Infectious Disease

Hospital air is commonly contaminated with SARS-CoV-2, though viruses are hardly ever viable

December 31, 2020

2 min read

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Birgand does not report any relevant financial information. In the study you will find all relevant financial information from all other authors.

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Around 17% of air samples taken near patients hospitalized with COVID-19 were contaminated with SARS-CoV-2 RNA, although the viruses were rarely viable, according to a systematic review published in JAMA .

“This confirms that the main mode of transmission of SARS-CoV-2 appears to be through droplets and direct contact. Airborne transmission remains rare and opportunistic, depending on the procedures performed on patients and the duration of exposure. ” Gabriel Birgand, PharmD, MPH, PhD, Healio from the National Institute for Health Research’s Department of Health Protection Research on Health Infections and Antibiotic Resistance at Imperial College London.

COVID19 graphic air samples

Source: Birgand G, et al. JAMA Netw Open. 2020; doi: 10.1001 / jamanetworkopen.2020.33232.

“For professionals, the surgical face mask works under most hospital circumstances. Respiratory protection equipment should be used to generate aerosols, ”said Birgand.

The review uncovered the highest levels of viral loads in the air of bathrooms, staff areas and public hallways, suggesting that “these areas must be carefully screened to prevent the transmission of COVID-19,” they write.

Gabriel Birgand

“However, the presence of viable viruses should be considered first as it is a required link for the potential for cross-transmission,” the authors wrote.

Birgand and colleagues checked 2,284 records on SARS-CoV-2 air pollution in hospitals from the MEDLINE, Embase and Web of Science databases. They described and compared SARS-CoV-2 virus RNA and culture positivity rates based on patient setting, ventilation systems, clinical contexts, and distance.

The researchers found that 82 out of 471 (17.4%) of the air samples taken near patients tested positive for SARS-CoV-2 RNA. Additionally, 27 out of 107 (25.2%) of the air samples tested near ICU patients tested positive for SARS-CoV-2, compared to only 39 out of 364 (10.7%) of the air samples tested outside the ICU (P. <0.001). . They also found that the virus positivity rate in air samples was 20 of 242 (8.3%) in clinical areas, 5 of 21 (23.8%) near toilets, and 14 of 42 (33.3%) in nearby areas fraud from public areas.

The review found that seven virus cultures (8.6%) from two studies were positive, “all from a close patient environment,” reported Birgand and colleagues.

“Some misclassifications may have occurred when variables are categorized without sufficient detail. In addition, the sampling and microbiology methods in all studies were very heterogeneous, ”stated Birgand. “These shortcomings may have affected the comparability of the data and the reliability of the analysis of pooled data. For better clarity of the analysis, we have not considered surface contamination. However, air and surface contaminants may be correlated and can help understand resuspension. “

Researchers said the problem “requires more robust studies,” including a randomized clinical trial comparing surgical face masks with respirators for recommendations on respiratory protection for healthcare providers (HCP).

“Assessment of SARS-CoV-2 RNA and viable viral contamination from surgical face masks and respirators worn by HCPs according to a series of procedures involving patients with COVID-19 would provide information about exposure in routine practice,” wrote she.

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