Evaluation for the Presence of SARS-CoV-2 in CO₂ Laser Plume

ImportanceSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly infectious virus that has been reported to be transmitted via aerosolization and other aerosol-generating activities. However, viral plumes from CO₂ lasers have yet to be investigated.ObjectiveEvaluate the viability of SARS-CoV-2 in the CO₂ laser plume in a porcine model for laryngeal surgery.DesignExperimental studies.SettingLaboratory.ParticipantsWild-type SARS-CoV-2 (Wt), Omicron SARS-CoV-2 (Omicron), and fluorescent SARS-CoV-2 (GFP).InterventionThree viral strains on porcine larynx exposed to CO₂ laser setting-1.5, 7, and 15 W.Main Outcome MeasuresThe laser plume was collected during ablation. Dilutant of the plume was then applied to Vero E6 cells for culture; quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR) (in duplicate) and fluoroscopy were used to establish the presence of viable virus.ResultsWt, Omicron, and GFP strains were found to be present on the larynx before and after the application of the laser by qPCR copies (cp) per microliter (µl). After ablation with 1.5, 7.0, and 15 W with Wt, the plume samples were shown to be 0, 0, and <10 cp/µl, respectively. For GFP, at all intensity levels, the copies were less than 10 cp/µl. Omicron did not show any copies at any of the power levels. Cultures did not show the presence of viable Wt, Omicron, and GFP strains in any of the collected laser plumes.ConclusionThe CO₂ laser plume of SARS-CoV-2 aerosolized minimal viral particles. None of the tested experimental conditions demonstrated a viable virus after laryngeal ablation with the CO₂ laser.RelevanceCO₂ laser use in the context of virus SARS-CoV-2 suggests minimal transmission risks associated with CO₂ laser procedures when appropriate safety protocols are followed.