Prevalence of Surface Contamination With SARS-CoV-2 in a Radiation Oncology Clinic

Jan, Imraan; Chen, Kenneth; Sayan, Mutlay; Uprety, Priyanka; Laumbach, Robert; Ennis, Ronald D.; Haffty, Bruce G.

doi:10.1001/jamaoncol.2020.3552

Cited by 11 publications

(8 citation statements)

References 5 publications

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“…The amount of viral RNA detected seems to be inversely correlated with cleaning protocols [23]. This probably explains otherwise surprising results such as the lack of viral RNA detected in an oncology ward housing patients with COVID-19 [24], or the very low probability of detection in an ICU [25]. Several studies detected SARS-CoV-2 RNA in these environments but were unable to culture infectious SARS-CoV-2 virions [26][27][28].…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 detection and genomic sequencing from hospital surface samples collected at UC Davis

et al. 2021

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Rationale There is little doubt that aerosols play a major role in the transmission of SARS-CoV-2. The significance of the presence and infectivity of this virus on environmental surfaces, especially in a hospital setting, remains less clear. Objectives We aimed to analyze surface swabs for SARS-CoV-2 RNA and infectivity, and to determine their suitability for sequence analysis. Methods Samples were collected during two waves of COVID-19 at the University of California, Davis Medical Center, in COVID-19 patient serving and staff congregation areas. qRT-PCR positive samples were investigated in Vero cell cultures for cytopathic effects and phylogenetically assessed by whole genome sequencing. Measurements and main results Improved cleaning and patient management practices between April and August 2020 were associated with a substantial reduction of SARS-CoV-2 qRT-PCR positivity (from 11% to 2%) in hospital surface samples. Even though we recovered near-complete genome sequences in some, none of the positive samples (11 of 224 total) caused cytopathic effects in cultured cells suggesting this nucleic acid was either not associated with intact virions, or they were present in insufficient numbers for infectivity. Phylogenetic analysis suggested that the SARS-CoV-2 genomes of the positive samples were derived from hospitalized patients. Genomic sequences isolated from qRT-PCR negative samples indicate a superior sensitivity of viral detection by sequencing. Conclusions This study confirms the low likelihood that SARS-CoV-2 contamination on hospital surfaces contains infectious virus, disputing the importance of fomites in COVID-19 transmission. Ours is the first report on recovering near-complete SARS-CoV-2 genome sequences directly from environmental surface swabs.

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Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 detection and genomic sequencing from hospital surface samples collected at UC Davis

et al. 2021

View full text Add to dashboard Cite

show abstract

“…The amount of viral RNA detected seems to be inversely correlated with cleaning protocols (23). This probably explains otherwise surprising results such as the lack of viral RNA detected in an oncology ward housing patients with COVID-19 (24), or the very low probability of detection in an ICU (25). Several studies detected SARS-CoV-2 RNA in these environments but were unable to culture infectious SARS-CoV-2 virions (26–28).…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 detection and genomic sequencing from hospital surface samples collected at UC Davis

Coil

Albertson

Banerjee

et al. 2021

Preprint

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RationaleThere is little doubt that aerosols play a major role in the transmission of SARS-CoV-2. The significance of the presence and infectivity of this virus on environmental surfaces, especially in a hospital setting, remains less clear.ObjectivesWe aimed to analyze surface swabs for SARS-CoV-2 RNA and infectivity, and to determine their suitability for sequence analysis.MethodsSamples were collected during two waves of COVID-19 at the University of California, Davis Medical Center, in COVID-19 patient serving and staff congregation areas. qRT-PCR positive samples were investigated in Vero cell cultures for cytopathic effects and phylogenetically assessed by whole genome sequencing.Measurements and Main ResultsImproved cleaning and patient management practices between April and August 2020 were associated with a substantial reduction of SARS-CoV-2 qRT-PCR positivity (from 11% to 2%) in hospital surface samples. Even though we recovered near-complete genome sequences in some, none of the positive samples (11 of 224 total) caused cytopathic effects in cultured cells suggesting this nucleic acid was either not associated with intact virions, or they were present in insufficient numbers for infectivity. Phylogenetic analysis suggested that the SARS-CoV-2 genomes of the positive samples were derived from hospitalized patients. Genomic sequences isolated from qRT-PCR negative samples indicate a superior sensitivity of viral detection by sequencing.ConclusionsThis study confirms the low likelihood that SARS-CoV-2 contamination on hospital surfaces contains infectious virus, disputing the importance of fomites in COVID-19 transmission. Ours is the first report on recovering near-complete SARS-CoV-2 genome sequences directly from environmental surface swabs.

