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Exhaled aerosol increases with COVID-19 infection, age, and obesity.
Proc Natl Acad Sci U S A. 2021 02 23; 118(8)PN

Abstract

COVID-19 transmits by droplets generated from surfaces of airway mucus during processes of respiration within hosts infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. We studied respiratory droplet generation and exhalation in human and nonhuman primate subjects with and without COVID-19 infection to explore whether SARS-CoV-2 infection, and other changes in physiological state, translate into observable evolution of numbers and sizes of exhaled respiratory droplets in healthy and diseased subjects. In our observational cohort study of the exhaled breath particles of 194 healthy human subjects, and in our experimental infection study of eight nonhuman primates infected, by aerosol, with SARS-CoV-2, we found that exhaled aerosol particles vary between subjects by three orders of magnitude, with exhaled respiratory droplet number increasing with degree of COVID-19 infection and elevated BMI-years. We observed that 18% of human subjects (35) accounted for 80% of the exhaled bioaerosol of the group (194), reflecting a superspreader distribution of bioaerosol analogous to a classical 20:80 superspreader of infection distribution. These findings suggest that quantitative assessment and control of exhaled aerosol may be critical to slowing the airborne spread of COVID-19 in the absence of an effective and widely disseminated vaccine.

Authors+Show Affiliations

John A. Paulson School of Engineering & Applied Sciences, Harvard University, Cambridge, MA 02138; dedwards@seas.harvard.edu rlanger@mit.edu croy@tulane.edu. Sensory Cloud, Boston, MA 02142.Center for Assessment Technology and Continuous Health (CATCH), Massachusetts General Hospital & Harvard Medical School, Boston, MA 02114.Sensory Cloud, Boston, MA 02142.Sensory Cloud, Boston, MA 02142.Department of Chemical & Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139; dedwards@seas.harvard.edu rlanger@mit.edu croy@tulane.edu.Division of Microbiology, Tulane National Primate Research Center, Covington, LA 70118.Division of Microbiology, Tulane National Primate Research Center, Covington, LA 70118.Division of Microbiology, Tulane National Primate Research Center, Covington, LA 70118.Division of Microbiology, Tulane National Primate Research Center, Covington, LA 70118.Division of Microbiology, Tulane National Primate Research Center, Covington, LA 70118.Division of Microbiology, Tulane National Primate Research Center, Covington, LA 70118.Division of Microbiology, Tulane National Primate Research Center, Covington, LA 70118; dedwards@seas.harvard.edu rlanger@mit.edu croy@tulane.edu. Department of Microbiology and Immunology, Tulane University School of Medicine, New Orleans, LA 70118.

Pub Type(s)

Journal Article
Observational Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

33563754

Citation

Edwards, David A., et al. "Exhaled Aerosol Increases With COVID-19 Infection, Age, and Obesity." Proceedings of the National Academy of Sciences of the United States of America, vol. 118, no. 8, 2021.
Edwards DA, Ausiello D, Salzman J, et al. Exhaled aerosol increases with COVID-19 infection, age, and obesity. Proc Natl Acad Sci U S A. 2021;118(8).
Edwards, D. A., Ausiello, D., Salzman, J., Devlin, T., Langer, R., Beddingfield, B. J., Fears, A. C., Doyle-Meyers, L. A., Redmann, R. K., Killeen, S. Z., Maness, N. J., & Roy, C. J. (2021). Exhaled aerosol increases with COVID-19 infection, age, and obesity. Proceedings of the National Academy of Sciences of the United States of America, 118(8). https://doi.org/10.1073/pnas.2021830118
Edwards DA, et al. Exhaled Aerosol Increases With COVID-19 Infection, Age, and Obesity. Proc Natl Acad Sci U S A. 2021 02 23;118(8) PubMed PMID: 33563754.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Exhaled aerosol increases with COVID-19 infection, age, and obesity. AU - Edwards,David A, AU - Ausiello,Dennis, AU - Salzman,Jonathan, AU - Devlin,Tom, AU - Langer,Robert, AU - Beddingfield,Brandon J, AU - Fears,Alyssa C, AU - Doyle-Meyers,Lara A, AU - Redmann,Rachel K, AU - Killeen,Stephanie Z, AU - Maness,Nicholas J, AU - Roy,Chad J, PY - 2021/2/10/entrez PY - 2021/2/11/pubmed PY - 2021/2/20/medline KW - COVID-19 KW - aerosols KW - respiratory medicine KW - superspreaders JF - Proceedings of the National Academy of Sciences of the United States of America JO - Proc Natl Acad Sci U S A VL - 118 IS - 8 N2 - COVID-19 transmits by droplets generated from surfaces of airway mucus during processes of respiration within hosts infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. We studied respiratory droplet generation and exhalation in human and nonhuman primate subjects with and without COVID-19 infection to explore whether SARS-CoV-2 infection, and other changes in physiological state, translate into observable evolution of numbers and sizes of exhaled respiratory droplets in healthy and diseased subjects. In our observational cohort study of the exhaled breath particles of 194 healthy human subjects, and in our experimental infection study of eight nonhuman primates infected, by aerosol, with SARS-CoV-2, we found that exhaled aerosol particles vary between subjects by three orders of magnitude, with exhaled respiratory droplet number increasing with degree of COVID-19 infection and elevated BMI-years. We observed that 18% of human subjects (35) accounted for 80% of the exhaled bioaerosol of the group (194), reflecting a superspreader distribution of bioaerosol analogous to a classical 20:80 superspreader of infection distribution. These findings suggest that quantitative assessment and control of exhaled aerosol may be critical to slowing the airborne spread of COVID-19 in the absence of an effective and widely disseminated vaccine. SN - 1091-6490 UR - https://www.unboundmedicine.com/medline/citation/33563754/Exhaled_aerosol_increases_with_COVID_19_infection_age_and_obesity_ L2 - http://www.pnas.org/cgi/pmidlookup?view=long&pmid=33563754 DB - PRIME DP - Unbound Medicine ER -