What Have We Learned About Transmission of Coronavirus Disease-2019: Implications for Pulmonary Function Testing and Pulmonary Procedures

Abstract

Because of the potential for high aerosol transmission during pulmonary function testing and pulmonary procedures, performing these tests and procedures must be considered carefully during the coronavirus disease-2019 (COVID-19) pandemic. Much has been learned about the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by aerosols and the potential for such transmission through pulmonary function tests and pulmonary procedures, and subsequently preventative practices have been enhanced and developed to reduce the risk of transmission of virus to patients and personnel. This article reviews what is known about the potential for transmission of SARS-CoV-2 during pulmonary function testing and pulmonary procedures and the recommended mitigation steps to prevent the spread of COVID-19.

Keywords: Aerosol transmission; Bronchoscopy; COVID-19; Pleural procedures; Pulmonary function testing; SARS-CoV-2; Tracheostomy.

Fig. 1

Overview of aerosol generation and transport. Aerosols and droplets are emitted during exhalation, including breathing, speaking, and coughing/sneezing. Larger droplets will settle out quickly to surfaces, whereas smaller aerosols may travel significant distances.

Fig. 2

A clear plastic coverage is used to provide an additional barrier to contamination during percutaneous dilatational tracheostomy. Shown are the positions of the bronchoscopist at the side of a surgical field.