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Roy CJ. Aerobiology-A New Open Access Journal. AEROBIOLOGY 2023; 1:1-2. [PMID: 37662559 PMCID: PMC10471951 DOI: 10.3390/aerobiology1010001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
It is simultaneously professionally humbling and an absolute pleasure to be associated with the launch of a new open access journal, with added emphasis in a scientific field as rich and diverse as aerobiology [...]
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Affiliation(s)
- Chad J Roy
- Department of Microbiology and Immunology, School of Medicine, Tulane University, New Orleans, LA 70118, USA
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2
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Salama KF, Alnimr A, Alamri A, Radi M, Alshehri B, Rabaan AA, Alshahrani M. Nano-treatment of HEPA filters in COVID-19 isolation rooms in an academic medical center in Saudi Arabia. J Infect Public Health 2022; 15:937-941. [PMID: 35914357 PMCID: PMC9295319 DOI: 10.1016/j.jiph.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 07/02/2022] [Accepted: 07/14/2022] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has spread globally. The major reservoir for SARS-CoV-2 transmission remains controversial, with the airborne route remaining a possible transmission vehicle for carrying the virus within indoor environments. This study aimed to detect contamination of SARS-CoV-2 in high-efficiency particulate air (HEPA) filters within hospital isolation rooms of confirmed COVID-19 patients, exploring the role of nano-treatment of these filters with silver and titanium dioxide nanoparticles (Ag/TiO2 NPs). MATERIALS AND METHODS We investigated the effectiveness of Ag-NPs/TiO2-treated HEPA filters in the air of rooms occupied by patients with confirmed COVID-19 in a university teaching hospital in the Eastern province of Saudi Arabia during the first wave of the pandemic. Ag/TiO2 NPs were designed and coated on HEPA filters to examine the filtration efficiency and antiviral ability in the presence of aerosolized virus particles. A total of 20 viral swab samples were collected from five patients' rooms before and after treatment with nanoparticle-prepared solutions into the sterile virus-transporting media. Samples were evaluated for SARS-CoV-2 with a reverse transcription-polymerase chain reaction. RESULTS Two samples taken from the HEPA filter air exhaust outlets prior to nano-treatment tested positive for SARS-CoV-2 RNA in the intensive care unit, which has stringent aerosolization control procedures, suggesting that small virus-laden droplets may be displaced by airflow. All air samples collected from the HEPA filters from the rooms of patients with confirmed COVID-19 following nano-treatment were negative. CONCLUSION We recommend further experimental exploration using a larger number of HEPA filters in areas with aerosol-generating procedures, along with viability studies on the HEPA filters to facilitate decision-making in high-risk facilities regarding the replacement, storage, and disposal of HEPA filters in wards occupied by cases diagnosed with a highly transmissible disease.
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Affiliation(s)
- Khaled F Salama
- Department of Environmental Health, College of Public Health & King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
| | - Amani Alnimr
- Department of Microbiology, College of Medicine & King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, King Faisal Road, Dammam, Saudi Arabia
| | - Aisha Alamri
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mahmoud Radi
- Department of Infection Control, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Bashayer Alshehri
- Microbiology Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Ali A Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia; Department of Public Health and Nutrition, The University of Haripur, Haripur, Pakistan.
| | - Mohammed Alshahrani
- Emergency and Critical Care Department, College of Medicine & King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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3
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Huang W, Wang K, Hung CT, Chow KM, Tsang D, Lai RWM, Xu RH, Yeoh EK, Ho KF, Chen C. Evaluation of SARS-CoV-2 transmission in COVID-19 isolation wards: On-site sampling and numerical analysis. JOURNAL OF HAZARDOUS MATERIALS 2022; 436:129152. [PMID: 35739698 PMCID: PMC9106403 DOI: 10.1016/j.jhazmat.2022.129152] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/06/2022] [Accepted: 05/11/2022] [Indexed: 05/29/2023]
Abstract
Although airborne transmission has been considered as a possible route for the spread of SARS-CoV-2, the role that aerosols play in SARS-CoV-2 transmission is still controversial. This study evaluated the airborne transmission of SARS-CoV-2 in COVID-19 isolation wards at Prince of Wales Hospital in Hong Kong by both on-site sampling and numerical analysis. A total of 838 air samples and 1176 surface samples were collected, and SARS-CoV-2 RNA was detected using the RT-PCR method. Testing revealed that 2.3% of the air samples and 9.3% of the surface samples were positive, indicating that the isolation wards were contaminated with the virus. The dispersion and deposition of exhaled particles in the wards were calculated by computational fluid dynamics (CFD) simulations. The calculated accumulated number of particles collected at the air sampling points was closely correlated with the SARS-CoV-2 positive rates from the field sampling, which confirmed the possibility of airborne transmission. Furthermore, three potential intervention strategies, i.e., the use of curtains, ceiling-mounted air cleaners, and periodic ventilation, were numerically investigated to explore effective control measures in isolation wards. According to the results, the use of ceiling-mounted air cleaners is effective in reducing the airborne transmission of SARS-CoV-2 in such wards.