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“… 10 . Additionally, in a recent study by Jan et al, which was performed at one of the institutions included in the current study during the same time-period, multiple-surfaces were tested for SARS-COV-2 in a radiation oncology clinic, but zero positive samples were collected, thereby, indicating the safety of radiation oncology clinics and the importance of treating without delay 20 .…”

Section: Discussionmentioning

confidence: 90%

A Statewide Multi-Institutional Study of Asymptomatic Pretreatment Testing of Radiation Therapy Patients for SARS-CoV-2 in a High-Incidence Region of the United States

Modi¹,

Dragun²,

Henson³

et al. 2021

Advances in Radiation Oncology

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Purpose/Objective(s) To establish the prevalence of SARS-CoV-2 in asymptomatic patients scheduled to receive radiation therapy and its impact on management decisions. Materials/Methods Between April 2020 and July 2020, patients without influenza-like-illness (ILI) symptoms at four radiation oncology departments (2 academic university hospitals and 2 community hospitals) underwent polymerase chain reaction (PCR) testing for SARS-CoV-2 prior to the initiation of treatment. Patients were tested either prior to radiotherapy simulation or after simulation but prior to treatment initiation. Patients tested for indications of ILI symptoms were excluded from this analysis. Management of SARS-CoV-2-positive patients was individualized based on disease site and acuity. Results Over a three-month period, a total of 385 tests were performed in 336 asymptomatic patients either prior to simulation (n=75), post-simulation, prior to treatment (n=230), or on-treatment (n=49). A total of 5 patients tested positive for SARS-CoV-2, for a pre-treatment prevalence of 1.3% (2.6% in North/Central NJ and 0.4% in Southern NJ/Southeast PA). The median age of positive patients was 58 years (range: 38-78 years). All positive patients were white and were relatively equally distributed with regard to gender (2 male, 3 female) and ethnicity (2 Hispanic and 3 non-Hispanic). The median Charlson comorbidity score among positive patients was 5. All 5 patients were treated for different primary tumor sites, the large majority had advanced disease (80%), and all were treated for curative intent. The majority of positive patients were being treated with either sequential or concurrent immunosuppressive systemic therapy (80%). Initiation of treatment was delayed for 14 days with the addition of re-testing for 4 patients, while one patient was treated without delay but with additional infectious-disease precautions. Conclusion Broad-based pre-treatment asymptomatic testing of radiation oncology patients for SARS-CoV-2 is of limited value, even in a high-incidence region. Future strategies may include focused risk-stratified asymptomatic testing.

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Prevalence of Surface Contamination With SARS-CoV-2 in a Radiation Oncology Clinic

Abstract: helped create a map of the radiation oncology clinic. They received no compensation for their contribution. The Breast Cancer Research Foundation provided support staff.

Cited by 11 publications

References 5 publications

SARS-CoV-2 detection and genomic sequencing from hospital surface samples collected at UC Davis

SARS-CoV-2 detection and genomic sequencing from hospital surface samples collected at UC Davis

SARS-CoV-2 detection and genomic sequencing from hospital surface samples collected at UC Davis

A Statewide Multi-Institutional Study of Asymptomatic Pretreatment Testing of Radiation Therapy Patients for SARS-CoV-2 in a High-Incidence Region of the United States

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