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SARS-CoV-2 environmental contamination associated with persistently infected COVID-19 patients.
Influenza Other Respir Viruses. 2020 11; 14(6):688-699.IO

Abstract

BACKGROUND

Severe COVID-19 patients typically test positive for SARS-CoV-2 RNA for extended periods of time, even after recovery from severe disease. Due to the timeframe involved, these patients may have developed humoral immunity to SARS-CoV-2 while still testing positive for viral RNA in swabs. Data are lacking on exposure risks in these situations. Here, we studied SARS-CoV-2 environmental contamination in an ICU and an isolation ward caring for such COVID-19 patients.

METHODS

We collected air and surface samples in a hospital caring for critical and severe COVID-19 cases from common areas and areas proximal to patients.

RESULTS

Of the 218 ICU samples, an air sample contained SARS-CoV-2 RNA. Of the 182 isolation ward samples, nine contained SARS-CoV-2 RNA. These were collected from a facemask, the floor, mobile phones, and the air in the patient room and bathroom. Serum antibodies against SARS-CoV-2 were detected in these patients at the beginning of the study.

CONCLUSIONS

While there is a perception of increased risk in the ICU, our study demonstrates that isolation wards may pose greater risks to healthcare workers and exposure risks remain with clinically improved patients, weeks after their initial diagnoses. As these patients had serum antibodies, further studies may be warranted to study the utility of serum antibodies as a surrogate of viral clearance in allowing people to return to work. We recommend continued vigilance even with patients who appear to have recovered from COVID-19.

Authors+Show Affiliations

Guangzhou Medical University, Guangzhou, China. State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou, China.State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou, China. Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou, China. Department of Intensive Care, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.Guangzhou Medical University, Guangzhou, China. State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou, China.Guangzhou Medical University, Guangzhou, China. State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou, China.Guangzhou Medical University, Guangzhou, China. State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou, China.Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.Department of Intensive Care, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.Guangzhou Medical University, Guangzhou, China.Guangzhou Medical University, Guangzhou, China.WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong SAR, China.Guangzhou Medical University, Guangzhou, China. State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou, China.Infection Control, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou, China. Guangzhou Institute of Respiratory Health, Guangzhou, China. Macau University of Science and Technology, Macau SAR, China.Department of Intensive Care, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong SAR, China.WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong SAR, China.Department of Thoracic Oncology and Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.Guangzhou Medical University, Guangzhou, China. State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou, China. WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong SAR, China. Guangzhou Institute of Respiratory Health, Guangzhou, China.Guangzhou Medical University, Guangzhou, China. State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou, China. WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong SAR, China. Guangzhou Institute of Respiratory Health, Guangzhou, China.

Pub Type(s)

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

Language

eng

PubMed ID

32578948

Citation

Lei, Hui, et al. "SARS-CoV-2 Environmental Contamination Associated With Persistently Infected COVID-19 Patients." Influenza and Other Respiratory Viruses, vol. 14, no. 6, 2020, pp. 688-699.
Lei H, Ye F, Liu X, et al. SARS-CoV-2 environmental contamination associated with persistently infected COVID-19 patients. Influenza Other Respir Viruses. 2020;14(6):688-699.
Lei, H., Ye, F., Liu, X., Huang, Z., Ling, S., Jiang, Z., Cheng, J., Huang, X., Wu, Q., Wu, S., Xie, Y., Xiao, C., Ye, D., Yang, Z., Li, Y., Leung, N. H. L., Cowling, B. J., He, J., Wong, S. S., & Zanin, M. (2020). SARS-CoV-2 environmental contamination associated with persistently infected COVID-19 patients. Influenza and Other Respiratory Viruses, 14(6), 688-699. https://doi.org/10.1111/irv.12783
Lei H, et al. SARS-CoV-2 Environmental Contamination Associated With Persistently Infected COVID-19 Patients. Influenza Other Respir Viruses. 2020;14(6):688-699. PubMed PMID: 32578948.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - SARS-CoV-2 environmental contamination associated with persistently infected COVID-19 patients. AU - Lei,Hui, AU - Ye,Feng, AU - Liu,Xiaoqing, AU - Huang,Zhenting, AU - Ling,Shiman, AU - Jiang,Zhanpeng, AU - Cheng,Jing, AU - Huang,Xiaoqun, AU - Wu,Qiubao, AU - Wu,Shiguan, AU - Xie,Yanmin, AU - Xiao,Cheng, AU - Ye,Dan, AU - Yang,Zifeng, AU - Li,Yimin, AU - Leung,Nancy H L, AU - Cowling,Benjamin J, AU - He,Jianxing, AU - Wong,Sook-San, AU - Zanin,Mark, Y1 - 2020/07/12/ PY - 2020/05/18/received PY - 2020/06/09/revised PY - 2020/06/19/accepted PY - 2020/6/25/pubmed PY - 2020/11/4/medline PY - 2020/6/25/entrez KW - COVID-19 KW - SARS-CoV-2 KW - coronavirus KW - intensive care unit KW - transmission SP - 688 EP - 699 JF - Influenza and other respiratory viruses JO - Influenza Other Respir Viruses VL - 14 IS - 6 N2 - BACKGROUND: Severe COVID-19 patients typically test positive for SARS-CoV-2 RNA for extended periods of time, even after recovery from severe disease. Due to the timeframe involved, these patients may have developed humoral immunity to SARS-CoV-2 while still testing positive for viral RNA in swabs. Data are lacking on exposure risks in these situations. Here, we studied SARS-CoV-2 environmental contamination in an ICU and an isolation ward caring for such COVID-19 patients. METHODS: We collected air and surface samples in a hospital caring for critical and severe COVID-19 cases from common areas and areas proximal to patients. RESULTS: Of the 218 ICU samples, an air sample contained SARS-CoV-2 RNA. Of the 182 isolation ward samples, nine contained SARS-CoV-2 RNA. These were collected from a facemask, the floor, mobile phones, and the air in the patient room and bathroom. Serum antibodies against SARS-CoV-2 were detected in these patients at the beginning of the study. CONCLUSIONS: While there is a perception of increased risk in the ICU, our study demonstrates that isolation wards may pose greater risks to healthcare workers and exposure risks remain with clinically improved patients, weeks after their initial diagnoses. As these patients had serum antibodies, further studies may be warranted to study the utility of serum antibodies as a surrogate of viral clearance in allowing people to return to work. We recommend continued vigilance even with patients who appear to have recovered from COVID-19. SN - 1750-2659 UR - https://www.unboundmedicine.com/medline/citation/32578948/SARS_CoV_2_environmental_contamination_associated_with_persistently_infected_COVID_19_patients_ L2 - https://doi.org/10.1111/irv.12783 DB - PRIME DP - Unbound Medicine ER -