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Observational Study
. 2022 May:123:87-91.
doi: 10.1016/j.jhin.2022.03.001. Epub 2022 Mar 12.

Airborne SARS-CoV-2 RNA excretion by patients with COVID-19 on different oxygen-delivery systems: a prospective observational study

M L Janssen  1 , Y P Klazen  2 , P de Man  3 , W Hanselaar  4 , D S Y Ong  5 , E-J Wils  6
Affiliations
Observational Study

Airborne SARS-CoV-2 RNA excretion by patients with COVID-19 on different oxygen-delivery systems: a prospective observational study

M L Janssen et al. J Hosp Infect. 2022 May.

Abstract

Background: Concerns persist regarding the risk of airborne SARS-CoV-2 transmission by patients with COVID-19 on various modalities of oxygen therapy, such as high-flow nasal cannula (HFNC).

Aim: We aimed to compare the presence of airborne RNA in air samples between groups of patients with COVID-19 on different oxygen-delivery systems. We also explored factors that were associated with SARS-CoV-2 RNA positivity in air samples.

Results: Air samples were positive for SARS-CoV-2 RNA in three of 39 patients (8%) on HFNC, 0 of 13 (0%) on masks, versus five of 20 (25%) on nasal cannula. Odds ratio for air sample positivity was 0.52 (95% confidence interval (CI) 0.11-2.34) when comparing HFNC vs non-HFNC group, and 5.78 (1.24-27.01) for nasal cannula vs non-nasal cannula group. Patients with positive air samples in comparison with those with negative air samples were sampled earlier after symptoms onset (median: 7 vs 10 days; P=0.04) and had lower Ct values of diagnostic nasopharyngeal samples (median: 22 vs 26; P=0.02).

Conclusions: Air sample positivity was not related to oxygen support device but to viral load. These data suggest that the use of personal protection equipment should be based on risk management according to viral load rather than oxygen support device.

Keywords: Air sampling; COVID-19; High-flow nasal cannula; SARS-CoV-2; Viral load.

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