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Air and environmental sampling for SARS-CoV-2 around hospitalized patients with coronavirus disease 2019 (COVID-19).
Infect Control Hosp Epidemiol. 2020 11; 41(11):1258-1265.IC

Abstract

BACKGROUND

The role of severe respiratory coronavirus virus 2 (SARS-CoV-2)-laden aerosols in the transmission of coronavirus disease 2019 (COVID-19) remains uncertain. Discordant findings of SARS-CoV-2 RNA in air samples were noted in early reports.

METHODS

Sampling of air close to 6 asymptomatic and symptomatic COVID-19 patients with and without surgical masks was performed with sampling devices using sterile gelatin filters. Frequently touched environmental surfaces near 21 patients were swabbed before daily environmental disinfection. The correlation between the viral loads of patients' clinical samples and environmental samples was analyzed.

RESULTS

All air samples were negative for SARS-CoV-2 RNA in the 6 patients singly isolated inside airborne infection isolation rooms (AIIRs) with 12 air changes per hour. Of 377 environmental samples near 21 patients, 19 (5.0%) were positive by reverse-transcription polymerase chain reaction (RT-PCR) assay, with a median viral load of 9.2 × 102 copies/mL (range, 1.1 × 102 to 9.4 × 104 copies/mL). The contamination rate was highest on patients' mobile phones (6 of 77, 7.8%), followed by bed rails (4 of 74, 5.4%) and toilet door handles (4 of 76, 5.3%). We detected a significant correlation between viral load ranges in clinical samples and positivity rate of environmental samples (P < .001).

CONCLUSION

SARS-CoV-2 RNA was not detectable by air samplers, which suggests that the airborne route is not the predominant mode of transmission of SARS-CoV-2. Wearing a surgical mask, appropriate hand hygiene, and thorough environmental disinfection are sufficient infection control measures for COVID-19 patients isolated singly in AIIRs. However, this conclusion may not apply during aerosol-generating procedures or in cohort wards with large numbers of COVID-19 patients.

Authors+Show Affiliations

Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China. Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China.Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China.Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China.Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China.Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China.Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China.Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China.Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32507114

Citation

Cheng, Vincent Chi-Chung, et al. "Air and Environmental Sampling for SARS-CoV-2 Around Hospitalized Patients With Coronavirus Disease 2019 (COVID-19)." Infection Control and Hospital Epidemiology, vol. 41, no. 11, 2020, pp. 1258-1265.
Cheng VC, Wong SC, Chan VW, et al. Air and environmental sampling for SARS-CoV-2 around hospitalized patients with coronavirus disease 2019 (COVID-19). Infect Control Hosp Epidemiol. 2020;41(11):1258-1265.
Cheng, V. C., Wong, S. C., Chan, V. W., So, S. Y., Chen, J. H., Yip, C. C., Chan, K. H., Chu, H., Chung, T. W., Sridhar, S., To, K. K., Chan, J. F., Hung, I. F., Ho, P. L., & Yuen, K. Y. (2020). Air and environmental sampling for SARS-CoV-2 around hospitalized patients with coronavirus disease 2019 (COVID-19). Infection Control and Hospital Epidemiology, 41(11), 1258-1265. https://doi.org/10.1017/ice.2020.282
Cheng VC, et al. Air and Environmental Sampling for SARS-CoV-2 Around Hospitalized Patients With Coronavirus Disease 2019 (COVID-19). Infect Control Hosp Epidemiol. 2020;41(11):1258-1265. PubMed PMID: 32507114.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Air and environmental sampling for SARS-CoV-2 around hospitalized patients with coronavirus disease 2019 (COVID-19). AU - Cheng,Vincent Chi-Chung, AU - Wong,Shuk-Ching, AU - Chan,Veronica Wing-Man, AU - So,Simon Yung-Chun, AU - Chen,Jonathan Hon-Kwan, AU - Yip,Cyril Chik-Yan, AU - Chan,Kwok-Hung, AU - Chu,Hin, AU - Chung,Tom Wai-Hin, AU - Sridhar,Siddharth, AU - To,Kelvin Kai-Wang, AU - Chan,Jasper Fuk-Woo, AU - Hung,Ivan Fan-Ngai, AU - Ho,Pak-Leung, AU - Yuen,Kwok-Yung, Y1 - 2020/06/08/ PY - 2020/6/9/pubmed PY - 2020/11/11/medline PY - 2020/6/9/entrez SP - 1258 EP - 1265 JF - Infection control and hospital epidemiology JO - Infect Control Hosp Epidemiol VL - 41 IS - 11 N2 - BACKGROUND: The role of severe respiratory coronavirus virus 2 (SARS-CoV-2)-laden aerosols in the transmission of coronavirus disease 2019 (COVID-19) remains uncertain. Discordant findings of SARS-CoV-2 RNA in air samples were noted in early reports. METHODS: Sampling of air close to 6 asymptomatic and symptomatic COVID-19 patients with and without surgical masks was performed with sampling devices using sterile gelatin filters. Frequently touched environmental surfaces near 21 patients were swabbed before daily environmental disinfection. The correlation between the viral loads of patients' clinical samples and environmental samples was analyzed. RESULTS: All air samples were negative for SARS-CoV-2 RNA in the 6 patients singly isolated inside airborne infection isolation rooms (AIIRs) with 12 air changes per hour. Of 377 environmental samples near 21 patients, 19 (5.0%) were positive by reverse-transcription polymerase chain reaction (RT-PCR) assay, with a median viral load of 9.2 × 102 copies/mL (range, 1.1 × 102 to 9.4 × 104 copies/mL). The contamination rate was highest on patients' mobile phones (6 of 77, 7.8%), followed by bed rails (4 of 74, 5.4%) and toilet door handles (4 of 76, 5.3%). We detected a significant correlation between viral load ranges in clinical samples and positivity rate of environmental samples (P < .001). CONCLUSION: SARS-CoV-2 RNA was not detectable by air samplers, which suggests that the airborne route is not the predominant mode of transmission of SARS-CoV-2. Wearing a surgical mask, appropriate hand hygiene, and thorough environmental disinfection are sufficient infection control measures for COVID-19 patients isolated singly in AIIRs. However, this conclusion may not apply during aerosol-generating procedures or in cohort wards with large numbers of COVID-19 patients. SN - 1559-6834 UR - https://www.unboundmedicine.com/medline/citation/32507114/Air_and_environmental_sampling_for_SARS_CoV_2_around_hospitalized_patients_with_coronavirus_disease_2019__COVID_19__ L2 - https://www.cambridge.org/core/product/identifier/S0899823X20002822/type/journal_article DB - PRIME DP - Unbound Medicine ER -