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Affiliation(s)
- Wenjie Huang
- Department of Mechanical and Automation Engineering, The Chinese University of Hong Kong, Shatin, N.T. 999077, Hong Kong, China
| | - Kailu Wang
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, N.T. 999077, Hong Kong, China; Centre for Health Systems and Policy Research, JCSPHPC, The Chinese University of Hong Kong, Shatin, N.T. 999077, Hong Kong, China
| | - Chi-Tim Hung
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, N.T. 999077, Hong Kong, China; Centre for Health Systems and Policy Research, JCSPHPC, The Chinese University of Hong Kong, Shatin, N.T. 999077, Hong Kong, China
| | - Kai-Ming Chow
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, N.T. 999077, Hong Kong, China
| | - Dominic Tsang
- Public Health Laboratory Centre, Centre for Health Protection, Kowloon 999077, Hong Kong, China
| | - Raymond Wai-Man Lai
- Department of Microbiology, Prince of Wales Hospital, Shatin, N.T. 999077, Hong Kong, China
| | - Richard Huan Xu
- Department of Rehabilitation Science, Faculty of Health and Social Science, The Hong Kong Polytechnic University, Kowloon 999077, Hong Kong, China
| | - Eng-Kiong Yeoh
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, N.T. 999077, Hong Kong, China; Centre for Health Systems and Policy Research, JCSPHPC, The Chinese University of Hong Kong, Shatin, N.T. 999077, Hong Kong, China
| | - Kin-Fai Ho
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, N.T. 999077, Hong Kong, China.
| | - Chun Chen
- Department of Mechanical and Automation Engineering, The Chinese University of Hong Kong, Shatin, N.T. 999077, Hong Kong, China; Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen 518057, China.
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4
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Tang JW, Caniza MA, Dinn M, Dwyer DE, Heraud JM, Jennings LC, Kok J, Kwok KO, Li Y, Loh TP, Marr LC, Nara EM, Perera N, Saito R, Santillan-Salas C, Sullivan S, Warner M, Watanabe A, Zaidi SK. An exploration of the political, social, economic and cultural factors affecting how different global regions initially reacted to the COVID-19 pandemic. Interface Focus 2022; 12:20210079. [PMID: 35261734 PMCID: PMC8831085 DOI: 10.1098/rsfs.2021.0079] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 01/13/2022] [Indexed: 12/15/2022] Open
Abstract
Responses to the early (February–July 2020) COVID-19 pandemic varied widely, globally. Reasons for this are multiple but likely relate to the healthcare and financial resources then available, and the degree of trust in, and economic support provided by, national governments. Cultural factors also affected how different populations reacted to the various pandemic restrictions, like masking, social distancing and self-isolation or self-quarantine. The degree of compliance with these measures depended on how much individuals valued their needs and liberties over those of their society. Thus, several themes may be relevant when comparing pandemic responses across different regions. East and Southeast Asian populations tended to be more collectivist and self-sacrificing, responding quickly to early signs of the pandemic and readily complied with most restrictions to control its spread. Australasian, Eastern European, Scandinavian, some Middle Eastern, African and South American countries also responded promptly by imposing restrictions of varying severity, due to concerns for their wider society, including for some, the fragility of their healthcare systems. Western European and North American countries, with well-resourced healthcare systems, initially reacted more slowly, partly in an effort to maintain their economies but also to delay imposing pandemic restrictions that limited the personal freedoms of their citizens.
