, France
| | - Damien Roux
- University Paris Cité, APHP, Louis Mourier Hospital, DMU ESPRIT, Intensive Care Unit, Colombes, France
| | - Nathan Ebstein
- University Sorbonne Paris Nord, APHP, Avicenne Hospital, Intensive Care Unit, Bobigny, France
| | - Pascal Pineau
- Pasteur Institute, Nuclear organization and oncogenesis, INSERM U993, France
| | - Agnes Marchio
- Pasteur Institute, Nuclear organization and oncogenesis, INSERM U993, France
| | - Coralie Bloch-Queyrat
- University Sorbonne Paris Nord, APHP, Avicenne hospital, Clinical Research Unit, Bobigny, France
| | - Alexandra Lomont
- University Sorbonne Paris Nord, APHP, Avicenne Hospital, Microbiology Department, Infection Control Unit, Bobigny, France Sorbonne Paris Nord University, Bobigny, France
| | - Chakib-Ahmed Alloui
- University Sorbonne Paris Nord, APHP, Avicenne Hospital, Microbiology Department Virology Unit, Bobigny, France, Sorbonne Paris Nord University, Bobigny, France
| | - Athenaïs Gerber
- University Sorbonne Paris Nord, APHP, Avicenne Hospital, Microbiology Department Virology Unit, Bobigny, France, Sorbonne Paris Nord University, Bobigny, France
| | - Heloise Delagrèverie
- University Sorbonne Paris Nord, APHP, Avicenne Hospital, Microbiology Department Virology Unit, Bobigny, France, Sorbonne Paris Nord University, Bobigny, France
| | - Yves Cohen
- University Sorbonne Paris Nord, APHP, Avicenne Hospital, Intensive Care Unit, Bobigny, France
| | - Jean Ralph Zahar
- University Paris Cité, APHP, Louis Mourier Hospital, DMU ESPRIT, Intensive Care Unit, Colombes, France
| | - Guillaume Voiriot
- Sorbonne Université, Centre de Recherche Saint-Antoine UMRS_938 INSERM, Assistance Publique - Hôpitaux de Paris, Service de Médecine Intensive Réanimation, Hôpital Tenon, Paris, France
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Zhang Y, Shankar SN, Vass WB, Lednicky JA, Fan ZH, Agdas D, Makuch R, Wu CY. Air Change Rate and SARS-CoV-2 Exposure in Hospitals and Residences: A Meta-Analysis. AEROSOL SCIENCE AND TECHNOLOGY : THE JOURNAL OF THE AMERICAN ASSOCIATION FOR AEROSOL RESEARCH 2024; 58:217-243. [PMID: 38764553 PMCID: PMC11101186 DOI: 10.1080/02786826.2024.2312178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 01/16/2024] [Indexed: 05/21/2024]
Abstract
As SARS-CoV-2 swept across the globe, increased ventilation and implementation of air cleaning were emphasized by the US CDC and WHO as important strategies to reduce the risk of inhalation exposure to the virus. To assess whether higher ventilation and air cleaning rates lead to lower exposure risk to SARS-CoV-2, 1274 manuscripts published between April 2020 and September 2022 were screened using key words "airborne SARS-CoV-2 or "SARS-CoV-2 aerosol". Ninety-three studies involved air sampling at locations with known sources (hospitals and residences) were selected and associated data were compiled. Two metrics were used to assess exposure risk: SARS-CoV-2 concentration and SARS-CoV-2 detection rate in air samples. Locations were categorized by type (hospital or residence) and proximity to the sampling location housing the isolated/quarantined patient (primary or secondary). The results showed that hospital wards had lower airborne virus concentrations than residential isolation rooms. A negative correlation was found between airborne virus concentrations in primary-occupancy areas and air changes per hour (ACH). In hospital settings, sample positivity rates were significantly reduced in secondary-occupancy areas compared to primary-occupancy areas, but they were similar across sampling locations in residential settings. ACH and sample positivity rates were negatively correlated, though the effect was diminished when ACH values exceeded 8. While limitations associated with diverse sampling protocols exist, data considered by this meta-analysis support the notion that higher ACH may reduce exposure risks to the virus in ambient air.
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Affiliation(s)
- Yuetong Zhang
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
- Department of Mechanical Engineering, University of British Columbia, Vancouver, British Columnia, Canada
| | - Sripriya Nannu Shankar
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
- Department of Environmental & Public Health Sciences, University of Cincinnati, Cincinnati, Ohio, USA
| | - William B. Vass
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
| | - John A. Lednicky
- Department of Environmental and Global Health, University of Florida, Gainesville, Florida, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA
| | - Z. Hugh Fan
- Mechanical and Aerospace Engineering, University of Florida, Gainesville, Florida, USA
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida, USA
| | - Duzgun Agdas
- Engineering School of Sustainable Infrastructure & Environment, University of Florida, Gainesville, Florida, USA
| | - Robert Makuch
- Department of Biostatistics, Yale University School of Public Health, New Haven, Connecticut, USA
| | - Chang-Yu Wu
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
- Department of Chemical, Environmental, and Materials Engineering, University of Miami, Coral Gables, Florida, USA
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5
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Barberá-Riera M, Barneo-Muñoz M, Gascó-Laborda JC, Bellido Blasco J, Porru S, Alfaro C, Esteve Cano V, Carrasco P, Rebagliato M, de Llanos R, Delgado-Saborit JM. Detection of SARS-CoV-2 in aerosols in long term care facilities and other indoor spaces with known COVID-19 outbreaks. ENVIRONMENTAL RESEARCH 2024; 242:117730. [PMID: 38000631 DOI: 10.1016/j.envres.2023.117730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 11/14/2023] [Accepted: 11/16/2023] [Indexed: 11/26/2023]
Abstract
Coronavirus outbreaks are likely to occur in crowded and congregate indoor spaces, and their effects are most severe in vulnerable long term care facilities (LTCFs) residents. Public health officers benefit from tools that allow them to control COVID-19 outbreaks in vulnerable settings such as LTCFs, but which could be translated in the future to control other known and future virus outbreaks. This study aims to develop and test a methodology based on detection of SARS-CoV-2 in aerosol samples collected with personal pumps that could be easily implemented by public health officers. The proposed methodology was used to investigate the levels of SARS-CoV-2 in aerosol in indoor settings, mainly focusing on LTCFs, suffering COVID-19 outbreaks, or in the presence of known COVID-19 cases, and targeting the initial days after diagnosis. Aerosol samples (N = 18) were collected between November 2020 and March 2022 in Castelló (Spain) from LTCFs, merchant ships and a private home with recently infected COVID-19 cases. Sampling was performed for 24-h, onto 47 mm polytetrafluoroethylene (PTFE) and quartz filters, connected to personal pumps at 2 and 4 L/min respectively. RNA from filters was extracted and SARS-CoV-2 was determined by detection of regions N1 and N2 of the nucleocapsid gene alongside the E gene using RT-PCR technique. SARS-CoV-2 genetic material was detected in 87.5% samples. Concentrations ranged ND-19,525 gc/m3 (gene E). No genetic traces were detected in rooms from contacts that were isolated as a preventative measure. Very high levels were also measured at locations with poor ventilation. Aerosol measurement conducted with the proposed methodology provided useful information to public health officers and contributed to manage and control 12 different COVID-19 outbreaks. SARS-CoV-2 was detected in aerosol samples collected during outbreaks in congregate spaces. Indoor aerosol sampling is a useful tool in the early detection and management of COVID-19 outbreaks and supports epidemiological investigations.
