Airborne SARS-CoV-2 RNA excretion by patients with COVID-19 on different oxygen-delivery systems: a prospective observational study

M L Janssen; Y P Klazen; P de Man; W Hanselaar; D S Y Ong; E-J Wils

doi:10.1016/j.jhin.2022.03.001

Airborne SARS-CoV-2 RNA excretion by patients with COVID-19 on different oxygen-delivery systems: a prospective observational study

M L Janssen, Y P Klazen, P de Man, W Hanselaar, D S Y Ong, E-J Wils

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: Concerns persist regarding the risk of airborne SARS-CoV-2 transmission by patients with COVID-19 on various modalities of oxygen therapy, such as high-flow nasal cannula (HFNC).

AIM: We aimed to compare the presence of airborne RNA in air samples between groups of patients with COVID-19 on different oxygen-delivery systems. We also explored factors that were associated with SARS-CoV-2 RNA positivity in air samples.

RESULTS: Air samples were positive for SARS-CoV-2 RNA in three of 39 patients (8%) on HFNC, 0 of 13 (0%) on masks, versus five of 20 (25%) on nasal cannula. Odds ratio for air sample positivity was 0.52 (95% confidence interval (CI) 0.11-2.34) when comparing HFNC vs non-HFNC group, and 5.78 (1.24-27.01) for nasal cannula vs non-nasal cannula group. Patients with positive air samples in comparison with those with negative air samples were sampled earlier after symptoms onset (median: 7 vs 10 days; P=0.04) and had lower Ct values of diagnostic nasopharyngeal samples (median: 22 vs 26; P=0.02).

CONCLUSIONS: Air sample positivity was not related to oxygen support device but to viral load. These data suggest that the use of personal protection equipment should be based on risk management according to viral load rather than oxygen support device.

Original language	English
Pages (from-to)	87-91
Number of pages	5
Journal	The journal of Hospital Infection
Volume	123
DOIs	https://doi.org/10.1016/j.jhin.2022.03.001
Publication status	Published - May 2022

Keywords

Air sampling
COVID-19
High-flow nasal cannula
SARS-CoV-2
Viral load

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10.1016/j.jhin.2022.03.001

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@article{c666246544a743a08906f994e751c5f7,

title = "Airborne SARS-CoV-2 RNA excretion by patients with COVID-19 on different oxygen-delivery systems: a prospective observational study",

abstract = "BACKGROUND: Concerns persist regarding the risk of airborne SARS-CoV-2 transmission by patients with COVID-19 on various modalities of oxygen therapy, such as high-flow nasal cannula (HFNC).AIM: We aimed to compare the presence of airborne RNA in air samples between groups of patients with COVID-19 on different oxygen-delivery systems. We also explored factors that were associated with SARS-CoV-2 RNA positivity in air samples.RESULTS: Air samples were positive for SARS-CoV-2 RNA in three of 39 patients (8%) on HFNC, 0 of 13 (0%) on masks, versus five of 20 (25%) on nasal cannula. Odds ratio for air sample positivity was 0.52 (95% confidence interval (CI) 0.11-2.34) when comparing HFNC vs non-HFNC group, and 5.78 (1.24-27.01) for nasal cannula vs non-nasal cannula group. Patients with positive air samples in comparison with those with negative air samples were sampled earlier after symptoms onset (median: 7 vs 10 days; P=0.04) and had lower Ct values of diagnostic nasopharyngeal samples (median: 22 vs 26; P=0.02).CONCLUSIONS: Air sample positivity was not related to oxygen support device but to viral load. These data suggest that the use of personal protection equipment should be based on risk management according to viral load rather than oxygen support device.",

keywords = "Air sampling, COVID-19, High-flow nasal cannula, SARS-CoV-2, Viral load",

author = "Janssen, {M L} and Klazen, {Y P} and {de Man}, P and W Hanselaar and Ong, {D S Y} and E-J Wils",

note = "Funding Information: We would like to thank the medical microbiology laboratory technicians of the Franciscus Gasthuis & Vlietland hospital, in particular Han Veltman, Gerda Doejaaren, and Dick Wille, and team managers for their assistance in performing the experiments. We would like to thank Rene Bakker for the pictures used in Supplementary Figures S1 and S2. Informed consent was obtained from the persons in Supplementary Figures S1 and S2. Publisher Copyright: {\textcopyright} 2022 The Healthcare Infection Society",

year = "2022",

month = may,

doi = "10.1016/j.jhin.2022.03.001",

language = "English",

volume = "123",

pages = "87--91",

journal = "The journal of Hospital Infection",

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T1 - Airborne SARS-CoV-2 RNA excretion by patients with COVID-19 on different oxygen-delivery systems