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Affiliation(s)
- Julian W. Tang
- Respiratory Sciences, University of Leicester, Leicester, UK
| | | | - Mike Dinn
- British Antarctic Survey Medical Unit, Emergency Department, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Dominic E. Dwyer
- NSW Health Pathology - Institute for Clinical Pathology and Medical Research, and University of Sydney, Westmead, New South Wales, Australia
| | | | - Lance C. Jennings
- Department of Pathology and Biomedical Science, University of Otago, and Canterbury Health Laboratories, Christchurch, New Zealand
| | - Jen Kok
- NSW Health Pathology - Institute for Clinical Pathology and Medical Research, and University of Sydney, Westmead, New South Wales, Australia
| | - Kin On Kwok
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
- Hong Kong Institute of Asia-Pacific Studies, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
- Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, People's Republic of China
| | - Yuguo Li
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Tze Ping Loh
- Laboratory Medicine, National University Hospital, Singapore, Singapore
| | - Linsey C. Marr
- Civil and Environmental Engineering, Virginia Tech, VA, USA
| | - Eva Megumi Nara
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | - Nelun Perera
- Clinical Microbiology, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Reiko Saito
- Division of International Health, Niigata University, Niigata, Japan
| | | | - Sheena Sullivan
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, Melbourne, Australia
- Department of Infectious Diseases, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Matt Warner
- British Antarctic Survey Medical Unit, Emergency Department, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Aripuanã Watanabe
- Department of Parasitology, Microbiology and Immunology, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Sabeen Khurshid Zaidi
- Karachi Institute of Medical Sciences affiliated with National University of Medical Sciences, Karachi, Pakistan
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5
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Polianski IJ. Airborne infection with Covid-19? A historical look at a current controversy. Microbes Infect 2021; 23:104851. [PMID: 34126250 PMCID: PMC8193962 DOI: 10.1016/j.micinf.2021.104851] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/31/2021] [Accepted: 06/01/2021] [Indexed: 12/03/2022]
Abstract
Since the start of the COVID-19 pandemic, experts and the broader public have vigorously debated the means by which SARS CoV-2 is spread. And understandably so, for identifying the routes of transmission is crucial for selecting appropriate nonpharmaceutical interventions to control the pandemic. The most controversial question in the debate is the role played by airborne transmission. What is at stake is not just the clinical evidence, but the implications for public health policy, society, and psychology. Interestingly, however, the issue of airborne transmission is not a new controversy. It has reappeared throughout the history of western medicine. This essay traces the notion of airborne infection from its development in ancient medical theories to its manifestation in the modern era and its impact today.
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6
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Djellabi R, Basilico N, Delbue S, D’Alessandro S, Parapini S, Cerrato G, Laurenti E, Falletta E, Bianchi CL. Oxidative Inactivation of SARS-CoV-2 on Photoactive AgNPs@TiO 2 Ceramic Tiles. Int J Mol Sci 2021; 22:ijms22168836. [PMID: 34445543 PMCID: PMC8396237 DOI: 10.3390/ijms22168836] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 08/13/2021] [Accepted: 08/15/2021] [Indexed: 12/29/2022] Open
Abstract
The current SARS-CoV-2 pandemic causes serious public health, social, and economic issues all over the globe. Surface transmission has been claimed as a possible SARS-CoV-2 infection route, especially in heavy contaminated environmental surfaces, including hospitals and crowded public places. Herein, we studied the deactivation of SARS-CoV-2 on photoactive AgNPs@TiO2 coated on industrial ceramic tiles under dark, UVA, and LED light irradiations. SARS-CoV-2 inactivation is effective under any light/dark conditions. The presence of AgNPs has an important key to limit the survival of SARS-CoV-2 in the dark; moreover, there is a synergistic action when TiO2 is decorated with Ag to enhance the virus photocatalytic inactivation even under LED. The radical oxidation was confirmed as the the central mechanism behind SARS-CoV-2 damage/inactivation by ESR analysis under LED light. Therefore, photoactive AgNPs@TiO2 ceramic tiles could be exploited to fight surface infections, especially during viral severe pandemics.
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Affiliation(s)
- Ridha Djellabi
- Department of Chemistry, University of Milan, Via Golgi 19, 20133 Milan, Italy;
- Correspondence: (R.D.); (C.L.B.)
| | - Nicoletta Basilico
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Carlo Pascal 36, 20133 Milan, Italy; (N.B.); (S.D.)
| | - Serena Delbue
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Carlo Pascal 36, 20133 Milan, Italy; (N.B.); (S.D.)
| | - Sarah D’Alessandro
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Via Carlo Pascal 36, 20133 Milan, Italy;
| | - Silvia Parapini
- Department of Biomedical Sciences for Health, University of Milan, Via Carlo Pascal 36, 20133 Milan, Italy;
| | - Giuseppina Cerrato
- Department of Chemistry, University of Turin, Via Pietro Giuria 7, 10125 Turin, Italy; (G.C.); (E.L.)
| | - Enzo Laurenti
- Department of Chemistry, University of Turin, Via Pietro Giuria 7, 10125 Turin, Italy; (G.C.); (E.L.)
| | - Ermelinda Falletta
- Department of Chemistry, University of Milan, Via Golgi 19, 20133 Milan, Italy;
| | - Claudia Letizia Bianchi
- Department of Chemistry, University of Milan, Via Golgi 19, 20133 Milan, Italy;
- Correspondence: (R.D.); (C.L.B.)
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7
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Birgand G, Mutters NT, Otter J, Eichel VM, Lepelletier D, Morgan DJ, Lucet JC. Variation of National and International Guidelines on Respiratory Protection for Health Care Professionals During the COVID-19 Pandemic. JAMA Netw Open 2021; 4:e2119257. [PMID: 34347062 PMCID: PMC8339937 DOI: 10.1001/jamanetworkopen.2021.19257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
This systematic review assesses variation in international and national guidelines on respiratory protection for health care professionals during the COVID-19 pandemic.
