SARS‐CoV‐2 environmental contamination associated with persistently infected COVID‐19 patients

Lei, Hui; Ye, Feng; Liu, Xiaoqing; Huang, Zhicheng; Ling, Shiman; Jiang, Zhanpeng; Cheng, Jing; Huang, Xiaoqun; Wu, Qiubao; Wu, Shiguan; Xie, Yanmin; Cheng, Xiuzhen; Ye, Dan; Yang, Zifeng; Li, Yimin; Leung, Naichung Conan; Cowling, Benjamin J.; He, Jianxing; Wong, Sook‐San; Zanin, Mark

doi:10.1111/irv.12783

Cited by 73 publications

(90 citation statements)

References 17 publications

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“…- [208] cps = copies per swab; cpm = copies per ml; *proportion of room with at least one environmental surface contaminated; **door handles; ***after cleaning and disinfection; ****detection of infectious SARS-CoV-2 was attempted in all samples and was consistently negative; *****only on ventilator tubing before HME filter.…”

mentioning

confidence: 99%

Potential sources, modes of transmission and effectiveness of prevention measures against SARS-CoV-2

Kampf

Brüggemann

Kaba

et al. 2020

Journal of Hospital Infection

131

121

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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confidence: 99%

Potential sources, modes of transmission and effectiveness of prevention measures against SARS-CoV-2

Kampf

Brüggemann

Kaba

et al. 2020

Journal of Hospital Infection

131

121

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“…After further screening, and supplementary searching of articles published or posted between 1 January 2020 and 21 July 2020, we identified an additional article and a total of 17 articles were included in the review (Figure 1). [3,[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23]…”

Section: Search Resultsmentioning

confidence: 99%

Airborne contamination of COVID-19 in hospitals: a scoping review of the current evidence

Birgand

Peiffer-Smadja

Fournier

et al. 2020

Preprint

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Introduction A controversy remains worldwide regarding the transmission routes of SARS-CoV-2 in hospital settings. We reviewed the current evidence on the air contamination with SARS-CoV-2 in hospital settings, and the factors associated to the contamination including the viral load and the particles size. Methods The MEDLINE, Embase, Web of Science databases were systematically interrogated for original English-language articles detailing COVID-19 air contamination in hospital settings between 1 December 2019 and 21 July 2020. This study was conducted in accordance with the 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 patient. The SARS-CoV-2 RNA concentrations in copies per m3 of air were pooled and their distribution were described by hospital areas. Particle sizes and SARS-CoV-2 RNA concentrations in copies or TCID50 per m3 were analysed after categorization of sizes in <1 micrometers, 1-4 micrometers, and >4 micrometers. Results Among 2,034 records identified, 17 articles were included in the review. Overall, 27.5% (68/247) of air sampled from close patients environment were positive for SARS-CoV-2 RNA, without difference according to the setting (ICU: 27/97, 27.8%; non-ICU: 41/150, 27.3%; p=0.93), the distance from patients (<1 meter: 1/64, 1.5%; 1-5 meters: 4/67, 6%; p=0.4). In other areas, the positivity rate was 23.8% (5/21) in toilets, 9.5% (20/221) in clinical areas, 12.4% (15/121) in staff areas, and 34.1% (14/41) in public areas. A total of 78 viral cultures were performed in three studies, and 3 (4%) were positive, all from close patients environment. The median SARS-CoV-2 RNA concentrations varied from 1.103 copies per m3 (IQR: 0.4.103-9.103) in clinical areas to 9.7.103 (5.1.103-14.3.103) in the air of toilets or bathrooms. The protective equipment removal and patients rooms had high concentrations/titre of SARS-CoV-2 with aerosol size distributions that showed peaks in the <1 micrometers region, and staff offices in the >4 micrometers region. Conclusion In hospital, the air near and away from COVID-19 patients is frequently contaminated with SARS-CoV-2 RNA, with however, rare proofs of their viability. High viral loads found in toilet/bathrooms, staff and public hallways suggests to carefully consider these areas.

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“…When using sing a human adenovirus virus (HAdV), Verani et al, 52 found 135 out of 172 surfaces within toilet facilities in a health care setting to be contaminated. Contamination of contact surfaces outside the sanitation setting has been reported in hospitals 55,56,57,58 home settings 59,60,61 and public spaces 60 .…”

Section: Discussionmentioning

confidence: 99%

Detection of SARS-CoV-2 on contact surfaces within shared sanitation facilities and assessment of the potential risks for COVID-19 infections

Amoah

Pillay

Deepnarian

et al. 2020

Preprint

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Contamination of contact surfaces with SARS-CoV-2 has been reported as a potential route for the community transmission of COVID-19. This could be a major issue in developing countries where access to basic sanitation is poor leading to the sharing of toilet facilities. In this study, we present the first report of SARS-CoV-2 contamination on key contact surfaces in shared toilets, in the city of Durban, using droplet digital PCR and assessed the probabilistic risks of COVID-19 infections.Approximately, 53-69% of the contact surfaces were contaminated, with SARS-CoV-2 viral loads per cm2 ranging from 25.9 to 132.69 gc/cm2. Toilet seats had the highest contamination per cm2. The results suggested that the leading cause of contamination in shared toilets could be the shedding of the viral particles in feces and contaminated hands. We observed a significant reduction in viral loads on the contaminated surfaces after cleaning, showing the potential of effective cleaning on the reduction of contamination of these surfaces. The probabilistic assessment showed a high potential for COVID-19 infections. Touching the internal latch of the toilet cubicle had the highest risk of infections (4.3x10-2(6.0x10-4)) when a person uses the toilet once in a day, increasing to 1.0x10-1(1.4x10-3) for three uses in a day. The risks estimated in this study were higher than any of the tolerable/acceptable risk figures proposed for COVID-19 from environmental exposure. This calls for the implementation of risk reduction measures, such as strict adherence to wearing face masks, regular washing of hands with soap, and effective and regular cleaning.

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SARS‐CoV‐2 environmental contamination associated with persistently infected COVID‐19 patients

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 73 publications

References 17 publications

Potential sources, modes of transmission and effectiveness of prevention measures against SARS-CoV-2

Potential sources, modes of transmission and effectiveness of prevention measures against SARS-CoV-2

Airborne contamination of COVID-19 in hospitals: a scoping review of the current evidence

Detection of SARS-CoV-2 on contact surfaces within shared sanitation facilities and assessment of the potential risks for COVID-19 infections

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