Characterization of hospital airborne SARS-CoV-2.
Characterization of hospital airborne SARS-CoV-2.
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DOI：
10.1186/s12931-021-01637-8
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发表时间：
2021-02-26
影响因子：
5.8
通讯作者：
Garshick E
中科院分区：
文献类型：
--
作者：
Stern RA;Koutrakis P;Martins MAG;Lemos B;Dowd SE;Sunderland EM;Garshick E
SARS-CoV-2 的传播机制归因于咳嗽和打喷嚏产生的大颗粒。更小的空气颗粒是否可能传播 SARS-CoV-2 存在争议。较小的颗粒，特别是细颗粒物（直径≤2.5 µm），可以比较大的颗粒在空气中停留更长时间，并且吸入后会深入肺部。人们对空气中 SARS-CoV-2 RNA 的大小分布和位置知之甚少。作为医院相关暴露的衡量标准，2020 年 4 月至 5 月在美国马萨诸塞州波士顿的一家医院收集了三种粒径（> 10.0 µm、10.0–2.5 µm 和 ≤ 2.5 µm）的空气样本（N = 90 个粒径分级样本）。地点包括负压 COVID-19 病房外、不直接参与 COVID-19 患者护理的医院病房以及急诊室。 9% 的样本和所有大小的组分中均存在 SARS-CoV-2 RNA，浓度为 5 至 51 个拷贝 m−3。 COVID-19 病房外的地点的阳性样本最少。非 COVID-19 病房的阳性样本数量最多，可能反映了工作人员的聚集情况。阳性样本的概率与医院中的 COVID-19 患者数量呈正相关（r = 0.95，p < 0.01）。马萨诸塞州医院的 COVID-19 患者数量与每日新增病例数呈正相关（r = 0.99，p < 0.01）。在非 COVID-19 地区检测到阳性样本的频率高于在 COVID-19 医院地区检测到的阳性样本，这表明了 COVID-19 病房医院控制措施在控制空气浓度方面的有效性，并表明疾病在没有最严格预防措施的地区传播的可能性。阳性样本的概率、医院中的 COVID-19 病例以及马萨诸塞州的病例之间的正相关表明，医院空气样本阳性与社区负担有关。带有细颗粒物的 SARS-CoV-2 RNA 支持空气传播距离超过 6 英尺的可能性。这些发现支持限制接触空气中颗粒的指南，包括能够更远距离传输和更大肺部渗透的细颗粒。
The mechanism for spread of SARS-CoV-2 has been attributed to large particles produced by coughing and sneezing. There is controversy whether smaller airborne particles may transport SARS-CoV-2. Smaller particles, particularly fine particulate matter (≤ 2.5 µm in diameter), can remain airborne for longer periods than larger particles and after inhalation will penetrate deeply into the lungs. Little is known about the size distribution and location of airborne SARS-CoV-2 RNA. As a measure of hospital-related exposure, air samples of three particle sizes (> 10.0 µm, 10.0–2.5 µm, and ≤ 2.5 µm) were collected in a Boston, Massachusetts (USA) hospital from April to May 2020 (N = 90 size-fractionated samples). Locations included outside negative-pressure COVID-19 wards, a hospital ward not directly involved in COVID-19 patient care, and the emergency department. SARS-CoV-2 RNA was present in 9% of samples and in all size fractions at concentrations of 5 to 51 copies m−3. Locations outside COVID-19 wards had the fewest positive samples. A non-COVID-19 ward had the highest number of positive samples, likely reflecting staff congregation. The probability of a positive sample was positively associated (r = 0.95, p < 0.01) with the number of COVID-19 patients in the hospital. The number of COVID-19 patients in the hospital was positively associated (r = 0.99, p < 0.01) with the number of new daily cases in Massachusetts. More frequent detection of positive samples in non-COVID-19 than COVID-19 hospital areas indicates effectiveness of COVID-ward hospital controls in controlling air concentrations and suggests the potential for disease spread in areas without the strictest precautions. The positive associations regarding the probability of a positive sample, COVID-19 cases in the hospital, and cases in Massachusetts suggests that hospital air sample positivity was related to community burden. SARS-CoV-2 RNA with fine particulate matter supports the possibility of airborne transmission over distances greater than six feet. The findings support guidelines that limit exposure to airborne particles including fine particles capable of longer distance transport and greater lung penetration.
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