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Affiliation(s)
- Gabriel Birgand
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London, London, United Kingdom
- Regional Center for Infection Prevention and Control Pays de la Loire, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Nico T. Mutters
- Institute for Hygiene and Public Health, University Hospital Bonn, Bonn, Germany
| | - Jonathan Otter
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London, London, United Kingdom
| | - Vanessa M. Eichel
- Centre for Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Didier Lepelletier
- Infection Control Unit, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Daniel J. Morgan
- University of Maryland School of Medicine, Baltimore
- VA Maryland Healthcare System, Baltimore
| | - Jean-Christophe Lucet
- Infection Antimicrobials Modelling Evolution, French Institute for Medical Research, University Paris Diderot, Sorbonne Paris Cité, Paris, France
- Infection Control Unit, Hôpital Bichat-Claude Bernard, Assistance Publique-Hôpitaux de Paris, Paris, France
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8
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Escandón K, Rasmussen AL, Bogoch II, Murray EJ, Escandón K, Popescu SV, Kindrachuk J. COVID-19 false dichotomies and a comprehensive review of the evidence regarding public health, COVID-19 symptomatology, SARS-CoV-2 transmission, mask wearing, and reinfection. BMC Infect Dis 2021; 21:710. [PMID: 34315427 PMCID: PMC8314268 DOI: 10.1186/s12879-021-06357-4] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 06/24/2021] [Indexed: 02/07/2023] Open
Abstract
Scientists across disciplines, policymakers, and journalists have voiced frustration at the unprecedented polarization and misinformation around coronavirus disease 2019 (COVID-19) pandemic. Several false dichotomies have been used to polarize debates while oversimplifying complex issues. In this comprehensive narrative review, we deconstruct six common COVID-19 false dichotomies, address the evidence on these topics, identify insights relevant to effective pandemic responses, and highlight knowledge gaps and uncertainties. The topics of this review are: 1) Health and lives vs. economy and livelihoods, 2) Indefinite lockdown vs. unlimited reopening, 3) Symptomatic vs. asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, 4) Droplet vs. aerosol transmission of SARS-CoV-2, 5) Masks for all vs. no masking, and 6) SARS-CoV-2 reinfection vs. no reinfection. We discuss the importance of multidisciplinary integration (health, social, and physical sciences), multilayered approaches to reducing risk ("Emmentaler cheese model"), harm reduction, smart masking, relaxation of interventions, and context-sensitive policymaking for COVID-19 response plans. We also address the challenges in understanding the broad clinical presentation of COVID-19, SARS-CoV-2 transmission, and SARS-CoV-2 reinfection. These key issues of science and public health policy have been presented as false dichotomies during the pandemic. However, they are hardly binary, simple, or uniform, and therefore should not be framed as polar extremes. We urge a nuanced understanding of the science and caution against black-or-white messaging, all-or-nothing guidance, and one-size-fits-all approaches. There is a need for meaningful public health communication and science-informed policies that recognize shades of gray, uncertainties, local context, and social determinants of health.
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Affiliation(s)
- Kevin Escandón
- School of Medicine, Universidad del Valle, Cali, Colombia.
| | - Angela L Rasmussen
- Vaccine and Infectious Disease Organization, University of Saskatchewan, Saskatoon, Canada
- Georgetown Center for Global Health Science and Security, Georgetown University, Washington, DC, USA
| | - Isaac I Bogoch
- Division of Infectious Diseases, University of Toronto, Toronto General Hospital, Toronto, Canada
| | - Eleanor J Murray
- Department of Epidemiology, Boston University School of Public Health, Boston, USA
| | - Karina Escandón
- Department of Anthropology, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Saskia V Popescu
- Georgetown Center for Global Health Science and Security, Georgetown University, Washington, DC, USA
- Schar School of Policy and Government, George Mason University, Fairfax, VA, USA
| | - Jason Kindrachuk
- Vaccine and Infectious Disease Organization, University of Saskatchewan, Saskatoon, Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada
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9
