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

作者：Rebecca Winslow, Jie Zhou, Ella F Windle, Intesar Nur, Ranjit Lall, Chen feng Ji, Jonathan Edward Millar, Paul M Dark, Jay Naisbitt, Anita Kay Simonds, Jake W Dunning, William Barclay, John Kenneth Baillie, Gavin D. Perkins, Malcolm Gracie Semple, Daniel Francis McAuley, Christopher Aird Green · 发表于：Thorax · 年份：2021 · DOI：10.1136/thoraxjnl-2021-218035 · 被引用次数：45 · 研究领域：Infection Control and Ventilation、Dental Research and COVID-19、SARS-CoV-2 detection and testing

BACKGROUND: Continuous positive airways pressure (CPAP) and high-flow nasal oxygen (HFNO) are considered 'aerosol-generating procedures' in the treatment of COVID-19. OBJECTIVE: 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. METHODS: 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. RESULTS: 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 environme...