ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2022
Airborne Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Hospitals: Effects of Aerosol-Generating Procedures, HEPA-Filtration Units, Patient Viral Load, and Physical Distance.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 3 of them syntheses that pooled it.
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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
17 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Non-pharmaceutical interventions for COVID-19: a systematic review on environmental control measures.Philosophical transactions. Series A, Mathematical, physical, and engineering sciences · 2023Pooled it
- Generation of Aerosols by Noninvasive Respiratory Support Modalities: A Systematic Review and Meta-Analysis.JAMA network open · 2023Pooled it
- Revised Guidelines for Coronavirus Disease 19 Management in Hematopoietic Cell Transplantation and Cellular Therapy Recipients (August 2022).Transplantation and cellular therapy · 2022Guideline
- From 'droplet' to 'respiratory' precautions: implementation and adherence monitoring in a Swiss tertiary care center, 2023-2025.Antimicrobial resistance and infection control · 2026Article
- Rationale and Strategy for Switching to an All-Nebulization Protocol for In-Hospital Administration of Respiratory Medications.Hospital pharmacy · 2026Article
- Integrated monitoring of enveloped viruses in hospital environments: Detection, persistence, and implications for infection control.PloS one · 2026Article
- Airborne SARS-CoV-2 RNA detected during deliveries with unmasked patients.Infection prevention in practice · 2024Article
- Morbidity and Mortality of Hospital-Onset SARS-CoV-2 Infections Due to Omicron Versus Prior Variants : A Propensity-Matched Analysis.Annals of internal medicine · 2024Article
- Ventilator-Associated Pneumonia, Ventilator-Associated Events, and Nosocomial Respiratory Viral Infections on the Leeside of the Pandemic.Respiratory care · 2024Review
- Reducing Transmission of Airborne Respiratory Pathogens: A New Beginning as the COVID-19 Emergency Ends.Environmental health perspectives · 2024Review
- Effect of SARS-CoV-2 prior infection and mRNA vaccination on contagiousness and susceptibility to infection.Nature communications · 2023Article
- Article
- Size distribution and relationship of airborne SARS-CoV-2 RNA to indoor aerosol in hospital ward environments.Scientific reports · 2023Article
- Use of portable air purifiers to reduce aerosols in hospital settings and cut down the clinical backlog.Epidemiology and infection · 2023Article
- Optimizing Respiratory Care for Patients While Protecting Ourselves.Respiratory care · 2023Article
- Environmental Contamination by SARS-CoV-2 During Noninvasive Ventilation in COVID-19.Respiratory care · 2023Observational
- Abrupt decreases in infectivity of SARS-CoV-2 in aerosols.Proceedings of the National Academy of Sciences of the United States of America · 2022Article
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8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTransmission of coronavirus disease 2019 (COVID-19) can occur through inhalation of fine droplets or aerosols containing infectious virus. The objective of this study was to identify situations, patient characteristics, environmental parameters, and aerosol-generating procedures (AGPs) associated with airborne severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus.
methodsAir samples were collected near hospitalized COVID-19 patients and analyzed by RT-qPCR. Results were related to distance to the patient, most recent patient diagnostic PCR cycle threshold (Ct) value, room ventilation, and ongoing potential AGPs.
resultsIn total, 310 air samples were collected; of these, 26 (8%) were positive for SARS-CoV-2. Of the 231 samples from patient rooms, 22 (10%) were positive for SARS-CoV-2. Positive air samples were associated with a low patient Ct value (OR, 5.0 for Ct <25 vs >25; P = .01; 95% CI: 1.18-29.5) and a shorter physical distance to the patient (OR, 2.0 for every meter closer to the patient; P = .05; 95% CI: 1.0-3.8). A mobile HEPA-filtration unit in the room decreased the proportion of positive samples (OR, .3; P = .02; 95% CI: .12-.98). No association was observed between SARS-CoV-2-positive air samples and mechanical ventilation, high-flow nasal cannula, nebulizer treatment, or noninvasive ventilation. An association was found with positive expiratory pressure training (P < .01) and a trend towards an association for airway manipulation, including bronchoscopies and in- and extubations.
conclusionsOur results show that major risk factors for airborne SARS-CoV-2 include short physical distance, high patient viral load, and poor room ventilation. AGPs, as traditionally defined, seem to be of secondary importance.
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