SARS-CoV-2 in the Air Surrounding Patients during Nebulizer Therapy

Area of Science:

• Infectious Diseases
• Pulmonology
• Aerosol Science

Background:

• Nebulizer therapy is a common treatment for obstructive lung conditions.
• It is considered a potential aerosol-generating procedure.
• The risk of SARS-CoV-2 transmission during nebulizer use in COVID-19 patients is not well understood.

Purpose of the Study:

• To evaluate if nebulizer therapy increases the dispersion of SARS-CoV-2 in hospitalized COVID-19 patients.
• To assess the association between nebulizer use and airborne viral RNA concentrations and particle counts.

Main Methods:

• Pilot study involving 13 hospitalized COVID-19 patients.
• Air sampling before and during nebulizer therapy.
• Analysis of air samples using RT-PCR and cell culture for SARS-CoV-2.
• Quantification of total aerosol particle concentrations.

Main Results:

• Seven out of 13 patients had detectable virus in oropharyngeal samples.
• Two patients had RT-PCR positive air samples; both showed higher SARS-CoV-2 RNA during nebulizer therapy.
• Significantly higher concentrations of aerosol particles (0.3-5 µm) were observed during nebulizer therapy compared to controls.

Conclusions:

• Nebulizer therapy in COVID-19 patients may be associated with increased SARS-CoV-2 dispersion.
• Elevated viral RNA levels and increased small airborne particles suggest a potential transmission risk to healthcare workers.
• Further research is needed to determine if the detected virus is replication-competent.