Viable SARS-CoV-2 in the air of a hospital room with COVID-19 patients
Open accessPublished version of a preprint
Abstract
Objectives Because the detection of SARS-CoV-2 RNA in aerosols but failure to isolate viable (infectious) virus are commonly reported, there is substantial controversy whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be transmitted through aerosols. This conundrum occurs because common air samplers can inactivate virions through their harsh collection processes. We sought to resolve the question whether viable SARS-CoV-2 can occur in aerosols using VIVAS air samplers that operate on a gentle water vapor condensation principle. Methods Air samples collected in the hospital room of two coronavirus disease-2019 (COVID-19) patients, one ready for discharge and the other newly admitted, were subjected to RT-qPCR and virus culture. The genomes of the SARS-CoV-2 collected from the air and isolated in cell culture were sequenced. Results Viable SARS-CoV-2 was isolated from air samples collected 2 to 4.8 m away from the patients. The genome sequence of the SARS-CoV-2 strain isolated from the material collected by the air samplers was identical to that isolated from the newly admitted patient. Estimates of viable viral concentrations ranged from 6 to 74 TCID 50 units/L of air. Conclusions Patients with respiratory manifestations of COVID-19 produce aerosols in the absence of aerosol-generating procedures that contain viable SARS-CoV-2, and these aerosols may serve as a source of transmission of the virus.
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Numerous earlier studies have established that aerosol expelled during normal respiratory activities can contain infectious influenza virus.
“Numerous earlier studies have established that aerosol expelled during normal respiratory activities can contain infectious influenza virus [42, 45–54].”
From The protective performance of reusable cloth face masks, disposable procedure masks, KN95 masks and N95 respirators: Filtration and total inward leakage (2021) · cites this paper as [42]
The References (page unavailable) list a prior study titled “Collection of viable aerosolized influenza virus and other respiratory viruses in a student health care center,” which supports the narrower point that viable influenza virus has been collected from air. The cited paper’s Discussion concerns SARS-CoV-2, however, and does not establish that numerous studies found infectious influenza aerosol expelled during normal respiratory activities. (LLM, conf=0.78)
Experimental — accuracy not yet measuredThere is a growing body of literature that supports airborne transmission of SARS-CoV-2 playing an increasingly important role in the spread of the disease.
“With the progression of the pandemic there is a growing body of literature that supports airborne transmission of SARS-CoV-2 playing an increasingly important role in the spread of the disease [29, 39–44].”
From The protective performance of reusable cloth face masks, disposable procedure masks, KN95 masks and N95 respirators: Filtration and total inward leakage (2021) · cites this paper as [42]
The Discussion reports viable SARS-CoV-2 in patient-generated aerosols and says this suggests an inhalation risk. It also says the relative importance of aerosol transmission remains uncertain, so the paper does not establish that airborne transmission played an increasingly important role in the spread of COVID-19. (LLM, conf=0.86)
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- Authors
- Lednicky, J. A., Lauzardo, M., Fan, Z. H., Jutla, A., Tilly, T. B., Gangwar, M., Usmani, M., Shankar, S. N., Mohamed, K., Eiguren-Fernandez, A., Stephenson, C. J., Alam, M. M., Elbadry, M. A., Loeb, J. C., Subramaniam, K., Waltzek, T. B., Cherabuddi, K., Morris, J. G., & Wu, C.-Y.
- Affiliations
- University of Florida (US)
- Corresponding author
- Lednicky, John A.
- ORCID
- Lednicky, John A.
- Lauzardo, Michael
- Fan, Z. Hugh
- Jutla, Antarpreet
- Tilly, Trevor B.
- Gangwar, Mayank
- Usmani, Moiz
- Shankar, Sripriya Nannu
- Mohamed, Karim
- Stephenson, Caroline J.
- Alam, Md. Mahbubul
- Elbadry, Maha A.
- Loeb, Julia C.
- Subramaniam, Kuttichantran
- Waltzek, Thomas B.
- Cherabuddi, Kartikeya
- Morris, J. Glenn
- Wu, Chang-Yu
- Venue
- International Journal of Infectious Diseases
- Publisher
- Elsevier BV
- Published
- 2020-11
- Volume
- 100
- Pages
- 476-482
- ISSN
- 1201-9712 (ISSN-L)
- PMC
- PMC7493737
- OpenAlex
- W3087735045
- Cited by
- 683
- References
- 34
- Citations by year
- 2026: 25 · 2025: 43 · 2024: 61 · 2023: 91 · 2022: 158 · 2021: 254 · 2020: 51
- FWCI
- 77.97
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Infectious Diseases (publishedVersion, cc-by-nc-nd)
- medRxiv (acceptedVersion, cc-by-nd)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (submittedVersion, cc-by-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institute of Environmental Health Sciences (1R43ES030649)
- College of Medicine, University of Florida
- Emerging Pathogens Institute, University of Florida
- National Institutes of Health
- University of Florida
- National Science Foundation (2030844, 1R43ES030649)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Infection Control and Ventilation
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 detection and testing
- Keywords
- SARS-CoV-2, COVID-19 pandemic, airborne transmission, aerosols, viral genome sequencing
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