Viable SARS-CoV-2 in the air of a hospital room with COVID-19 patients

• Published in: International journal of infectious diseases Vol. 100; pp. 476 - 482
• Main Authors: Lednicky, John A., Lauzardo, Michael, Fan, Z. Hugh, Jutla, Antarpreet, Tilly, Trevor B., Gangwar, Mayank, Usmani, Moiz, Shankar, Sripriya Nannu, Mohamed, Karim, Eiguren-Fernandez, Arantza, Stephenson, Caroline J., Alam, Md. Mahbubul, Elbadry, Maha A., Loeb, Julia C., Subramaniam, Kuttichantran, Waltzek, Thomas B., Cherabuddi, Kartikeya, Morris, J. Glenn, Wu, Chang-Yu
• Format: Journal Article
• Language: English
• Published: Canada Elsevier Ltd 01.11.2020; The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases; Elsevier
• Subjects: Aerosols; Air Microbiology; Betacoronavirus - isolation & purification; Coronavirus Infections - transmission; Coronavirus Infections - virology; COVID-19; Hospitals; Humans; Pandemics; Pneumonia, Viral - transmission; Pneumonia, Viral - virology; SARS-CoV-2
• ISSN: 1201-9712; 1878-3511; 1878-3511
• DOI: 10.1016/j.ijid.2020.09.025

[Display omitted] •Viable (infectious) SARS-CoV-2 was present in aerosols within the hospital room of COVID-19 patients.•Airborne virus was detected in the absence of healthcare aerosol-generating procedures.•The virus strain detected in the aerosols matched with the virus strain isolated from a patient with acute COVID-19. Because the detection of SARS-CoV-2 RNA in aerosols but failure to isolate viable (infectious) virus are commonly reported, there is substantial controversy whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be transmitted through aerosols. This conundrum occurs because common air samplers can inactivate virions through their harsh collection processes. We sought to resolve the question whether viable SARS-CoV-2 can occur in aerosols using VIVAS air samplers that operate on a gentle water vapor condensation principle. Air samples collected in the hospital room of two coronavirus disease-2019 (COVID-19) patients, one ready for discharge and the other newly admitted, were subjected to RT-qPCR and virus culture. The genomes of the SARS-CoV-2 collected from the air and isolated in cell culture were sequenced. Viable SARS-CoV-2 was isolated from air samples collected 2 to 4.8 m away from the patients. The genome sequence of the SARS-CoV-2 strain isolated from the material collected by the air samplers was identical to that isolated from the newly admitted patient. Estimates of viable viral concentrations ranged from 6 to 74 TCID50 units/L of air. Patients with respiratory manifestations of COVID-19 produce aerosols in the absence of aerosol-generating procedures that contain viable SARS-CoV-2, and these aerosols may serve as a source of transmission of the virus.