期刊
CLINICAL INFECTIOUS DISEASES
卷 75, 期 1, 页码 E50-E56出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/cid/ciac202
关键词
exhaled aerosol; singing; aerosol sampling; airborne SARS-CoV-2
资金
- AFA insurance [180113, 200109]
- Swedish Research Council FORMAS [2017-00383, 2020-01490]
- Swedish Research Council FORTE [2017-00690]
- Royal Physiographic Society of Lund
- Swedish Government Funds for Clinical Research (ALF)
- Swedish Research Council [2019-05235, 2020-02344]
- SciLifeLab National COVID-19 Research Program - Knut and Alice Wallenberg Foundation
- Formas [2020-01490, 2017-00383] Funding Source: Formas
- Vinnova [2019-05235] Funding Source: Vinnova
- Forte [2020-01490, 2017-00690] Funding Source: Forte
- Swedish Research Council [2019-05235, 2020-02344, 2017-00383] Funding Source: Swedish Research Council
This study quantifies the presence of SARS-CoV-2 RNA in exhaled air samples and establishes a direct link between positive air samples and increased household transmission. The findings suggest that individuals who exhale viral aerosol particles are more likely to transmit COVID-19, especially during activities like singing or talking.
Transmission of covid-19 via exhaled aerosol particles were identified from case reports where air samples were missing. Our study quantifies SARS-CoV-2 RNA in exhaled air and provides a direct link between positive air samples and increased household transmission. Background Coronavirus disease 2019 (COVID-19) transmission via exhaled aerosol particles has been considered an important route for the spread of infection, especially during super-spreading events involving loud talking or singing. However, no study has previously linked measurements of viral aerosol emissions to transmission rates. Methods During February-March 2021, COVID-19 cases that were close to symptom onset were visited with a mobile laboratory for collection of exhaled aerosol particles during breathing, talking, and singing, respectively, and of nasopharyngeal and saliva samples. Aerosol samples were collected using a BioSpot-VIVAS and a NIOSH bc-251 2-stage cyclone, and all samples were analyzed by RT-qPCR for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA detection. We compared transmission rates between households with aerosol-positive and aerosol-negative index cases. Results SARS-CoV-2 RNA was detected in at least 1 aerosol sample from 19 of 38 (50%) included cases. The odds ratio (OR) of finding positive aerosol samples decreased with each day from symptom onset (OR 0.55, 95 confidence interval [CI] .30-1.0, P = .049). The highest number of positive aerosol samples were from singing, 16 (42%), followed by talking, 11 (30%), and the least from breathing, 3 (8%). Index cases were identified for 13 households with 31 exposed contacts. Higher transmission rates were observed in households with aerosol-positive index cases, 10/16 infected (63%), compared to households with aerosol-negative index cases, 4/15 infected (27%) (chi(2) test, P = .045). Conclusions COVID-19 cases were more likely to exhale SARS-CoV-2-containing aerosol particles close to symptom onset and during singing or talking as compared to breathing. This study supports that individuals with SARS-CoV-2 in exhaled aerosols are more likely to transmit COVID-19.
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