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Our paper is available online! "Environmental and Aerosolized SARS-CoV-2 Among Hospitalized COVID-19 Patients" https://doi.org/10.1093/infdis/jiaa575 Highlights below:
Among the more than 400 samples,
we found molecular evidence of virus in most sample types, especially the
nasopharyngeal (NP), saliva, and fecal samples, but the prevalence of molecular
positivity among fomites and aerosols was low. 1/n
we found molecular evidence of virus in most sample types, especially the
nasopharyngeal (NP), saliva, and fecal samples, but the prevalence of molecular
positivity among fomites and aerosols was low. 1/n
Eight National Institute for Occupational
Safety and Health (NIOSH) BC 251 Aerosol Samplers were placed
1.5 m from the ground, at ~1 m, ~1.4 m, ~2.2 m, and ~3.2 m
from the SARS-CoV-2 patient’s head, and subsequently run for ~4
hours. 2/n
Safety and Health (NIOSH) BC 251 Aerosol Samplers were placed
1.5 m from the ground, at ~1 m, ~1.4 m, ~2.2 m, and ~3.2 m
from the SARS-CoV-2 patient’s head, and subsequently run for ~4
hours. 2/n
Among the 20 COVID-19 patients, all (100%) provided a saliva specimen, 19
(95.0%) permitted a NP swab, and 12 (60.0%) provided a rectal swab
during the enrollment visit. Of those, 12 (60.0%) saliva, 11 (57.9%) NP swabs, and
3 (25.0%) rectal swabs were SARS-CoV-2 RNA positive 3/n
(95.0%) permitted a NP swab, and 12 (60.0%) provided a rectal swab
during the enrollment visit. Of those, 12 (60.0%) saliva, 11 (57.9%) NP swabs, and
3 (25.0%) rectal swabs were SARS-CoV-2 RNA positive 3/n
Among the aerosol samples collected in 20 patient rooms,
three patients (15.0%) had one + aerosol sample. Patient number six was 4 DPSO (runny nose, headache and fever) when SARSCoV-2 RNA was detected in aerosols particle size <4 µm at ~1.4 m from her head 4/n
three patients (15.0%) had one + aerosol sample. Patient number six was 4 DPSO (runny nose, headache and fever) when SARSCoV-2 RNA was detected in aerosols particle size <4 µm at ~1.4 m from her head 4/n
Patient number nine was 10 DPSO (cough, difficulty breathing, fatigue, loss of
smell and gastrointestinal symptoms) when SARS-CoV-2 RNA was detected in
aerosols particle size <4 µm at ~2.2 m from her head 5/n
smell and gastrointestinal symptoms) when SARS-CoV-2 RNA was detected in
aerosols particle size <4 µm at ~2.2 m from her head 5/n
Patient number 16 was six DPSO (cough, difficulty breathing, fatigue) when
SARS-CoV-2 RNA was detected in aerosols particle size >4 µm at ~2.2 m from her head. 6/n
SARS-CoV-2 RNA was detected in aerosols particle size >4 µm at ~2.2 m from her head. 6/n
Measurements performed in a
representative empty DUH patient room on the COVID-19 ward determined that air
inside the room was exchanged ~14 times every hour. 7/n
representative empty DUH patient room on the COVID-19 ward determined that air
inside the room was exchanged ~14 times every hour. 7/n
All SARS-CoV-2 RNA + biological, fomite, and aerosol samples collected
from COVID-19 patient were screened for infectious virus through cell
culture (Cts ranged from 19.4 to 39.8)
Among these, the two samples with the
lowest Ct counts demonstrated viable virus in culture 8/n
from COVID-19 patient were screened for infectious virus through cell
culture (Cts ranged from 19.4 to 39.8)
Among these, the two samples with the
lowest Ct counts demonstrated viable virus in culture 8/n
The enrollment NP swabs (showing CPE) had been collected
from COVID-19 patient number 2 and 19 at one and seven DPSO, respectively. No infectious virus was cultured from fomite or aerosol samples. 9/n
from COVID-19 patient number 2 and 19 at one and seven DPSO, respectively. No infectious virus was cultured from fomite or aerosol samples. 9/n
Importantly, 10
(50.0%) of our study participants were enrolled eight days or more into their illness,
a cut point after which others have found it difficult to culture viable virus from
patient samples and after which viral shedding may be cleared. 10/n
(50.0%) of our study participants were enrolled eight days or more into their illness,
a cut point after which others have found it difficult to culture viable virus from
patient samples and after which viral shedding may be cleared. 10/n
While our findings support the position that fomites and aerosol transmission were of relatively low risk among these COVID-19 patients, our results may also be
consistent with aerosol transmission occurring early on in the course of disease...(cont.)
consistent with aerosol transmission occurring early on in the course of disease...(cont.)
...well before COVID-19 patients are ill enough to require hospitalization. We further
conclude that fomite and aerosol transmission should be assessed soon after
disease onset. /end
conclude that fomite and aerosol transmission should be assessed soon after
disease onset. /end
*Edited to fit thread. Thanks to @RaqBurCal for leading this work and to our teammates including @AnfalAbdelgadir
@AmandaSFarrell @drkristenkc @cclautredou @marcdeshusses and others.
@AmandaSFarrell @drkristenkc @cclautredou @marcdeshusses and others.
