Environmental contamination in the isolation rooms of COVID-19 patients with severe pneumonia requiring mechanical ventilation or high-flow oxygen therapy

J. Y. Ahn, S. An, Y. Sohn, Y. Cho, J. H. Hyun, Y. J. Baek, M. H. Kim, S. J. Jeong, J. H. Kim, N. S. Ku, J. S. Yeom, D. M. Smith, H. Lee, D. Yong, Y. J. Lee, J. W. Kim, H. R. Kim, J. Hwang, J. Y. Choi

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2 Citations (Scopus)

Abstract

Background: Identifying the extent of environmental contamination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is essential for infection control and prevention. The extent of environmental contamination has not been fully investigated in the context of severe coronavirus disease (COVID-19) patients. Aim: To investigate environmental SARS-CoV-2 contamination in the isolation rooms of severe COVID-19 patients requiring mechanical ventilation or high-flow oxygen therapy. Methods: Environmental swab samples and air samples were collected from the isolation rooms of three COVID-19 patients with severe pneumonia. Patients 1 and 2 received mechanical ventilation with a closed suction system, while patient 3 received high-flow oxygen therapy and non-invasive ventilation. Real-time reverse transcription–polymerase chain reaction (rRT–PCR) was used to detect SARS-CoV-2; viral cultures were performed for samples not negative on rRT–PCR. Findings: Of the 48 swab samples collected in the rooms of patients 1 and 2, only samples from the outside surfaces of the endotracheal tubes tested positive for SARS-CoV-2 by rRT–PCR. However, in patient 3's room, 13 of the 28 environmental samples (fomites, fixed structures, and ventilation exit on the ceiling) showed positive results. Air samples were negative for SARS-CoV-2. Viable viruses were identified on the surface of the endotracheal tube of patient 1 and seven sites in patient 3's room. Conclusion: Environmental contamination of SARS-CoV-2 may be a route of viral transmission. However, it might be minimized when patients receive mechanical ventilation with a closed suction system. These findings can provide evidence for guidelines for the safe use of personal protective equipment.

Original languageEnglish
Pages (from-to)570-576
Number of pages7
JournalJournal of Hospital Infection
Volume106
Issue number3
DOIs
Publication statusPublished - 2020 Nov

Bibliographical note

Funding Information:
This work was supported by the Research Program funded by the Korea Centers for Disease Control and Prevention ( 2019-ER5408-00 ), research grants for deriving the major clinical and epidemiological indicators of people with HIV (Korea HIV/AIDS Cohort Study, 2019-ER5101-00), and a grant from the Ministry of Health & Welfare , Republic of Korea (grant number: HI14C1324 ). D.S. was supported by the John and Mary Tu Foundation .

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases

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