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Affiliation(s)
- M Barberá-Riera
- Department of Medicine, Faculty of Health Sciences, Universitat Jaume I, Avenida de Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain
| | - M Barneo-Muñoz
- Department of Medicine, Faculty of Health Sciences, Universitat Jaume I, Avenida de Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain
| | - J C Gascó-Laborda
- Epidemiology Division, Public Health Center, Castelló de la Plana, Spain
| | - J Bellido Blasco
- Department of Medicine, Faculty of Health Sciences, Universitat Jaume I, Avenida de Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain; Epidemiology Division, Public Health Center, Castelló de la Plana, Spain; Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Av. Catalunya 21, 46020, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029, Madrid, Spain
| | - S Porru
- Department of Medicine, Faculty of Health Sciences, Universitat Jaume I, Avenida de Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain
| | - C Alfaro
- Department of Medicine, Faculty of Health Sciences, Universitat Jaume I, Avenida de Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain
| | - V Esteve Cano
- Department of Inorganic and Organic Chemistry, Universitat Jaume I, Avenida de Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain
| | - P Carrasco
- Department of Medicine, Faculty of Health Sciences, Universitat Jaume I, Avenida de Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain; Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Av. Catalunya 21, 46020, Valencia, Spain
| | - M Rebagliato
- Department of Medicine, Faculty of Health Sciences, Universitat Jaume I, Avenida de Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain; Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Av. Catalunya 21, 46020, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029, Madrid, Spain
| | - R de Llanos
- Department of Medicine, Faculty of Health Sciences, Universitat Jaume I, Avenida de Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain.
| | - J M Delgado-Saborit
- Department of Medicine, Faculty of Health Sciences, Universitat Jaume I, Avenida de Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain; Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Av. Catalunya 21, 46020, Valencia, Spain.
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6
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Reissner J, Siller P, Bartel A, Roesler U, Friese A. Stability of Feline Coronavirus in aerosols and dried in organic matrices on surfaces at various environmental conditions. Sci Rep 2023; 13:22012. [PMID: 38086913 PMCID: PMC10716419 DOI: 10.1038/s41598-023-49361-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 12/07/2023] [Indexed: 12/18/2023] Open
Abstract
Enveloped respiratory viruses, including the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can be transmitted through aerosols and contact with contaminated surfaces. The stability of these viruses outside the host significantly impacts their transmission dynamics and the spread of diseases. In this study, we investigated the tenacity of Feline Coronavirus (FCoV) in aerosols and on surfaces under varying environmental conditions. We found that airborne FCoV showed different stability depending on relative humidity (RH), with higher stability observed at low and high RH. Medium RH conditions (50-60%) were associated with increased loss of infectivity. Furthermore, FCoV remained infectious in the airborne state over 7 h. On stainless-steel surfaces, FCoV remained infectious for several months, with stability influenced by organic material and temperature. The presence of yeast extract and a temperature of 4 °C resulted in the longest maintenance of infectivity, with a 5 log10 reduction of the initial concentration after 167 days. At 20 °C, this reduction was achieved after 19 days. These findings highlight the potential risk of aerosol and contact transmission of respiratory viruses, especially in enclosed environments, over extended periods. Studying surrogate viruses like FCoV provides important insights into the behavior of zoonotic viruses like SARS-CoV-2 in the environment.
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Affiliation(s)
- Janina Reissner
- Institute of Animal Hygiene and Environmental Health, Veterinary Centre for Resistance Research-TZR, School of Veterinary Medicine, Freie Universität Berlin, 14163, Berlin, Germany.