T2 - a prospective observational study

AU - Janssen, M L

AU - Klazen, Y P

AU - de Man, P

AU - Hanselaar, W

AU - Ong, D S Y

AU - Wils, E-J

N1 - Funding Information: We would like to thank the medical microbiology laboratory technicians of the Franciscus Gasthuis & Vlietland hospital, in particular Han Veltman, Gerda Doejaaren, and Dick Wille, and team managers for their assistance in performing the experiments. We would like to thank Rene Bakker for the pictures used in Supplementary Figures S1 and S2. Informed consent was obtained from the persons in Supplementary Figures S1 and S2. Publisher Copyright: © 2022 The Healthcare Infection Society

PY - 2022/5

Y1 - 2022/5

N2 - BACKGROUND: Concerns persist regarding the risk of airborne SARS-CoV-2 transmission by patients with COVID-19 on various modalities of oxygen therapy, such as high-flow nasal cannula (HFNC).AIM: We aimed to compare the presence of airborne RNA in air samples between groups of patients with COVID-19 on different oxygen-delivery systems. We also explored factors that were associated with SARS-CoV-2 RNA positivity in air samples.RESULTS: Air samples were positive for SARS-CoV-2 RNA in three of 39 patients (8%) on HFNC, 0 of 13 (0%) on masks, versus five of 20 (25%) on nasal cannula. Odds ratio for air sample positivity was 0.52 (95% confidence interval (CI) 0.11-2.34) when comparing HFNC vs non-HFNC group, and 5.78 (1.24-27.01) for nasal cannula vs non-nasal cannula group. Patients with positive air samples in comparison with those with negative air samples were sampled earlier after symptoms onset (median: 7 vs 10 days; P=0.04) and had lower Ct values of diagnostic nasopharyngeal samples (median: 22 vs 26; P=0.02).CONCLUSIONS: Air sample positivity was not related to oxygen support device but to viral load. These data suggest that the use of personal protection equipment should be based on risk management according to viral load rather than oxygen support device.

AB - BACKGROUND: Concerns persist regarding the risk of airborne SARS-CoV-2 transmission by patients with COVID-19 on various modalities of oxygen therapy, such as high-flow nasal cannula (HFNC).AIM: We aimed to compare the presence of airborne RNA in air samples between groups of patients with COVID-19 on different oxygen-delivery systems. We also explored factors that were associated with SARS-CoV-2 RNA positivity in air samples.RESULTS: Air samples were positive for SARS-CoV-2 RNA in three of 39 patients (8%) on HFNC, 0 of 13 (0%) on masks, versus five of 20 (25%) on nasal cannula. Odds ratio for air sample positivity was 0.52 (95% confidence interval (CI) 0.11-2.34) when comparing HFNC vs non-HFNC group, and 5.78 (1.24-27.01) for nasal cannula vs non-nasal cannula group. Patients with positive air samples in comparison with those with negative air samples were sampled earlier after symptoms onset (median: 7 vs 10 days; P=0.04) and had lower Ct values of diagnostic nasopharyngeal samples (median: 22 vs 26; P=0.02).CONCLUSIONS: Air sample positivity was not related to oxygen support device but to viral load. These data suggest that the use of personal protection equipment should be based on risk management according to viral load rather than oxygen support device.

KW - Air sampling

KW - COVID-19

KW - High-flow nasal cannula

KW - SARS-CoV-2

KW - Viral load

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U2 - 10.1016/j.jhin.2022.03.001

DO - 10.1016/j.jhin.2022.03.001

M3 - Article

C2 - 35288255

SN - 0195-6701

VL - 123

SP - 87

EP - 91

JO - The journal of Hospital Infection

JF - The journal of Hospital Infection

ER -

Airborne SARS-CoV-2 RNA excretion by patients with COVID-19 on different oxygen-delivery systems: a prospective observational study

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