Risk mitigation of shared room ventilation and filtration on SARS-CoV-2 transmission: a multicenter test-negative...

Area of Science:

• Infectious Diseases
• Environmental Health
• Hospital Epidemiology

Background:

• Shared hospital rooms are a significant risk factor for healthcare-associated (HA) SARS-CoV-2 transmission.
• Quantifying the impact of engineering controls like ventilation and filtration is crucial for infection prevention strategies.

Purpose of the Study:

• To assess the impact of engineering controls on SARS-CoV-2 transmission in shared hospital rooms.
• To evaluate the effectiveness of air changes per hour (ACH), room mechanical ventilation (RMV), and portable high-efficiency particulate air (HEPA) filters.

Main Methods:

• A multicenter test-negative study involving 468 patients exposed to SARS-CoV-2 in shared rooms.
• Utilized multilevel logistic mixed models to analyze the association between engineering controls and infection transmission.
• Independent variables included ACH, RMV, and HEPA filter presence; covariates included patient and facility factors.

Main Results:

• The secondary attack rate among exposed patients was 26.3%.
• Increased ACH (aOR 0.88) and the presence of RMV (aOR 0.51) were independently associated with decreased odds of SARS-CoV-2 infection.
• Portable HEPA filter use was not statistically significant (aOR 0.58).

Conclusions:

• Enhanced ventilation, specifically optimized ACH and RMV, can significantly mitigate the risk of HA-SARS-CoV-2 transmission in shared hospital rooms.
• Further research is needed to determine optimal ACH thresholds and the role of HEPA filters.