| | - Paul Siller
- Institute of Animal Hygiene and Environmental Health, Veterinary Centre for Resistance Research-TZR, School of Veterinary Medicine, Freie Universität Berlin, 14163, Berlin, Germany
- Federal Office of Consumer Protection and Food Safety, Department Veterinary Drugs, Mittelstraße 51-54, 10117, Berlin, Germany
| | - Alexander Bartel
- Institute of Veterinary Epidemiology and Biostatistics, School of Veterinary Medicine, Freie Universität Berlin, 14163, Berlin, Germany
| | - Uwe Roesler
- Institute of Animal Hygiene and Environmental Health, Veterinary Centre for Resistance Research-TZR, School of Veterinary Medicine, Freie Universität Berlin, 14163, Berlin, Germany
| | - Anika Friese
- Institute of Animal Hygiene and Environmental Health, Veterinary Centre for Resistance Research-TZR, School of Veterinary Medicine, Freie Universität Berlin, 14163, Berlin, Germany
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7
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Mallach G, Sun L(S, McKay M, Kovesi T, Lawlor G, Kulka R, Miller JD. Indoor air quality in remote first nations communities in Ontario, Canada. PLoS One 2023; 18:e0294040. [PMID: 37992001 PMCID: PMC10664901 DOI: 10.1371/journal.pone.0294040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/24/2023] [Indexed: 11/24/2023] Open
Abstract
A recent study of the health of Indigenous children in four First Nations Communities in remote northwestern Ontario found that 21% of children had been admitted to hospital for respiratory infections before age 2 years. Here we report a detailed analysis of the housing conditions in these communities. We employed a variety of statistical methods, including linear regression, mixed models, and logistic regression, to assess the correlations between housing conditions and loadings of biocontaminants (dust mite allergens, fungal glucan, and endotoxin) and indoor concentrations of PM2.5, CO2, benzene, and formaldehyde. The houses (n = 101) were crowded with an average of approximately 7 people. Approximately 27% of the homes had sustained CO2 concentrations above 1500 ppm. Most homes had more than one smoker. Commercial tobacco smoking and the use of non-electric heating (e.g., wood, oil) were associated with increased fine particle concentrations. Over 90% of the homes lacked working Heat Recovery Ventilators (HRVs), which was associated with increased fine particle concentrations and higher CO2. Of the 101 homes, 12 had mold damage sufficient to increase the relative risk of respiratory disease. This resulted from roof leaks, through walls or around the windows due to construction defects or lack of maintenance. A similar percentage had mold resulting from condensation on windows. Endotoxin loadings were much higher than any previous study in Canada. This work provides evidence for the need for more effort to repair existing houses and to ensure the HRVs are properly installed and maintained.
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Affiliation(s)
- Gary Mallach
- Water and Air Quality Bureau, Health Canada, Ottawa, Canada
| | | | | | - Thomas Kovesi
- Department of Pediatrics, Children’s Hospital of Eastern Ontario (CHEO), University of Ottawa, Ottawa, Canada
| | | | - Ryan Kulka
- Water and Air Quality Bureau, Health Canada, Ottawa, Canada
| | - J. David Miller
- Department of Chemistry, Carleton University, Ottawa, Canada
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8
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Chang Y, Ai Z, Ye J, Ma G. A cost-effectiveness assessment of the operational parameters of central HVAC systems during pandemics. BUILDING SIMULATION 2023; 16:667-682. [PMID: 37101942 PMCID: PMC10040913 DOI: 10.1007/s12273-023-1000-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/19/2023] [Accepted: 02/05/2023] [Indexed: 06/19/2023]
Abstract
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.
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Affiliation(s)
- Yufan Chang
- Department of Building Environment and Energy, College of Civil Engineering, Hunan University, Changsha, Hunan, China
- National Center for International Research Collaboration in Building Safety and Environment, Hunan University, Changsha, Hunan, China
| | - Zhengtao Ai
- Department of Building Environment and Energy, College of Civil Engineering, Hunan University, Changsha, Hunan, China
- National Center for International Research Collaboration in Building Safety and Environment, Hunan University, Changsha, Hunan, China
| | - Jinjun Ye
- Department of Building Environment and Energy, College of Civil Engineering, Hunan University, Changsha, Hunan, China
- National Center for International Research Collaboration in Building Safety and Environment, Hunan University, Changsha, Hunan, China
| | - Guochuan Ma
- China Southwest Architectural Design and Research Institute, Chengdu, Sichuan, China
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9
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Hadavi I, Hashemi M, Asadikaram G, Kalantar-Neyestanaki D, Hosseininasab A, Darijani T, Faraji M. Investigation of SARS-CoV-2 Genome in the Indoor Air and High-Touch Surfaces. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH 2022; 16:103. [PMID: 36267501 PMCID: PMC9568984 DOI: 10.1007/s41742-022-00462-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 08/06/2022] [Accepted: 08/16/2022] [Indexed: 06/16/2023]
Abstract
This study aimed to investigate the presence/absence of SARS-CoV-2 genome in the air and high-touch surfaces. This cross-sectional study was conducted from late-2020 to mid-2021 in the sections of Intensive Care Unit (ICU), emergency, infectious disease ward, and nursing station of the COVID-19 patient reception center in Kerman, Iran. The presence/absence of SARS-CoV-2 genome in the 60 samples of high-touch surfaces and 23 air samples was analyzed by reverse transcription polymerase chain reaction (RT-PCR). Fisher's exact test was used to compare the number of positive samples in different sampling sites. The genome of SARS-CoV-2 was found in the eight samples (13.32%) taken from the high-touch surfaces (two samples in COVID-19 ICU, two samples in general ICU, two samples in emergency ward, and two samples in nursing station) and two air samples (8.70%) (one sample in the general ICU and one sample in the emergency ward). Statistical analysis showed that there was no significant difference between the type of sampling site and the positive cases of SARS-CoV-2 in the surface samples (p value = 0.80) and air samples (p value = 0.22). According to the results, the SARS-CoV-2 can find in the high-touch surfaces and indoor air of the COVID-19 patient reception centers. Therefore, suitable safety and health measures should be taken, including regular and accurate disinfection of surfaces and equipment and proper ventilation to protect healthcare workers and prevent disease transmission. More studies are recommended to investigate the SARS-CoV-2 concentration in the high-touch surfaces and air samples in the similar researches, efficacy of different disinfectants used on the high-touch surfaces and compare the effect of type of ventilation (natural or mechanical) on the viral load.
