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Ahn, J.Y.; An, S.; Sohn, Y.; Cho, Y.; Hyun, J.H.; Baek, Y.J.; Kim, M.H.; Jeong, S.J.; Kim, J.H.; Ku, N.S.; Yeom, J.-S.; Smith, D.M.; Lee, H.; Yong, D.; Lee, Y.-J.; Kim, J.W.; Kim, H.R.; Hwang, J.; Choi, J.Y.
The Journal of hospital infection, 11/2020, Volume: 106, Issue: 3Journal Article
Identifying the extent of environmental contamination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is essential for infection control and prevention. The extent of environmental contamination has not been fully investigated in the context of severe coronavirus disease (COVID-19) patients. To investigate environmental SARS-CoV-2 contamination in the isolation rooms of severe COVID-19 patients requiring mechanical ventilation or high-flow oxygen therapy. Environmental swab samples and air samples were collected from the isolation rooms of three COVID-19 patients with severe pneumonia. Patients 1 and 2 received mechanical ventilation with a closed suction system, while patient 3 received high-flow oxygen therapy and non-invasive ventilation. Real-time reverse transcription–polymerase chain reaction (rRT–PCR) was used to detect SARS-CoV-2; viral cultures were performed for samples not negative on rRT–PCR. Of the 48 swab samples collected in the rooms of patients 1 and 2, only samples from the outside surfaces of the endotracheal tubes tested positive for SARS-CoV-2 by rRT–PCR. However, in patient 3's room, 13 of the 28 environmental samples (fomites, fixed structures, and ventilation exit on the ceiling) showed positive results. Air samples were negative for SARS-CoV-2. Viable viruses were identified on the surface of the endotracheal tube of patient 1 and seven sites in patient 3's room. Environmental contamination of SARS-CoV-2 may be a route of viral transmission. However, it might be minimized when patients receive mechanical ventilation with a closed suction system. These findings can provide evidence for guidelines for the safe use of personal protective equipment.
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