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. 2021 May;31(3):e2184.
doi: 10.1002/rmv.2184. Epub 2020 Oct 26.

Airborne transmission of SARS-CoV-2 via aerosols

Laura Comber  1 , Eamon O Murchu  1 , Linda Drummond  1 , Paul G Carty  1 , Kieran A Walsh  1 , Cillian F De Gascun  2 , Máire A Connolly  3 , Susan M Smith  4 , Michelle O'Neill  1 , Máirín Ryan  1   5 , Patricia Harrington  1
Affiliations

Airborne transmission of SARS-CoV-2 via aerosols

Laura Comber et al. Rev Med Virol. 2021 May.

Abstract

A key consideration in the Covid-19 pandemic is the dominant modes of transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. The objective of this review was to synthesise the evidence for the potential airborne transmission of SARS-CoV-2 via aerosols. Systematic literature searches were conducted in PubMed, Embase, Europe PMC and National Health Service UK evidence up to 27 July 2020. A protocol was published and Cochrane guidance for rapid review methodology was adhered to throughout. Twenty-eight studies were identified. Seven out of eight epidemiological studies suggest aerosol transmission may occur, with enclosed environments and poor ventilation noted as possible contextual factors. Ten of the 16 air sampling studies detected SARS-CoV-2 ribonucleic acid; however, only three of these studies attempted to culture the virus with one being successful in a limited number of samples. Two of four virological studies using artificially generated aerosols indicated that SARS-CoV-2 is viable in aerosols. The results of this review indicate there is inconclusive evidence regarding the viability and infectivity of SARS-CoV-2 in aerosols. Epidemiological studies suggest possible transmission, with contextual factors noted. Viral particles have been detected in air sampling studies with some evidence of clinical infectivity, and virological studies indicate these particles may represent live virus, adding further plausibility. However, there is uncertainty as to the nature and impact of aerosol transmission of SARS-CoV-2, and its relative contribution to the Covid-19 pandemic compared with other modes of transmission.

Keywords: Covid-19; SARS-CoV-2; aerosols; coronavirus; infection control; review; transmission.

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Conflict of interest statement

Laura Comber: Investigation, formal analysis, writing—original draft. Kieran Walsh: Investigation, writing—original draft. Eamon O Murchu: Investigation, writing—original draft. Paul G. Carty: Investigation, formal analysis. Linda Drummond: Writing, reviewing and editing. Cillian De Gascun: Writing, reviewing and editing. Máire A. Connolly: Writing, reviewing and editing. Susan M. Smith: Writing, reviewing and editing. Michelle O'Neill: Supervision, writing, reviewing and editing. Máirín Ryan: Supervision, writing, reviewing and editing. Patricia Harrington: Supervision, writing, reviewing and editing. All authors attest they meet the ICMJE criteria for authorship.

Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram
See this image and copyright information in PMC

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