J Korean Med Sci.  2020 Sep;35(37):e332. 10.3346/jkms.2020.35.e332.

Air and Environmental Contamination Caused by COVID-19 Patients: a MultiCenter Study

Affiliations
  • 1Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Korea
  • 2Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
  • 3Department of Infectious Disease, Keimyung University Dongsan Hospital, Daegu, Korea
  • 4Office for Infection Control, Chonnam National University Hwasun Hospital, Hwasun, Korea

Abstract

Background
The purpose of this study was to determine the extent of air and surface contamination of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in four health care facilities with hospitalized coronavirus disease 2019 (COVID-19) patients.
Methods
We investigated air and environmental contamination in the rooms of eight COVID-19 patients in four hospitals. Some patients were in negative-pressure rooms, and others were not. None had undergone aerosol-generating procedures. On days 0, 3, 5, and 7 of hospitalization, the surfaces in the rooms and anterooms were swabbed, and air samples were collected 2 m from the patient and from the anterooms.
Results
All 52 air samples were negative for SARS-CoV-2 RNA. Widespread surface contamination of SARS-CoV-2 RNA was observed. In total, 89 of 320 (27%) environmental surface samples were positive for SARS-CoV-2 RNA. Surface contamination of SARSCoV-2 RNA was common in rooms without surface disinfection and in rooms sprayed with disinfectant twice a day. However, SARS-CoV-2 RNA was not detected in a room cleaned with disinfectant wipes on a regular basis.
Conclusion
Our data suggest that remote (> 2 m) airborne transmission of SARS-CoV-2 from hospitalized COVID-19 patients is uncommon when aerosol-generating procedures have not been performed. Surface contamination was widespread, except in a room routinely cleaned with disinfectant wipes.

Keyword

SARS-CoV-2; Transmission; Environmental Sampling; Droplet

Figure

  • Fig. 1 Environmental sampling sites and the Ct values of rooms in each hospital are illustrated in dots. Red dot indicates sample with Ct value ≤ 35 in real-time polymerase chain reaction; orange dot indicates sample with Ct value > 35 and ≤ 40; green dot indicates sample with negative result. Two AIIRs in Hospital A (A) and an AIIR in Hospital B (B). Two non-AIIRs in Hospital C (C) and a cohort non-AIIR in Hospital D (D).Ct = cycle threshold, AIIR = airborne infection isolation room, Hospital A = Chonnam National University Hospital, Hospital B = Chonnam National University Hwasun Hospital, Hospital C = Chonnam National University Bitgoeul Hospital, Hospital D = Keimyung University Daegu Dongsan Hospital.


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