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Meylan S, Dafni U, Lamoth F, Tsourti Z, Lobritz MA, Regina J, Bressin P, Senn L, Grandbastien B, Andre C, Fenwick C, D'Acremont V, Croxatto A, Guilleret I, Greub G, Manuel O, Calandra T, Pantaleo G, Lazor-Blanchet C. SARS-CoV-2 seroprevalence in healthcare workers of a Swiss tertiary care centre at the end of the first wave: a cross-sectional study. BMJ Open 2021; 11:e049232. [PMID: 34226231 PMCID: PMC8260307 DOI: 10.1136/bmjopen-2021-049232] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 05/18/2021] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE To assess the SARS-CoV-2 transmission in healthcare workers (HCWs) using seroprevalence as a surrogate marker of infection in our tertiary care centre according to exposure. DESIGN Seroprevalence cross-sectional study. SETTING Single centre at the end of the first COVID-19 wave in Lausanne, Switzerland. PARTICIPANTS 1874 of 4074 responders randomly selected (46% response rate), stratified by work category among the 13 474 (13.9%) HCWs. MAIN OUTCOME MEASURES Evaluation of SARS-CoV-2 serostatus paired with a questionnaire of SARS-CoV-2 acquisition risk factors internal and external to the workplace. RESULTS The overall SARS-CoV-2 seroprevalence rate among HCWs was 10.0% (95% CI 8.7% to 11.5%). HCWs with daily patient contact did not experience increased rates of seropositivity relative to those without (10.3% vs 9.6%, respectively, p=0.64). HCWs with direct contact with patients with COVID-19 or working in COVID-19 units did not experience increased seropositivity rates relative to their counterparts (10.4% vs 9.8%, p=0.69 and 10.6% vs 9.9%, p=0.69, respectively). However, specific locations of contact with patients irrespective of COVID-19 status-in patient rooms or reception areas-did correlate with increased rates of seropositivity (11.9% vs 7.5%, p=0.019 and 14.3% vs 9.2%, p=0.025, respectively). In contrast, HCWs with a suspected or proven SARS-CoV-2-infected household contact had significantly higher seropositivity rates than those without such contacts (19.0% vs 8.7%, p<0.001 and 42.1% vs 9.4%, p<0.001, respectively). Finally, consistent use of a mask on public transportation correlated with decreased seroprevalence (5.3% for mask users vs 11.2% for intermittent or no mask use, p=0.030). CONCLUSIONS The overall seroprevalence was 10% without significant differences in seroprevalence between HCWs exposed to patients with COVID-19 and HCWs not exposed. This suggests that, once fully in place, protective measures limited SARS-CoV-2 occupational acquisition within the hospital environment. SARS-CoV-2 seroconversion among HCWs was associated primarily with community risk factors, particularly household transmission.
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Affiliation(s)
- Sylvain Meylan
- Infectious Diseases Service, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Urania Dafni
- Laboratory of Biostatistics, School of Health Sciences, Frontier Science Foundation-Hellas and University of Athens, Athens, Greece
| | - Frederic Lamoth
- Infectious Diseases Service, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Zoi Tsourti
- Laboratory of Biostatistics, School of Health Sciences, Frontier Science Foundation-Hellas and University of Athens, Athens, Greece
| | | | - Jean Regina
- Infectious Diseases Service, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Philippe Bressin
- Occupational Health Service, Lausanne University Hospital, Lausanne, Switzerland
| | - Laurence Senn
- Service of Hospital Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Bruno Grandbastien
- Service of Hospital Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Cyril Andre
- Immunology Service, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Craig Fenwick
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Valerie D'Acremont
- Department of Ambulatory Care and Community Medicine, Centre for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Antony Croxatto
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Isabelle Guilleret
- Clinical Trial Unit, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Gilbert Greub
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Oriol Manuel
- Infectious Diseases Service, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Thierry Calandra
- Infectious Diseases Service, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Giuseppe Pantaleo
- Immunology Service, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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10
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Silva-Ayarza I, Bachelet VC. What we know and dont know on SARS-CoV-2 and COVID-19. Medwave 2021; 21:e8198. [PMID: 34213514 DOI: 10.5867/medwave.2021.04.8198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 05/18/2021] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19), caused by the SARS-CoV-2 virus discovered in December 2019 in Wuhan, China, has had an enormous impact on public health worldwide due to its rapid spread and pandemic behavior, challenges in its control and mitigation, and few therapeutic alternatives. In this review, we summarize the pathophysiological mechanisms, clinical presentation, and diagnostic techniques. In addition, the main lineages and the different strategies for disease prevention are reviewed, with emphasis on the development of vaccines and their different platforms. Finally, some of the currently available therapeutic strategies are summarized. Throughout the article, we point out the current knowns and unknowns at the time of writing this article.