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Affiliation(s)
- Iman Hadavi
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Department of Environmental Health Engineering, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Majid Hashemi
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Department of Environmental Health Engineering, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Gholamreza Asadikaram
- Department of Biochemistry, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Davood Kalantar-Neyestanaki
- Medical Mycology and Bacteriology Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Department of Medical Microbiology (Bacteriology and Virology), Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Hosseininasab
- Infectious and Tropical Diseases Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Tooba Darijani
- Department of Environmental Health Engineering, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Faraji
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Department of Environmental Health Engineering, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran
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10
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Barberá-Riera M, Porru S, Barneo-Muñoz M, Villasante Ferrer A, Carrasco P, de Llanos R, Llueca A, Delgado-Saborit JM. Genetic Load of SARS-CoV-2 in Aerosols Collected in Operating Theaters. Appl Environ Microbiol 2022; 88:e0129722. [PMID: 36102660 PMCID: PMC9552596 DOI: 10.1128/aem.01297-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 08/05/2022] [Indexed: 11/30/2022] Open
Abstract
After the outbreak of COVID-19, additional protocols have been established to prevent the transmission of the SARS-CoV-2 from the patient to the health personnel and vice versa in health care settings. However, in the case of emergency surgeries, it is not always possible to ensure that the patient is not infected with SARS-CoV-2, assuming a potential source of transmission of the virus to health personnel. This work aimed to evaluate the presence of the SARS-CoV-2 and quantify the viral load in indoor air samples collected inside operating rooms, where emergency and scheduled operations take place. Samples were collected for 3 weeks inside two operating rooms for 24 h at 38 L/min in quartz filters. RNA was extracted from the filters and analyzed using RT-qPCR targeting SARS-CoV-2 genes E, N1 and N2 regions. SARS-CoV-2 RNA was detected in 11.3% of aerosol samples collected in operating rooms, despite with low concentrations (not detected at 13.5 cg/m3 and 10.5 cg/m3 in the scheduled and emergency operating rooms, respectively). Potential sources of airborne SARS-CoV-2 could be aerosolization of the virus during aerosol-generating procedures and in open surgery from patients that might have been recently infected with the virus, despite presenting a negative COVID-19 test. Another source could be related to health care workers unknowingly infected with the virus and exhaling SARS-CoV-2 virions into the air. These results highlight the importance of reinforcing preventive measures against COVID-19 in operating rooms, such as the correct use of protective equipment, screening programs for health care workers, and information campaigns. IMPORTANCE Operating rooms are critical environments in which asepsis must be ensured. The COVID-19 pandemic entailed the implementation of additional preventative measures in health care settings, including operating theaters. Although one of the measures is to operate only COVID-19 free patients, this measure cannot be always implemented, especially in emergency interventions. Therefore, a surveillance campaign was conducted during 3 weeks in two operating rooms to assess the level of SARS-CoV-2 genetic material detected in operating theaters with the aim to assess the risk of COVID-19 transmission during operating procedures. SARS-CoV-2 genetic material was detected in 11% of aerosol samples collected in operating rooms, despite with low concentrations. Plausible SARS-CoV-2 sources have been discussed, including patients and health care personnel infected with the virus. These results highlight the importance of reinforcing preventive measures against COVID-19 in operating rooms, such as the correct use of protective equipment, screening programs for health care workers and information campaigns.
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Affiliation(s)
- María Barberá-Riera
- Department of Medicine, School of Health Sciences, Universitat Jaume I, Castellón de la Plana, Spain
| | - Simona Porru
- Department of Medicine, School of Health Sciences, Universitat Jaume I, Castellón de la Plana, Spain
| | - Manuela Barneo-Muñoz
- Department of Medicine, School of Health Sciences, Universitat Jaume I, Castellón de la Plana, Spain
| | - Andrea Villasante Ferrer
- Department of Medicine, School of Health Sciences, Universitat Jaume I, Castellón de la Plana, Spain
| | - Paula Carrasco
- Department of Medicine, School of Health Sciences, Universitat Jaume I, Castellón de la Plana, Spain
- Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, FISABIO–Universitat Jaume I–Universitat de València, Valencia, Spain
| | - Rosa de Llanos
- Department of Medicine, School of Health Sciences, Universitat Jaume I, Castellón de la Plana, Spain
| | - Antoni Llueca
- Department of Medicine, School of Health Sciences, Universitat Jaume I, Castellón de la Plana, Spain
- Multidisciplinary Unit of Abdominal Pelvic Oncology Surgery (MUAPOS), University General Hospital of Castellon, Castellón, Spain
| | - Juana María Delgado-Saborit
- Department of Medicine, School of Health Sciences, Universitat Jaume I, Castellón de la Plana, Spain
- Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, FISABIO–Universitat Jaume I–Universitat de València, Valencia, Spain
- Environmental Research Group, MRC Centre for Environment and Health, Imperial College London, United Kingdom
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11
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Allender MC, Adkesson MJ, Langan JN, Delk KW, Meehan T, Aitken‐Palmer C, McEntire MM, Killian ML, Torchetti M, Morales SA, Austin C, Fredrickson R, Olmstead C, Ke R, Smith R, Hostnik ET, Terio K, Wang L. Multi-species outbreak of SARS-CoV-2 Delta variant in a zoological institution, with the detection in two new families of carnivores. Transbound Emerg Dis 2022; 69:e3060-e3075. [PMID: 35839756 PMCID: PMC9349917 DOI: 10.1111/tbed.14662] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/06/2022] [Accepted: 07/13/2022] [Indexed: 02/05/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a worldwide distribution in humans and many other mammalian species. In late September 2021, 12 animals maintained by the Chicago Zoological Society's Brookfield Zoo were observed with variable clinical signs. The Delta variant of SARS-CoV-2 was detected in faeces and nasal swabs by qRT-PCR, including the first detection in animals from the families Procyonidae and Viverridae. Test positivity rate was 12.5% for 35 animals tested. All animals had been vaccinated with at least one dose of a recombinant vaccine designed for animals and all recovered with variable supportive treatment. Sequence analysis showed that six zoo animal strains were closely correlated with 18 human SARS-CoV-2 strains, suggestive of potential human-to-animal transmission events. This report documents the expanding host range of COVID-19 during the ongoing pandemic.
