SARS-CoV-2 environmental contamination from hospitalised patients with COVID-19 receiving aerosol-generating procedures
Author
Winslow, Rebecca LZhou, Jie
Windle, Ella F
Nur, Intesar
Lall, Ranjit
Ji, Chen
Millar, Jonathan Edward
Dark, Paul M
Naisbitt, Jay
Simonds, Anita
Dunning, Jake
Barclay, Wendy
Baillie, John Kenneth
Perkins, Gavin D
Semple, Malcolm Gracie
McAuley, Daniel Francis
Green, Christopher A
Publication date
2021-11-04Subject
Communicable diseasesPublic health. Health statistics. Occupational health. Health education
Respiratory medicine
Intensive care
Microbiology. Immunology
Metadata
Show full item recordAbstract
Background: Continuous positive airways pressure (CPAP) and high-flow nasal oxygen (HFNO) are considered 'aerosol-generating procedures' in the treatment of COVID-19. Objective: To measure air and surface environmental contamination with SARS-CoV-2 virus when CPAP and HFNO are used, compared with supplemental oxygen, to investigate the potential risks of viral transmission to healthcare workers and patients. Methods: 30 hospitalised patients with COVID-19 requiring supplemental oxygen, with a fraction of inspired oxygen ≥0.4 to maintain oxygen saturation ≥94%, were prospectively enrolled into an observational environmental sampling study. Participants received either supplemental oxygen, CPAP or HFNO (n=10 in each group). A nasopharyngeal swab, three air and three surface samples were collected from each participant and the clinical environment. Real-time quantitative polymerase chain reaction analyses were performed for viral and human RNA, and positive/suspected-positive samples were cultured for the presence of biologically viable virus. Results: Overall 21/30 (70%) participants tested positive for SARS-CoV-2 RNA in the nasopharynx. In contrast, only 4/90 (4%) and 6/90 (7%) of all air and surface samples tested positive (positive for E and ORF1a) for viral RNA respectively, although there were an additional 10 suspected-positive samples in both air and surfaces samples (positive for E or ORF1a). CPAP/HFNO use or coughing was not associated with significantly more environmental contamination than supplemental oxygen use. Only one nasopharyngeal sample was culture positive. Conclusions: The use of CPAP and HFNO to treat moderate/severe COVID-19 did not appear to be associated with substantially higher levels of air or surface viral contamination in the immediate care environment, compared with the use of supplemental oxygen.Citation
Winslow RL, Zhou J, Windle EF, Nur I, Lall R, Ji C, Millar JE, Dark PM, Naisbitt J, Simonds A, Dunning J, Barclay W, Baillie JK, Perkins GD, Semple MG, McAuley DF, Green CA. SARS-CoV-2 environmental contamination from hospitalised patients with COVID-19 receiving aerosol-generating procedures. Thorax. 2022 Mar;77(3):259-267. doi: 10.1136/thoraxjnl-2021-218035. Epub 2021 Nov 4Type
ArticleOther
Additional Links
https://thorax.bmj.com/PMID
34737194Journal
ThoraxPublisher
British Medical Associationae974a485f413a2113503eed53cd6c53
10.1136/thoraxjnl-2021-218035