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Affiliation(s)
- Ignacio Silva-Ayarza
- Escuela de Medicina, Universidad de Santiago de Chile (USACH), Santiago, Chile; Departamento de Infectología, Hospital Barros Luco, Santiago, Chile. Adress: Escuela de Medicina, Universidad de Santiago de Chile, Avenida Libertador Bernardo O'Higgins 3363, Estación Central, Santiago, Chile. . ORCID: 0000-0002-6996-3695
| | - Vivienne C Bachelet
- Escuela de Medicina, Universidad de Santiago de Chile (USACH), Santiago, Chile. ORCID: 0000-0002-5715-9755
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11
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Fundamental and Advanced Therapies, Vaccine Development against SARS-CoV-2. Pathogens 2021; 10:pathogens10060636. [PMID: 34064300 PMCID: PMC8224379 DOI: 10.3390/pathogens10060636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/11/2021] [Accepted: 05/19/2021] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease (COVID-19) caused by the SARS-CoV-2 virus has been affecting the world since the end of 2019. The severity of the disease can range from an asymptomatic or mild course to acute respiratory distress syndrome (ARDS) with respiratory failure, which may lead to death. Since the outbreak of the pandemic, scientists around the world have been studying the genome and molecular mechanisms of SARS-CoV-2 infection to develop effective therapies and prevention. In this review, we summarize the progressive development of various treatments and vaccines as they have emerged, a year after the outbreak of the pandemic. Initially for COVID-19, patients were recommended drugs with presumed antiviral, anti-inflammatory, and antimicrobial effects that were previously used to treat other diseases. Thereafter, therapeutic interventions were supplemented with promising approaches based on antibodies, peptides, and stem cells. However, licensed COVID-19 vaccines remain the most effective weapon in combating the pandemic. While there is an enormous effort to enhance the vaccination rate to increase the entire population immunity, the production and delivery of vaccines is becoming limited in several countries. In this regard, there are new challenges needing to be addressed by combining non-pharmacological intervention with effective therapies until vaccination is accessible to all.
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12
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Khalil MI, Banik GR, Mansoor S, Alqahtani AS, Rashid H. SARS-CoV-2, surgeons and surgical masks. World J Clin Cases 2021; 9:2170-2180. [PMID: 33869593 PMCID: PMC8026839 DOI: 10.12998/wjcc.v9.i10.2170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 12/25/2020] [Accepted: 02/12/2021] [Indexed: 02/06/2023] Open
Abstract
The exact risk association of coronavirus disease 2019 (COVID-19) for surgeons is not quantified which may be affected by their risk of exposure and individual factors. The objective of this review is to quantify the risk of COVID-19 among surgeons, and explore whether facemask can minimise the risk of COVID-19 among surgeons. A systematised review was carried out by searching MEDLINE to locate items on severe acute respiratory syndrome coronavirus 2 or COVID-19 in relation to health care workers (HCWs) especially those work in surgical specialities including surgical nurses and intensivists. Additionally, systematic reviews that assessed the effectiveness of facemask against viral respiratory infections, including COVID-19, among HCWs were identified. Data from identified articles were abstracted, synthesised and summarised. Fourteen primary studies that provided data on severe acute respiratory syndrome coronavirus 2 infection or experience among surgeons and 11 systematic reviews that provided evidence of the effectiveness of facemask (and other personal protective equipment) were summarised. Although the risk of COVID-19 could not be quantified precisely among surgeons, about 14% of HCWs including surgeons had COVID-19, there could be variations depending on settings. Facemask was found to be somewhat protective against COVID-19, but the HCWs’ compliance was highly variable ranging from zero to 100%. Echoing surgical societies’ guidelines we continue to recommend facemask use among surgeons to prevent COVID-19.
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Affiliation(s)
| | - Gouri Rani Banik
- Clinical Research Unit, The Department of Medicine, University of New South Wales, Sydney 2217, New South Wales, Australia
- National Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead and the University of Sydney, Westmead 2145, New South Wales, Australia
| | - Sarab Mansoor
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, New South Wales, Australia
| | - Amani S Alqahtani
- Research Department, Saudi Food and Drug Authority, Riyadh 13312, Saudi Arabia
| | - Harunor Rashid
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, and the University of Sydney, Westmead 2145, New South Wales, Australia
- Discipline of Child and Adolescent Health, the Faculty of Medicine and Health, The University of Sydney, Sydney 2145, New South Wales, Australia
- Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Biological Sciences and Sydney Medical School, The University of Sydney, Westmead 2145, New South Wales, Australia
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Abstract
Human respiratory virus infections lead to a spectrum of respiratory symptoms and disease severity, contributing to substantial morbidity, mortality and economic losses worldwide, as seen in the COVID-19 pandemic. Belonging to diverse families, respiratory viruses differ in how easy they spread (transmissibility) and the mechanism (modes) of transmission. Transmissibility as estimated by the basic reproduction number (R0) or secondary attack rate is heterogeneous for the same virus. Respiratory viruses can be transmitted via four major modes of transmission: direct (physical) contact, indirect contact (fomite), (large) droplets and (fine) aerosols. We know little about the relative contribution of each mode to the transmission of a particular virus in different settings, and how its variation affects transmissibility and transmission dynamics. Discussion on the particle size threshold between droplets and aerosols and the importance of aerosol transmission for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza virus is ongoing. Mechanistic evidence supports the efficacies of non-pharmaceutical interventions with regard to virus reduction; however, more data are needed on their effectiveness in reducing transmission. Understanding the relative contribution of different modes to transmission is crucial to inform the effectiveness of non-pharmaceutical interventions in the population. Intervening against multiple modes of transmission should be more effective than acting on a single mode.