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Affiliation(s)
- Matthew C. Allender
- Brookfield ZooChicago Zoological SocietyBrookfieldIllinoisUSA
- Veterinary Diagnostic LabUniversity of Illinois Wildlife Epidemiology LaboratoryUrbanaIllinoisUSA
| | | | - Jennifer N. Langan
- Brookfield ZooChicago Zoological SocietyBrookfieldIllinoisUSA
- Department of Veterinary Clinical Medicine, College of Veterinary MedicineUniversity of IllinoisUrbanaIllinoisUSA
| | - Katie W. Delk
- Brookfield ZooChicago Zoological SocietyBrookfieldIllinoisUSA
| | - Thomas Meehan
- Brookfield ZooChicago Zoological SocietyBrookfieldIllinoisUSA
| | | | - Michael M. McEntire
- Illinois Zoological and Aquatic Animal ResidencyUniversity of IllinoisUrbanaIllinoisUSA
| | - Mary L. Killian
- National Veterinary Services Laboratories, Animal and Plant Health Inspection ServiceUnited States Department of AgricultureAmesIowaUSA
| | - Mia Torchetti
- National Veterinary Services Laboratories, Animal and Plant Health Inspection ServiceUnited States Department of AgricultureAmesIowaUSA
| | | | - Connie Austin
- Illinois Department of Public HealthSpringfieldIllinoisUSA
| | - Richard Fredrickson
- Veterinary Diagnostic Laboratory and Department of Veterinary Clinical Medicine, College of Veterinary MedicineUniversity of IllinoisUrbanaIllinoisUSA
| | - Colleen Olmstead
- Veterinary Diagnostic Laboratory and Department of Veterinary Clinical Medicine, College of Veterinary MedicineUniversity of IllinoisUrbanaIllinoisUSA
| | - Ruian Ke
- T‐6, Theoretical Biology and Biophysics, T DivisionLos Alamos National LaboratoryLos AlamosNew MexicoUSA
| | - Rebecca Smith
- Department of PathobiologyUniversity of Illinois at Urbana–ChampaignUrbanaIllinoisUSA
| | - Eric T. Hostnik
- Brookfield ZooChicago Zoological SocietyBrookfieldIllinoisUSA
- Department of Veterinary Clinical SciencesOhio State UniversityColumbusOhioUSA
| | - Karen Terio
- Zoological Pathology Program, College of Veterinary MedicineUniversity of IllinoisBrookfieldIllinoisUSA
| | - Leyi Wang
- Veterinary Diagnostic Laboratory and Department of Veterinary Clinical Medicine, College of Veterinary MedicineUniversity of IllinoisUrbanaIllinoisUSA
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12
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Thuresson S, Fraenkel CJ, Sasinovich S, Soldemyr J, Widell A, Medstrand P, Alsved M, Löndahl J. Airborne Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Hospitals: Effects of Aerosol-Generating Procedures, HEPA-Filtration Units, Patient Viral Load, and Physical Distance. Clin Infect Dis 2022; 75:e89-e96. [PMID: 35226740 PMCID: PMC9383519 DOI: 10.1093/cid/ciac161] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Transmission of coronavirus disease 2019 (COVID-19) can occur through inhalation of fine droplets or aerosols containing infectious virus. The objective of this study was to identify situations, patient characteristics, environmental parameters, and aerosol-generating procedures (AGPs) associated with airborne severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. METHODS Air samples were collected near hospitalized COVID-19 patients and analyzed by RT-qPCR. Results were related to distance to the patient, most recent patient diagnostic PCR cycle threshold (Ct) value, room ventilation, and ongoing potential AGPs. RESULTS In total, 310 air samples were collected; of these, 26 (8%) were positive for SARS-CoV-2. Of the 231 samples from patient rooms, 22 (10%) were positive for SARS-CoV-2. Positive air samples were associated with a low patient Ct value (OR, 5.0 for Ct <25 vs >25; P = .01; 95% CI: 1.18-29.5) and a shorter physical distance to the patient (OR, 2.0 for every meter closer to the patient; P = .05; 95% CI: 1.0-3.8). A mobile HEPA-filtration unit in the room decreased the proportion of positive samples (OR, .3; P = .02; 95% CI: .12-.98). No association was observed between SARS-CoV-2-positive air samples and mechanical ventilation, high-flow nasal cannula, nebulizer treatment, or noninvasive ventilation. An association was found with positive expiratory pressure training (P < .01) and a trend towards an association for airway manipulation, including bronchoscopies and in- and extubations. CONCLUSIONS Our results show that major risk factors for airborne SARS-CoV-2 include short physical distance, high patient viral load, and poor room ventilation. AGPs, as traditionally defined, seem to be of secondary importance.
