COVID-19 virus released from larynx might cause a higher exposure dose in indoor environment

COVID-19 virus can replicate in the infected individual's larynx independently, which is different from other viruses that replicate in lungs only, e.g. SARS. It might contribute to the fast spread of COVID-19. However, there are few scientific reports about quantitative comparison of COVID-19 exposure dose (inhalation dose and adhesion dose) for the susceptible individual when the viruses were released from the larynx or lungs. In this paper, a typical numerical model was built based on a breathing human model with real respiratory tract. By using a computational fluid dynamics (CFD) method, two kinds of virus released sites in the infected individual's respiratory tract (larynx, lungs), seven kinds of particle sizes between 1 and 50 μm, three kinds of expiratory flow rates: calm (10 L/min), moderate (30 L/min) and intense (90 L/min) were used to compare the particle deposition proportion and escape proportion. The inhalation dose and the adhesion dose of the susceptible individual were quantified. The results showed that COVID-19 virus-containing droplets and aerosols might be released into the environment at higher proportions (39.1%-44.2%) than viruses that replicate in lungs only (15.3%-37.1%). The exposure doses (inhalation dose and adhesion dose) of the susceptible individual in different situations were discussed. The susceptible individual suffered a higher exposure dose when the viruses were released from the larynx rather than lungs (the difference for 1 μm particles was 1.2-2.2 times). This study provides a possible explanation for the higher transmission risk of COVID-19 virus compared to other viruses and some control advice of COVID-19 in typical indoor environments were also discussed.