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Affiliation(s)
- Nancy H. L. Leung
- grid.194645.b0000000121742757WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
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14
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Birgand G, Peiffer-Smadja N, Fournier S, Kerneis S, Lescure FX, Lucet JC. Assessment of Air Contamination by SARS-CoV-2 in Hospital Settings. JAMA Netw Open 2020. [PMID: 33355679 DOI: 10.1001/jamaetworkopen.2020.33232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Abstract
IMPORTANCE Controversy remains regarding the transmission routes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). OBJECTIVE To review current evidence on air contamination with SARS-CoV-2 in hospital settings and the factors associated with contamination, including viral load and particle size. EVIDENCE REVIEW The MEDLINE, Embase, and Web of Science databases were systematically queried for original English-language articles detailing SARS-CoV-2 air contamination in hospital settings between January 1 and October 27, 2020. This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. The positivity rate of SARS-CoV-2 viral RNA and culture were described and compared according to the setting, clinical context, air ventilation system, and distance from patients. The SARS-CoV-2 RNA concentrations in copies per meter cubed of air were pooled, and their distribution was described by hospital areas. Particle sizes and SARS-CoV-2 RNA concentrations in copies or median tissue culture infectious dose (TCID50) per meter cubed were analyzed after categorization as less than 1 μm, from 1 to 4 μm, and greater than 4 μm. FINDINGS Among 2284 records identified, 24 cross-sectional observational studies were included in the review. Overall, 82 of 471 air samples (17.4%) from close patient environments were positive for SARS-CoV-2 RNA, with a significantly higher positivity rate in intensive care unit settings (intensive care unit, 27 of 107 [25.2%] vs non-intensive care unit, 39 of 364 [10.7%]; P < .001). There was no difference according to the distance from patients (≤1 m, 3 of 118 [2.5%] vs >1-5 m, 13 of 236 [5.5%]; P = .22). The positivity rate was 5 of 21 air samples (23.8%) in toilets, 20 of 242 (8.3%) in clinical areas, 15 of 122 (12.3%) in staff areas, and 14 of 42 (33.3%) in public areas. A total of 81 viral cultures were performed across 5 studies, and 7 (8.6%) from 2 studies were positive, all from close patient environments. The median (interquartile range) SARS-CoV-2 RNA concentrations varied from 1.0 × 103 copies/m3 (0.4 × 103 to 3.1 × 103 copies/m3) in clinical areas to 9.7 × 103 copies/m3 (5.1 × 103 to 14.3 × 103 copies/m3) in the air of toilets or bathrooms. Protective equipment removal and patient rooms had high concentrations per titer of SARS-CoV-2 (varying from 0.9 × 103 to 40 × 103 copies/m3 and 3.8 × 103 to 7.2 × 103 TCID50/m3), with aerosol size distributions that showed peaks in the region of particle size less than 1 μm; staff offices had peaks in the region of particle size greater than 4 μm. CONCLUSIONS AND RELEVANCE In this systematic review, the air close to and distant from patients with coronavirus disease 2019 was frequently contaminated with SARS-CoV-2 RNA; however, few of these samples contained viable viruses. High viral loads found in toilets and bathrooms, staff areas, and public hallways suggest that these areas should be carefully considered.