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Affiliation(s)
- Sara Thuresson
- Division of Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Lund, Sweden
| | - Carl Johan Fraenkel
- Department of Infection Control, Region Skåne, Lund, Sweden
- Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Swedenand
| | | | - Jonathan Soldemyr
- Division of Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Lund, Sweden
| | - Anders Widell
- Department of Translational Medicine, Lund University, Lund, Sweden
| | - Patrik Medstrand
- Department of Translational Medicine, Lund University, Lund, Sweden
| | - Malin Alsved
- Division of Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Lund, Sweden
| | - Jakob Löndahl
- Division of Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Lund, Sweden
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13
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Silva PG, Branco PTBS, Soares RRG, Mesquita JR, Sousa SIV. SARS-CoV-2 air sampling: A systematic review on the methodologies for detection and infectivity. INDOOR AIR 2022; 32:e13083. [PMID: 36040285 PMCID: PMC9538005 DOI: 10.1111/ina.13083] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 06/15/2023]
Abstract
This systematic review aims to present an overview of the current aerosol sampling methods (and equipment) being used to investigate the presence of SARS-CoV-2 in the air, along with the main parameters reported in the studies that are essential to analyze the advantages and disadvantages of each method and perspectives for future research regarding this mode of transmission. A systematic literature review was performed on PubMed/MEDLINE, Web of Science, and Scopus to assess the current air sampling methodologies being applied to SARS-CoV-2. Most of the studies took place in indoor environments and healthcare settings and included air and environmental sampling. The collection mechanisms used were impinger, cyclone, impactor, filters, water-based condensation, and passive sampling. Most of the reviewed studies used RT-PCR to test the presence of SARS-CoV-2 RNA in the collected samples. SARS-CoV-2 RNA was detected with all collection mechanisms. From the studies detecting the presence of SARS-CoV-2 RNA, fourteen assessed infectivity. Five studies detected viable viruses using impactor, water-based condensation, and cyclone collection mechanisms. There is a need for a standardized protocol for sampling SARS-CoV-2 in air, which should also account for other influencing parameters, including air exchange ratio in the room sampled, relative humidity, temperature, and lighting conditions.
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Affiliation(s)
- Priscilla G Silva
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- School of Medicine and Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal
- LEPABE - Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Porto, Portugal
- ALiCE - Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Porto, Portugal
- Epidemiology Research Unit (EPI Unit), Institute of Public Health, University of Porto, Porto, Portugal
| | - Pedro T B S Branco
- LEPABE - Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Porto, Portugal
- ALiCE - Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Porto, Portugal
| | - Ruben R G Soares
- Department of Biochemistry and Biophysics, Science for Life Laboratory, Stockholm University, Solna, Sweden
- Division of Nanobiotechnology, Department of Protein Science, Science for Life Laboratory, KTH Royal Institute of Technology, Solna, Sweden
| | - João R Mesquita
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- Epidemiology Research Unit (EPI Unit), Institute of Public Health, University of Porto, Porto, Portugal
| | - Sofia I V Sousa
- LEPABE - Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Porto, Portugal
- ALiCE - Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Porto, Portugal
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14
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Yan S, Wang LL, Birnkrant MJ, Zhai J, Miller SL. Evaluating SARS-CoV-2 airborne quanta transmission and exposure risk in a mechanically ventilated multizone office building. BUILDING AND ENVIRONMENT 2022; 219:109184. [PMID: 35602249 PMCID: PMC9102535 DOI: 10.1016/j.buildenv.2022.109184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/19/2022] [Accepted: 05/09/2022] [Indexed: 05/11/2023]
Abstract
The world has faced tremendous challenges during the COVID-19 pandemic since 2020, and effective clean air strategies that mitigate infectious risks indoors have become more essential. In this study, a novel approach based on the Wells-Riley model applied to a multizone building was proposed to simulate exposure to infectious doses in terms of "quanta". This modeling approach quantifies the relative benefits of different risk mitigation strategies so that their effectiveness could be compared. A case study for the US Department of Energy large office prototype building was conducted to illustrate the approach. The infectious risk propagation from the infection source throughout the building was evaluated. Different mitigation strategies were implemented, including increasing outdoor air ventilation rates and adding air-cleaning devices such as Minimum Efficiency Reporting Value (MERV) filters and portable air cleaners (PACs) with HEPA filters in-room/in-duct germicidal ultraviolet (GUV) lights, layering with wearing masks. Results showed that to keep the risk of the infection propagating low the best strategy without universal masking was the operation of in-room GUV or a large industrial-sized PAC; whereas with masking all strategies were acceptable. This study contributes to a better understanding of the airborne transmission risks in multizone, mechanically ventilated buildings and how to reduce infection risk from a public health perspective of different mitigation strategies.
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Affiliation(s)
- Shujie Yan
- Dept. of Building, Civil & Environmental Engineering, Concordia University, 1455 de Maisonneuve Blvd. West, Montreal, Quebec, H3G1M8, Canada
| | - Liangzhu Leon Wang
- Dept. of Building, Civil & Environmental Engineering, Concordia University, 1455 de Maisonneuve Blvd. West, Montreal, Quebec, H3G1M8, Canada
| | | | - John Zhai
- Department of Civil, Environmental and Architectural Engineering, University of Colorado, Boulder, USA
| | - Shelly L Miller
- Department of Mechanical Engineering, University of Colorado, Boulder, USA
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15
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Döhla M, Schulte B, Wilbring G, Kümmerer BM, Döhla C, Sib E, Richter E, Ottensmeyer PF, Haag A, Engelhart S, Eis-Hübinger AM, Exner M, Mutters NT, Schmithausen RM, Streeck H. SARS-CoV-2 in Environmental Samples of Quarantined Households. Viruses 2022; 14:1075. [PMID: 35632816 PMCID: PMC9147922 DOI: 10.3390/v14051075] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/12/2022] [Accepted: 05/12/2022] [Indexed: 02/01/2023] Open
Abstract
The role of environmental transmission of SARS-CoV-2 remains unclear. Thus, the aim of this study was to investigate whether viral contamination of air, wastewater, and surfaces in quarantined households result in a higher risk for exposed persons. For this study, a source population of 21 households under quarantine conditions with at least one person who tested positive for SARS-CoV-2 RNA were randomly selected from a community in North Rhine-Westphalia in March 2020. All individuals living in these households participated in this study and provided throat swabs for analysis. Air and wastewater samples and surface swabs were obtained from each household and analysed using qRT-PCR. Positive swabs were further cultured to analyse for viral infectivity. Out of all the 43 tested adults, 26 (60.47%) tested positive using qRT-PCR. All 15 air samples were qRT-PCR-negative. In total, 10 out of 66 wastewater samples were positive for SARS-CoV-2 (15.15%) and 4 out of 119 surface samples (3.36%). No statistically significant correlation between qRT-PCR-positive environmental samples and the extent of the spread of infection between household members was observed. No infectious virus could be propagated under cell culture conditions. Taken together, our study demonstrates a low likelihood of transmission via surfaces. However, to definitively assess the importance of hygienic behavioural measures in the reduction of SARS-CoV-2 transmission, larger studies should be designed to determine the proportionate contribution of smear vs. droplet transmission.
