Neurological

Risk to medical personnel from the use of CPAP, High Flow Nasal O2 in COVID-19?

Using continuous positive airway pressure (CPAP) or high-flow nasal oxygen (HFNO) to treat moderate / severe COVID-19 does not result in any significant additional air or surface virus contamination compared to additional oxygen, according to an observational study published in Thorax.

CPAP and HFNO machines have been associated with a reduction in mortality and progression to intubation in hypoxemic respiratory failure; however, they are considered “aerosol generating processes” in the treatment of COVID-19. Few studies have looked at their risk of transmission to healthcare workers.

To better understand the risks of airborne SARS-CoV-2 contamination and exposure of healthcare workers, researchers examined the clinical setting of 30 hospitalized patients with COVID-19 who received either supplemental oxygen, CPAP, or HFNO (n = 10 in each group). Researchers collected one nasopharynx swab and 3 air and 3 surface samples from each patient and the clinical setting. Of these patients, 70% (n = 21) tested positive for SARS-CoV-2 RNA in the nasopharynx. Of all air and surface samples, only 4/90 (4%) and 6/90 (7%) tested positive for viral RNA. The researchers found that there were an additional 10 suspected positive samples in both air and surface samples; However, they did not find any biologically viable virus in cell cultures of positive or suspected positive samples, with the exception of 1 nasopharyngeal sample from an HFNO patient.

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“We found limited SARS-CoV-2 virus RNA in the immediate vicinity of hospitalized patients with COVID-19, and that this did not appear to be significantly affected by CPAP / HFNO machine use or coughing, and more importantly That viable virus was undetectable biologically, ”concluded the authors. Therefore, it is more likely that health worker exposure and nosocomial transmission are due to patient factors, such as cough, in earlier stages of the infection rather than the type of breathing assistance used for treatment.

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Winslow RL, Zhou J, Windle EF et al. SARS-CoV-2 environmental contamination from hospital patients with COVID-19 receiving aerosol generating procedures. Thorax. Published online November 4, 2021. doi: 10.1136 / thoraxjnl-2021-218035

This article originally appeared on Pulmonology Advisor

Subjects:

COVID19 general medicine

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