SARS-CoV-2 environmental contamination from hospitalised patients with COVID-19 receiving aerosol-generating procedures

Winslow, Rebecca L, Zhou, Jie, Windle, Ella F, Nur, Intesar, Lall, Ranjit, Ji, Chen, Millar, Jonathan Edward, Dark, Paul M, Naisbitt, Jay, Simonds, Anita
et al (show 7 more authors) (2022) SARS-CoV-2 environmental contamination from hospitalised patients with COVID-19 receiving aerosol-generating procedures. THORAX, 77 (3). pp. 259-267.

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<h4>Background</h4>Continuous positive airways pressure (CPAP) and high-flow nasal oxygen (HFNO) are considered 'aerosol-generating procedures' in the treatment of COVID-19.<h4>Objective</h4>To measure air and surface environmental contamination with SARS-CoV-2 virus when CPAP and HFNO are used, compared with supplemental oxygen, to investigate the potential risks of viral transmission to healthcare workers and patients.<h4>Methods</h4>30 hospitalised patients with COVID-19 requiring supplemental oxygen, with a fraction of inspired oxygen ≥0.4 to maintain oxygen saturation ≥94%, were prospectively enrolled into an observational environmental sampling study. Participants received either supplemental oxygen, CPAP or HFNO (n=10 in each group). A nasopharyngeal swab, three air and three surface samples were collected from each participant and the clinical environment. Real-time quantitative polymerase chain reaction analyses were performed for viral and human RNA, and positive/suspected-positive samples were cultured for the presence of biologically viable virus.<h4>Results</h4>Overall 21/30 (70%) participants tested positive for SARS-CoV-2 RNA in the nasopharynx. In contrast, only 4/90 (4%) and 6/90 (7%) of all air and surface samples tested positive (positive for E and ORF1a) for viral RNA respectively, although there were an additional 10 suspected-positive samples in both air and surfaces samples (positive for E or ORF1a). CPAP/HFNO use or coughing was not associated with significantly more environmental contamination than supplemental oxygen use. Only one nasopharyngeal sample was culture positive.<h4>Conclusions</h4>The use of CPAP and HFNO to treat moderate/severe COVID-19 did not appear to be associated with substantially higher levels of air or surface viral contamination in the immediate care environment, compared with the use of supplemental oxygen.

Item Type: Article
Uncontrolled Keywords: COVID-19, non invasive ventilation
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User: Symplectic Admin
Date Deposited: 10 Jan 2022 14:20
Last Modified: 15 Dec 2022 10:08
DOI: 10.1136/thoraxjnl-2021-218035
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