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Affiliation(s)
- Manuel Döhla
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (M.D.); (G.W.); (C.D.); (E.S.); (A.H.); (S.E.); (M.E.); (N.T.M.); (R.M.S.)
- Department of Microbiology and Hospital Hygiene, Bundeswehr Central Hospital Koblenz, Rübenacher Straße 170, 56072 Koblenz, Germany
| | - Bianca Schulte
- Institute of Virology, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (B.S.); (B.M.K.); (E.R.); (P.F.O.); (A.M.E.-H.)
| | - Gero Wilbring
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (M.D.); (G.W.); (C.D.); (E.S.); (A.H.); (S.E.); (M.E.); (N.T.M.); (R.M.S.)
| | - Beate Mareike Kümmerer
- Institute of Virology, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (B.S.); (B.M.K.); (E.R.); (P.F.O.); (A.M.E.-H.)
| | - Christin Döhla
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (M.D.); (G.W.); (C.D.); (E.S.); (A.H.); (S.E.); (M.E.); (N.T.M.); (R.M.S.)
| | - Esther Sib
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (M.D.); (G.W.); (C.D.); (E.S.); (A.H.); (S.E.); (M.E.); (N.T.M.); (R.M.S.)
| | - Enrico Richter
- Institute of Virology, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (B.S.); (B.M.K.); (E.R.); (P.F.O.); (A.M.E.-H.)
| | - Patrick Frank Ottensmeyer
- Institute of Virology, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (B.S.); (B.M.K.); (E.R.); (P.F.O.); (A.M.E.-H.)
| | - Alexandra Haag
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (M.D.); (G.W.); (C.D.); (E.S.); (A.H.); (S.E.); (M.E.); (N.T.M.); (R.M.S.)
| | - Steffen Engelhart
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (M.D.); (G.W.); (C.D.); (E.S.); (A.H.); (S.E.); (M.E.); (N.T.M.); (R.M.S.)
| | - Anna Maria Eis-Hübinger
- Institute of Virology, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (B.S.); (B.M.K.); (E.R.); (P.F.O.); (A.M.E.-H.)
| | - Martin Exner
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (M.D.); (G.W.); (C.D.); (E.S.); (A.H.); (S.E.); (M.E.); (N.T.M.); (R.M.S.)
| | - Nico Tom Mutters
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (M.D.); (G.W.); (C.D.); (E.S.); (A.H.); (S.E.); (M.E.); (N.T.M.); (R.M.S.)
| | - Ricarda Maria Schmithausen
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (M.D.); (G.W.); (C.D.); (E.S.); (A.H.); (S.E.); (M.E.); (N.T.M.); (R.M.S.)
| | - Hendrik Streeck
- Institute of Virology, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (B.S.); (B.M.K.); (E.R.); (P.F.O.); (A.M.E.-H.)
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16
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Döhla M, Schulte B, Wilbring G, Kümmerer BM, Döhla C, Sib E, Richter E, Ottensmeyer PF, Haag A, Engelhart S, Eis-Hübinger AM, Exner M, Mutters NT, Schmithausen RM, Streeck H. SARS-CoV-2 in Environmental Samples of Quarantined Households. Viruses 2022. [PMID: 35632816 DOI: 10.1101/2020.05.28.20114041] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
The role of environmental transmission of SARS-CoV-2 remains unclear. Thus, the aim of this study was to investigate whether viral contamination of air, wastewater, and surfaces in quarantined households result in a higher risk for exposed persons. For this study, a source population of 21 households under quarantine conditions with at least one person who tested positive for SARS-CoV-2 RNA were randomly selected from a community in North Rhine-Westphalia in March 2020. All individuals living in these households participated in this study and provided throat swabs for analysis. Air and wastewater samples and surface swabs were obtained from each household and analysed using qRT-PCR. Positive swabs were further cultured to analyse for viral infectivity. Out of all the 43 tested adults, 26 (60.47%) tested positive using qRT-PCR. All 15 air samples were qRT-PCR-negative. In total, 10 out of 66 wastewater samples were positive for SARS-CoV-2 (15.15%) and 4 out of 119 surface samples (3.36%). No statistically significant correlation between qRT-PCR-positive environmental samples and the extent of the spread of infection between household members was observed. No infectious virus could be propagated under cell culture conditions. Taken together, our study demonstrates a low likelihood of transmission via surfaces. However, to definitively assess the importance of hygienic behavioural measures in the reduction of SARS-CoV-2 transmission, larger studies should be designed to determine the proportionate contribution of smear vs. droplet transmission.