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Affiliation(s)
- Gabriel Birgand
- National Institute of Health Research Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance, Imperial College London, London, United Kingdom
- Centre Hospitalo-Universitaire de Nantes, Nantes, France
| | - Nathan Peiffer-Smadja
- National Institute of Health Research Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance, Imperial College London, London, United Kingdom
- INSERM, IAME, UMR 1137, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Infectious Diseases Unit, Paris, Paris, France
- Equipe Operationnelle d'Hygiène, Siège Assistance Publique-Hôpitaux de Paris, Paris, France
- Universitaire Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Sandra Fournier
- Central Infection Control Team, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Solen Kerneis
- Equipe Mobile d'Infectiologie, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
- Equipe de Prévention du Risque Infectieux, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - François-Xavier Lescure
- INSERM, IAME, UMR 1137, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Infectious Diseases Unit, Paris, Paris, France
- Equipe Operationnelle d'Hygiène, Siège Assistance Publique-Hôpitaux de Paris, Paris, France
- Universitaire Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Jean-Christophe Lucet
- INSERM, IAME, UMR 1137, Paris, France
- Equipe Operationnelle d'Hygiène, Siège Assistance Publique-Hôpitaux de Paris, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Infection Control Unit, Paris, France
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15
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Birgand G, Peiffer-Smadja N, Fournier S, Kerneis S, Lescure FX, Lucet JC. Assessment of Air Contamination by SARS-CoV-2 in Hospital Settings. JAMA Netw Open 2020; 3:e2033232. [PMID: 33355679 PMCID: PMC7758808 DOI: 10.1001/jamanetworkopen.2020.33232] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
IMPORTANCE Controversy remains regarding the transmission routes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). OBJECTIVE To review current evidence on air contamination with SARS-CoV-2 in hospital settings and the factors associated with contamination, including viral load and particle size. EVIDENCE REVIEW The MEDLINE, Embase, and Web of Science databases were systematically queried for original English-language articles detailing SARS-CoV-2 air contamination in hospital settings between January 1 and October 27, 2020. This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. The positivity rate of SARS-CoV-2 viral RNA and culture were described and compared according to the setting, clinical context, air ventilation system, and distance from patients. The SARS-CoV-2 RNA concentrations in copies per meter cubed of air were pooled, and their distribution was described by hospital areas. Particle sizes and SARS-CoV-2 RNA concentrations in copies or median tissue culture infectious dose (TCID50) per meter cubed were analyzed after categorization as less than 1 μm, from 1 to 4 μm, and greater than 4 μm. FINDINGS Among 2284 records identified, 24 cross-sectional observational studies were included in the review. Overall, 82 of 471 air samples (17.4%) from close patient environments were positive for SARS-CoV-2 RNA, with a significantly higher positivity rate in intensive care unit settings (intensive care unit, 27 of 107 [25.2%] vs non-intensive care unit, 39 of 364 [10.7%]; P < .001). There was no difference according to the distance from patients (≤1 m, 3 of 118 [2.5%] vs >1-5 m, 13 of 236 [5.5%]; P = .22). The positivity rate was 5 of 21 air samples (23.8%) in toilets, 20 of 242 (8.3%) in clinical areas, 15 of 122 (12.3%) in staff areas, and 14 of 42 (33.3%) in public areas. A total of 81 viral cultures were performed across 5 studies, and 7 (8.6%) from 2 studies were positive, all from close patient environments. The median (interquartile range) SARS-CoV-2 RNA concentrations varied from 1.0 × 103 copies/m3 (0.4 × 103 to 3.1 × 103 copies/m3) in clinical areas to 9.7 × 103 copies/m3 (5.1 × 103 to 14.3 × 103 copies/m3) in the air of toilets or bathrooms. Protective equipment removal and patient rooms had high concentrations per titer of SARS-CoV-2 (varying from 0.9 × 103 to 40 × 103 copies/m3 and 3.8 × 103 to 7.2 × 103 TCID50/m3), with aerosol size distributions that showed peaks in the region of particle size less than 1 μm; staff offices had peaks in the region of particle size greater than 4 μm. CONCLUSIONS AND RELEVANCE In this systematic review, the air close to and distant from patients with coronavirus disease 2019 was frequently contaminated with SARS-CoV-2 RNA; however, few of these samples contained viable viruses. High viral loads found in toilets and bathrooms, staff areas, and public hallways suggest that these areas should be carefully considered.
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Affiliation(s)
- Gabriel Birgand
- National Institute of Health Research Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance, Imperial College London, London, United Kingdom
- Centre Hospitalo-Universitaire de Nantes, Nantes, France
| | - Nathan Peiffer-Smadja
- National Institute of Health Research Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance, Imperial College London, London, United Kingdom
- INSERM, IAME, UMR 1137, Paris, France
- Assistance Publique–Hôpitaux de Paris, Hôpital Bichat–Claude Bernard, Infectious Diseases Unit, Paris, Paris, France
- Equipe Operationnelle d'Hygiène, Siège Assistance Publique–Hôpitaux de Paris, Paris, France
- Universitaire Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Sandra Fournier
- Central Infection Control Team, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Solen Kerneis
- Equipe Mobile d’Infectiologie, Hôpital Cochin, Assistance Publique–Hôpitaux de Paris, Paris, France
- Equipe de Prévention du Risque Infectieux, Hôpital Bichat, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - François-Xavier Lescure
- INSERM, IAME, UMR 1137, Paris, France
- Assistance Publique–Hôpitaux de Paris, Hôpital Bichat–Claude Bernard, Infectious Diseases Unit, Paris, Paris, France
- Equipe Operationnelle d'Hygiène, Siège Assistance Publique–Hôpitaux de Paris, Paris, France
- Universitaire Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Jean-Christophe Lucet
- INSERM, IAME, UMR 1137, Paris, France
- Equipe Operationnelle d'Hygiène, Siège Assistance Publique–Hôpitaux de Paris, Paris, France
- Assistance Publique–Hôpitaux de Paris, Hôpital Bichat–Claude Bernard, Infection Control Unit, Paris, France
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