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Gutmann D, Scheuch G, Lehmkühler T, Herrlich LS, Landeis A, Hutter M, Stephan C, Vehreschild M, Khodamoradi Y, Gossmann AK, King F, Weis F, Weiss M, Rabenau HF, Graf J, Donath H, Schubert R, Zielen S. Aerosol measurement identifies SARS-CoV 2 PCR positive adults compared with healthy controls. Environ Res 2023; 216:114417. [PMID: 36162469 PMCID: PMC9507996 DOI: 10.1016/j.envres.2022.114417] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 07/24/2022] [Accepted: 09/20/2022] [Indexed: 05/04/2023]
Abstract
BACKGROUND SARS-CoV-2 is spread primarily through droplets and aerosols. Exhaled aerosols are generated in the upper airways through shear stress and in the lung periphery by 'reopening of collapsed airways'. Aerosol measuring may detect highly contagious individuals ("super spreaders or super-emitters") and discriminate between SARS-CoV-2 infected and non-infected individuals. This is the first study comparing exhaled aerosols in SARS-CoV-2 infected individuals and healthy controls. DESIGN A prospective observational cohort study in 288 adults, comprising 64 patients testing positive by SARS CoV-2 PCR before enrollment, and 224 healthy adults testing negative (matched control sample) at the University Hospital Frankfurt, Germany, from February to June 2021. Study objective was to evaluate the concentration of exhaled aerosols during physiologic breathing in SARS-CoV-2 PCR-positive and -negative subjects. Secondary outcome measures included correlation of aerosol concentration to SARS-CoV-2 PCR results, change in aerosol concentration due to confounders, and correlation between clinical symptoms and aerosol. RESULTS There was a highly significant difference in respiratory aerosol concentrations between SARS-CoV-2 PCR-positive (median 1490.5/L) and -negative subjects (median 252.0/L; p < 0.0001). There were no significant differences due to age, sex, smoking status, or body mass index. ROC analysis showed an AUC of 0.8918. CONCLUSIONS Measurements of respiratory aerosols were significantly elevated in SARS-CoV-2 positive individuals, which helps to understand the spread and course of respiratory viral infections, as well as the detection of highly infectious individuals.
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Affiliation(s)
- Desireé Gutmann
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, University Hospital Frankfurt, Goethe University, 60590, Frankfurt, Germany.
| | - Gerhard Scheuch
- GS Bio-Inhalation GmbH, Headquarters & Logistics, Gemuenden, Germany
| | - Timon Lehmkühler
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, University Hospital Frankfurt, Goethe University, 60590, Frankfurt, Germany
| | - Laura-Sabine Herrlich
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, University Hospital Frankfurt, Goethe University, 60590, Frankfurt, Germany
| | - Anton Landeis
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, University Hospital Frankfurt, Goethe University, 60590, Frankfurt, Germany
| | - Martin Hutter
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, University Hospital Frankfurt, Goethe University, 60590, Frankfurt, Germany
| | - Christoph Stephan
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University, 60590, Frankfurt, Germany
| | - Maria Vehreschild
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University, 60590, Frankfurt, Germany
| | - Yascha Khodamoradi
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University, 60590, Frankfurt, Germany
| | - Ann-Kathrin Gossmann
- Palas GmbH, Partikel- und Lasermesstechnik, Greschbachstrasse 3b; 76229, Karlsruhe, Germany
| | - Florian King
- Palas GmbH, Partikel- und Lasermesstechnik, Greschbachstrasse 3b; 76229, Karlsruhe, Germany
| | - Frederik Weis
- Palas GmbH, Partikel- und Lasermesstechnik, Greschbachstrasse 3b; 76229, Karlsruhe, Germany
| | - Maximilian Weiss
- Palas GmbH, Partikel- und Lasermesstechnik, Greschbachstrasse 3b; 76229, Karlsruhe, Germany
| | - Holger F Rabenau
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University, 60590, Frankfurt, Germany
| | - Juergen Graf
- Medical Director, University Hospital Frankfurt, Goethe University, 60590, Frankfurt, Germany
| | - Helena Donath
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, University Hospital Frankfurt, Goethe University, 60590, Frankfurt, Germany
| | - Ralf Schubert
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, University Hospital Frankfurt, Goethe University, 60590, Frankfurt, Germany
| | - Stefan Zielen
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, University Hospital Frankfurt, Goethe University, 60590, Frankfurt, Germany
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Gutmann D, Donath H, Herrlich L, Lehmkühler T, Landeis A, Ume ER, Hutter M, Goßmann AK, Weis F, Weiß M, Rabenau HF, Zielen S. Exhaled Aerosols in SARS-CoV-2 Polymerase Chain Reaction-Positive Children and Age-Matched-Negative Controls. Front Pediatr 2022; 10:941785. [PMID: 35923787 PMCID: PMC9339682 DOI: 10.3389/fped.2022.941785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/14/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Children and adolescents seem to be less affected by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease in terms of severity, especially until the increasing spread of the omicron variant in December 2021. Anatomical structures and lower number of exhaled aerosols may in part explain this phenomenon. In a cohort of healthy and SARS-CoV-2 infected children, we compared exhaled particle counts to gain further insights about the spreading of SARS-CoV-2. MATERIALS AND METHODS In this single-center prospective observational trial, a total of 162 children and adolescents (age 6-17 years), of whom 39 were polymerase chain reaction (PCR)-positive for SARS-CoV-2 and 123 PCR-negative, were included. The 39 PCR-positive children were compared to 39 PCR-negative age-matched controls. The data of all PCR-negative children were analyzed to determine baseline exhaled particle counts in children. In addition, medical and clinical history was obtained and spirometry was measured. RESULTS Baseline exhaled particle counts were low in healthy children. Exhaled particle counts were significantly increased in SARS-CoV-2 PCR-positive children (median 355.0/L; range 81-6955/L), compared to age-matched -negative children (median 157.0/L; range 1-533/L; p < 0.001). CONCLUSION SARS-CoV-2 PCR-positive children exhaled significantly higher levels of aerosols than healthy children. Overall children had low levels of exhaled particle counts, possibly indicating that children are not the major driver of the SARS-CoV-2 pandemic. TRIAL REGISTRATION [ClinicalTrials.gov], Identifier [NCT04739020].
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Affiliation(s)
- Desiree Gutmann
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Helena Donath
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Laura Herrlich
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Timon Lehmkühler
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Anton Landeis
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Emily R Ume
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Martin Hutter
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | | | - Frederik Weis
- Palas GmbH, Partikel- und Lasermesstechnik, Karlsruhe, Germany
| | - Maximilian Weiß
- Palas GmbH, Partikel- und Lasermesstechnik, Karlsruhe, Germany
| | - Holger F Rabenau
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Stefan Zielen
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
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