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Affiliation(s)
- Manuel Döhla
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
- Department of Microbiology and Hospital Hygiene, Bundeswehr Central Hospital Koblenz, Rübenacher Straße 170, 56072 Koblenz, Germany
| | - Bianca Schulte
- Institute of Virology, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Gero Wilbring
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Beate Mareike Kümmerer
- Institute of Virology, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Christin Döhla
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Esther Sib
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Enrico Richter
- Institute of Virology, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | | | - Alexandra Haag
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Steffen Engelhart
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Anna Maria Eis-Hübinger
- Institute of Virology, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Martin Exner
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Nico Tom Mutters
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Ricarda Maria Schmithausen
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Hendrik Streeck
- Institute of Virology, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
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17
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Baselga M, Güemes A, Alba JJ, Schuhmacher AJ. SARS-CoV-2 Droplet and Airborne Transmission Heterogeneity. J Clin Med 2022; 11:2607. [PMID: 35566733 PMCID: PMC9099777 DOI: 10.3390/jcm11092607] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 04/21/2022] [Accepted: 05/03/2022] [Indexed: 12/13/2022] Open
Abstract
The spread dynamics of the SARS-CoV-2 virus have not yet been fully understood after two years of the pandemic. The virus's global spread represented a unique scenario for advancing infectious disease research. Consequently, mechanistic epidemiological theories were quickly dismissed, and more attention was paid to other approaches that considered heterogeneity in the spread. One of the most critical advances in aerial pathogens transmission was the global acceptance of the airborne model, where the airway is presented as the epicenter of the spread of the disease. Although the aerodynamics and persistence of the SARS-CoV-2 virus in the air have been extensively studied, the actual probability of contagion is still unknown. In this work, the individual heterogeneity in the transmission of 22 patients infected with COVID-19 was analyzed by close contact (cough samples) and air (environmental samples). Viral RNA was detected in 2/19 cough samples from patient subgroups, with a mean Ct (Cycle Threshold in Quantitative Polymerase Chain Reaction analysis) of 25.7 ± 7.0. Nevertheless, viral RNA was only detected in air samples from 1/8 patients, with an average Ct of 25.0 ± 4.0. Viral load in cough samples ranged from 7.3 × 105 to 8.7 × 108 copies/mL among patients, while concentrations between 1.1-4.8 copies/m3 were found in air, consistent with other reports in the literature. In patients undergoing follow-up, no viral load was found (neither in coughs nor in the air) after the third day of symptoms, which could help define quarantine periods in infected individuals. In addition, it was found that the patient's Ct should not be considered an indicator of infectiousness, since it could not be correlated with the viral load disseminated. The results of this work are in line with proposed hypotheses of superspreaders, which can attribute part of the heterogeneity of the spread to the oversized emission of a small percentage of infected people.
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Affiliation(s)
- Marta Baselga
- Institute for Health Research Aragon (IIS Aragón), 50009 Zaragoza, Spain; (M.B.); (A.G.); (J.J.A.)
| | - Antonio Güemes
- Institute for Health Research Aragon (IIS Aragón), 50009 Zaragoza, Spain; (M.B.); (A.G.); (J.J.A.)
- Department of Surgery, University of Zaragoza, 50009 Zaragoza, Spain
| | - Juan J. Alba
- Institute for Health Research Aragon (IIS Aragón), 50009 Zaragoza, Spain; (M.B.); (A.G.); (J.J.A.)
- Department of Mechanical Engineering, University of Zaragoza, 50018 Zaragoza, Spain
| | - Alberto J. Schuhmacher
- Institute for Health Research Aragon (IIS Aragón), 50009 Zaragoza, Spain; (M.B.); (A.G.); (J.J.A.)
- Fundación Agencia Aragonesa para la Investigación y el Desarrollo (ARAID), 50018 Zaragoza, Spain
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18
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Lebreil AL, Greux V, Glenet M, Huguenin A, N'Guyen Y, Berri F, Bajolet O, Mourvillier B, Andreoletti L. Surfaces and Air contamination by SARS-CoV-2 using High-flow Nasal Oxygenation or Assisted Mechanical Ventilation System in ICU rooms of COVID-19 Patients. J Infect Dis 2021; 225:385-391. [PMID: 34788831 DOI: 10.1093/infdis/jiab564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 11/08/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Understanding patterns of environmental contamination by SARS-CoV-2 is essential for infection prevention policies. METHODS We screened surfaces and air samples from single bed ICU rooms of COVID-19 adult patients for SARS-CoV-2 RNA and viable viruses. RESULTS AND DISCUSSION We evidenced viral RNA environmental contamination in 76% of 100 surfaces samples and in 30% of 40 air samples without any viable virus detection by cell culture assays. No significant differences of viral RNA levels on surfaces and in ambient air were observed between rooms of patients with assisted mechanical ventilation and those of patients with high-flow nasal cannula system. Using an original experimental SARS-CoV-2 infection model of surfaces, we assessed that infectious viruses might have been present on benches within 15 hours before the time of sampling in patient rooms. CONCLUSIONS We observed that SARS-CoV-2 environmental contamination around COVID-19 patients hospitalized in single ICU rooms was extensive and that a high-flow nasal cannula system did not generate more viral aerosolization than a mechanical ventilation system in COVID-19 patients. Despite an absence of SARS-CoV-2 viable particles in study samples, our experimental model confirmed the need to apply strict environmental disinfection procedures and classical standard and droplet precautions in ICU wards.
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Affiliation(s)
| | - Vincent Greux
- CHU Reims, Hôpital Robert Debré, Intensive Care Unit (UMIRP), Reims, France
| | - Marie Glenet
- Université de Reims Champagne Ardenne, Cardiovir EA-4684, Reims, France
| | - Antoine Huguenin
- CHU Reims, Hôpital Robert Debré, Parasitology Department, Reims, France.,Université de Reims Champagne Ardenne, ESCAPE EA7510, 51097 Reims, France
| | - Yohan N'Guyen
- Université de Reims Champagne Ardenne, Cardiovir EA-4684, Reims, France.,CHU Reims, Hôpital Robert Debré, Infectious diseases and internal medicine Department, Reims, France
| | - Fatma Berri
- Université de Reims Champagne Ardenne, Cardiovir EA-4684, Reims, France
| | - Odile Bajolet
- CHU Reims, Hôpital Robert Debré, Hygiene Department, Reims, France
| | - Bruno Mourvillier
- Université de Reims Champagne Ardenne, Cardiovir EA-4684, Reims, France.,CHU Reims, Hôpital Robert Debré, Intensive Care Unit (UMIRP), Reims, France
| | - Laurent Andreoletti
- Université de Reims Champagne Ardenne, Cardiovir EA-4684, Reims, France.,CHU Reims, Hôpital Robert Debré, Virology Department, Reims, France
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