ArticleThe Journal of infection2021
Exhaled SARS-CoV-2 quantified by face-mask sampling in hospitalised patients with COVID-19.
Article in The Journal of infection, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
36 citing papers in PubMed, 1 synthesis or guideline pooled it, 51 citations in OpenAlex.
- Severe acute respiratory syndrome coronavirus-2 shedding in exhaled material: a systematic review.Epidemiology and infection · 2025Pooled it
- Face mask sampling for the detection of microbes in expelled aerosols and the impact of airway clearance on microbial yield in children with cystic fibrosis: a feasibility trial.Journal of medical microbiology · 2026Article
- Detection of SARS-CoV-2 RNA and Biomarkers in Device-Captured Droplets From the Lung.CHEST pulmonary · 2025Article
- High Propensity for Multidrug-Resistant Pneumococcal Shedding Among Adults Living With HIV on Stable Antiretroviral Therapy in Malawi.Open forum infectious diseases · 2025Article
- Authors' response: 'Implementation of facemask sampling for the detection of infectious individuals with SARS-CoV-2 in high stakes clinical examinations - a feasibility study'.Future healthcare journal · 2025Article
- Article
- Implementation of facemask sampling for the detection of infectious individuals with SARS-CoV-2 in high stakes clinical examinations - a feasibility study.Future healthcare journal · 2024Article
- Pediatric Tuberculosis: A Review of Evidence-Based Best Practices for Clinicians and Health Care Providers.Pathogens (Basel, Switzerland) · 2024Review
- Frequency, kinetics and determinants of viable SARS-CoV-2 in bioaerosols from ambulatory COVID-19 patients infected with the Beta, Delta or Omicron variants.Nature communications · 2024Article
- Efficacy of SARS-CoV-2 detection from used surgical masks compared with standard detection method.Biosafety and health · 2024Article
- Blazing the trail for innovative tuberculosis diagnostics.Infection · 2024Review
- A safer framework to evaluate characterization technologies of exhaled biologic materials using electrospun nanofibers.Nanoscale · 2023Article
- Mask device as a new wearable sampler for breath analysis: what can we expect in the future?Analytical and bioanalytical chemistry · 2023Article
- Risk factors and vectors for SARS-CoV-2 household transmission: a prospective, longitudinal cohort study.The Lancet. Microbe · 2023Article
- Exhaled SARS-CoV-2 RNA viral load kinetics measured by facemask sampling associates with household transmission.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2023Article
- Testing of worn face mask and saliva for SARS-CoV-2.Frontiers in public health · 2023Observational
- Assessing the performance of regular surgical nose masks as a sampling method for SARS-CoV-2 detection in a cross-sectional study.PloS one · 2023Article
- Monitoring Prevalence and Persistence of Environmental Contamination by SARS-CoV-2 RNA in a Makeshift Hospital for Asymptomatic and Very Mild COVID-19 Patients.International journal of public health · 2023Article
- Observational
- Quantifying the Risk to Health Care Workers of Cough as an Aerosol Generating Event in an Ambulance Setting: A Research Report.Prehospital and disaster medicine · 2022Review
Corrections and comments
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Authors and funding
17 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundHuman to human transmission of SARS-CoV-2 is driven by the respiratory route but little is known about the pattern and quantity of virus output from exhaled breath. We have previously shown that face-mask sampling (FMS) can detect exhaled tubercle bacilli and have adapted its use to quantify exhaled SARS-CoV-2 RNA in patients admitted to hospital with Coronavirus Disease-2019 (COVID-19).
methodsBetween May and December 2020, we took two concomitant FMS and nasopharyngeal samples (NPS) over two days, starting within 24 h of a routine virus positive NPS in patients hospitalised with COVID-19, at University Hospitals of Leicester NHS Trust, UK. Participants were asked to wear a modified duckbilled facemask for 30 min, followed by a nasopharyngeal swab. Demographic, clinical, and radiological data, as well as International Severe Acute Respiratory and emerging Infections Consortium (ISARIC) mortality and deterioration scores were obtained. Exposed masks were processed by removal, dissolution and analysis of sampling matrix strips fixed within the mask by RT-qPCR. Viral genome copy numbers were determined and results classified as Negative; Low: ≤999 copies; Medium: 1000-99,999 copies and High ≥ 100,000 copies per strip for FMS or per 100 µl for NPS.
results102 FMS and NPS were collected from 66 routinely positive patients; median age: 61 (IQR 49 - 77), of which FMS was positive in 38% of individuals and concomitant NPS was positive in 50%. Positive FMS viral loads varied over five orders of magnitude (<10-3.3 x 10
conclusionWe demonstrate a simple and effective method for detecting and quantifying exhaled SARS-CoV-2 in hospitalised patients with COVID-19. Higher FMS viral loads were more likely to be associated with developing severe disease compared to NPS viral loads. Similar to NPS, FMS viral load was highest in early disease and in those with active respiratory symptoms, highlighting the potential role of FMS in understanding infectivity.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.