Airborne SARS-CoV-2 RNA excretion by patients with COVID-19 on different oxygen-delivery systems: a prospective observational study

Janssen, Matthijs L.; Klazen, Yoram P.; Man, Peter de; Hanselaar, Wessel; Ong, David S. Y.; Wils, Evert‐Jan

doi:10.1016/j.jhin.2022.03.001

Cited by 3 publications

(17 citation statements)

References 16 publications

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“…For example, one study found that intubation in controlled settings generated very few aerosols, whereas extubation that induced coughing increased aerosol generation 15-fold and volitional coughing increased aerosol generation 35-fold [42 ▪▪ ]. Other studies similarly report that noninvasive positive pressure ventilation, extubation without coughing, bronchoscopy, and high flow nasal cannula have minimal impact on aerosol generation [38 ▪▪ ,43,44,45 ▪▪ ]. In contrast to these procedures, however, talking loudly, exercising, singing, coughing, and even playing wind instruments substantially increase aerosol production [9,37 ▪▪ ,38 ▪▪ ,46].…”

Section: Science Of Respiratory Pathogen Transmissionmentioning

confidence: 99%

“…This is because viral loads and viral transmission risk are greatest in the days preceding and immediately following initial symptom onset [97]. By the time patients progress enough to require hospitalization, their viral loads are typically lower [45 ▪▪ ]. Patients with early unsuspected infection, by contrast, can have very high viral loads.…”

Section: Personal Approaches To Preventionmentioning

confidence: 99%

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Prevention of SARS-CoV-2 and respiratory viral infections in healthcare settings: current and emerging concepts

Rhee

Baker

2022

Current Opinion in Infectious Diseases

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Purpose of review COVID-19 has catalyzed a wealth of new data on the science of respiratory pathogen transmission and revealed opportunities to enhance infection prevention practices in healthcare settings. Recent findingsNew data refute the traditional division between droplet vs airborne transmission and clarify the central role of aerosols in spreading all respiratory viruses, including Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), even in the absence of so-called 'aerosol-generating procedures' (AGPs). Indeed, most AGPs generate fewer aerosols than talking, labored breathing, or coughing. Risk factors for transmission include high viral loads, symptoms, proximity, prolonged exposure, lack of masking, and poor ventilation. Testing all patients on admission and thereafter can identify early occult infections and prevent hospital-based clusters. Additional prevention strategies include universal masking, encouraging universal vaccination, preferential use of N95 respirators when community rates are high, improving native ventilation, utilizing portable high-efficiency particulate air filters when ventilation is limited, and minimizing room sharing when possible. SummaryMultifaceted infection prevention programs that include universal testing, masking, vaccination, and enhanced ventilation can minimize nosocomial SARS-CoV-2 infections in patients and workplace infections in healthcare personnel. Extending these insights to other respiratory viruses may further increase the safety of healthcare and ready hospitals for novel respiratory viruses that may emerge in the future.

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Section: Science Of Respiratory Pathogen Transmissionmentioning

confidence: 99%

Section: Personal Approaches To Preventionmentioning

confidence: 99%

Prevention of SARS-CoV-2 and respiratory viral infections in healthcare settings: current and emerging concepts

Rhee

Baker

2022

Current Opinion in Infectious Diseases

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“…Data from the 15 patients with the alpha variant were derived from our previous cohort study. 3 Abbreviation: SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.…”

Section: Resultsmentioning

confidence: 99%

“… Note : Data are reported as absolute number (percentage). Data from the 15 patients with the alpha variant were derived from our previous cohort study 3 …”

Section: Resultsmentioning

confidence: 99%

“…Moreover, we included only patients on low‐flow oxygenation modality, because air sample positivity was more frequent in these patients as compared to patients on high‐flow nasal cannula oxygen therapy 3 . The current results are in line with previous findings that were derived using the same air sampling method and consistently showing the frequent detection of SARS‐CoV‐2 RNA in air samples that were taken in repetition or from different locations for every individual participant 2,3 . This study also has important limitations to consider.…”

Section: Discussionmentioning

confidence: 99%

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Airborne virus shedding of the alpha, delta, omicron SARS‐CoV‐2 variants and influenza virus in hospitalized patients

Ong

Man

Verhagen

et al. 2023

Journal of Medical Virology

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Airborne transmission is an important transmission route for the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological data indicate that certain SARS-CoV-2 variants, like the omicron variant, are associated with higher transmissibility. We compared virus detection in air samples between hospitalized patients infected with different SARS-CoV-2 variants or influenza virus.The study was performed during three separate time periods in which subsequently the alpha, delta, and omicron SARS-CoV-2 variants were predominant. In total, 79 patients with coronavirus disease 2019 (COVID-19) and 22 patients with influenza A virus infection were included. Collected air samples were positive in 55% of patients infected with the omicron variant in comparison to 15% of those infected with the delta variant (p < 0.01). In multivariable analysis, the SARS-CoV-2 omicron BA.1/ BA.2 variant (as compared to the delta variant) and the viral load in nasopharynx were both independently associated with air sample positivity, but the alpha variant and COVID-19 vaccination were not. The proportion of positive air samples patients infected with the influenza A virus was 18%. In conclusion, the higher air sample positivity rate of the omicron variant compared to previous SARS-CoV-2 variants may partially explain the higher transmission rates seen in epidemiological trends.

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Risk of air and surface contamination during application of different noninvasive respiratory support for patients with COVID-19

Hui

Yung²,

Chan

et al. 2023

International Journal of Infectious Diseases

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Airborne SARS-CoV-2 RNA excretion by patients with COVID-19 on different oxygen-delivery systems: a prospective observational study

Cited by 3 publications

References 16 publications

Prevention of SARS-CoV-2 and respiratory viral infections in healthcare settings: current and emerging concepts

Prevention of SARS-CoV-2 and respiratory viral infections in healthcare settings: current and emerging concepts

Airborne virus shedding of the alpha, delta, omicron SARS‐CoV‐2 variants and influenza virus in hospitalized patients

Risk of air and surface contamination during application of different noninvasive respiratory support for patients with COVID-19

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