SARS-CoV-2 in the Air Surrounding Patients during Nebulizer Therapy

Nebulizer therapy is commonly used for patients with obstructive pulmonary disease or acute pulmonary infections with signs of obstruction. It is considered a “potential aerosol-generating procedure,” and the risk of disease transmission to health care workers is uncertain. The aim of this pilot stu...

Full description

Saved in:
Bibliographic Details
Main Authors: Jostein Gohli, Arne Broch Brantsæter, Kari Oline Bøifot, Carola Grub, Beathe Kiland Granerud, Jan Cato Holter, Anne Margarita Dyrhol Riise, Madelen Foss Smedholen, Marius Dybwad
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Canadian Journal of Infectious Diseases and Medical Microbiology
Online Access:http://dx.doi.org/10.1155/2022/9297974
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849412767132418048
author Jostein Gohli
Arne Broch Brantsæter
Kari Oline Bøifot
Carola Grub
Beathe Kiland Granerud
Jan Cato Holter
Anne Margarita Dyrhol Riise
Madelen Foss Smedholen
Marius Dybwad
author_facet Jostein Gohli
Arne Broch Brantsæter
Kari Oline Bøifot
Carola Grub
Beathe Kiland Granerud
Jan Cato Holter
Anne Margarita Dyrhol Riise
Madelen Foss Smedholen
Marius Dybwad
author_sort Jostein Gohli
collection DOAJ
description Nebulizer therapy is commonly used for patients with obstructive pulmonary disease or acute pulmonary infections with signs of obstruction. It is considered a “potential aerosol-generating procedure,” and the risk of disease transmission to health care workers is uncertain. The aim of this pilot study was to assess whether nebulizer therapy in hospitalized COVID-19 patients is associated with increased dispersion of SARS-CoV-2. Air samples collected prior to and during nebulizer therapy were analyzed by RT-PCR and cell culture. Total aerosol particle concentrations were also quantified. Of 13 patients, seven had quantifiable virus in oropharynx samples, and only two had RT-PCR positive air samples. For both these patients, air samples collected during nebulizer therapy had higher SARS-CoV-2 RNA concentrations compared to control air samples. Also, for particle sizes 0.3–5 µm, particle concentrations were significantly higher during nebulizer therapy than in controls. We were unable to cultivate virus from any of the RT-PCR positive air samples, and it is therefore unknown if the detected virus were replication-competent; however, the significant increase in smaller particles, which can remain airborne for extended periods of time, and increased viral RNA concentrations during treatment may indicate that nebulizer therapy is associated with increased risk of SARS-CoV-2 transmission.
format Article
id doaj-art-54e613633d4946029cbc7e9ff6d94f90
institution Kabale University
issn 1918-1493
language English
publishDate 2022-01-01
publisher Wiley
record_format Article
series Canadian Journal of Infectious Diseases and Medical Microbiology
spelling doaj-art-54e613633d4946029cbc7e9ff6d94f902025-08-20T03:34:21ZengWileyCanadian Journal of Infectious Diseases and Medical Microbiology1918-14932022-01-01202210.1155/2022/9297974SARS-CoV-2 in the Air Surrounding Patients during Nebulizer TherapyJostein Gohli0Arne Broch Brantsæter1Kari Oline Bøifot2Carola Grub3Beathe Kiland Granerud4Jan Cato Holter5Anne Margarita Dyrhol Riise6Madelen Foss Smedholen7Marius Dybwad8Norwegian Defence Research EstablishmentDepartment of Infectious DiseasesNorwegian Defence Research EstablishmentInstitute of MicrobiologyDepartment of MicrobiologyDepartment of MicrobiologyDepartment of Infectious DiseasesOslo University HospitalNorwegian Defence Research EstablishmentNebulizer therapy is commonly used for patients with obstructive pulmonary disease or acute pulmonary infections with signs of obstruction. It is considered a “potential aerosol-generating procedure,” and the risk of disease transmission to health care workers is uncertain. The aim of this pilot study was to assess whether nebulizer therapy in hospitalized COVID-19 patients is associated with increased dispersion of SARS-CoV-2. Air samples collected prior to and during nebulizer therapy were analyzed by RT-PCR and cell culture. Total aerosol particle concentrations were also quantified. Of 13 patients, seven had quantifiable virus in oropharynx samples, and only two had RT-PCR positive air samples. For both these patients, air samples collected during nebulizer therapy had higher SARS-CoV-2 RNA concentrations compared to control air samples. Also, for particle sizes 0.3–5 µm, particle concentrations were significantly higher during nebulizer therapy than in controls. We were unable to cultivate virus from any of the RT-PCR positive air samples, and it is therefore unknown if the detected virus were replication-competent; however, the significant increase in smaller particles, which can remain airborne for extended periods of time, and increased viral RNA concentrations during treatment may indicate that nebulizer therapy is associated with increased risk of SARS-CoV-2 transmission.http://dx.doi.org/10.1155/2022/9297974
spellingShingle Jostein Gohli
Arne Broch Brantsæter
Kari Oline Bøifot
Carola Grub
Beathe Kiland Granerud
Jan Cato Holter
Anne Margarita Dyrhol Riise
Madelen Foss Smedholen
Marius Dybwad
SARS-CoV-2 in the Air Surrounding Patients during Nebulizer Therapy
Canadian Journal of Infectious Diseases and Medical Microbiology
title SARS-CoV-2 in the Air Surrounding Patients during Nebulizer Therapy
title_full SARS-CoV-2 in the Air Surrounding Patients during Nebulizer Therapy
title_fullStr SARS-CoV-2 in the Air Surrounding Patients during Nebulizer Therapy
title_full_unstemmed SARS-CoV-2 in the Air Surrounding Patients during Nebulizer Therapy
title_short SARS-CoV-2 in the Air Surrounding Patients during Nebulizer Therapy
title_sort sars cov 2 in the air surrounding patients during nebulizer therapy
url http://dx.doi.org/10.1155/2022/9297974
work_keys_str_mv AT josteingohli sarscov2intheairsurroundingpatientsduringnebulizertherapy
AT arnebrochbrantsæter sarscov2intheairsurroundingpatientsduringnebulizertherapy
AT kariolinebøifot sarscov2intheairsurroundingpatientsduringnebulizertherapy
AT carolagrub sarscov2intheairsurroundingpatientsduringnebulizertherapy
AT beathekilandgranerud sarscov2intheairsurroundingpatientsduringnebulizertherapy
AT jancatoholter sarscov2intheairsurroundingpatientsduringnebulizertherapy
AT annemargaritadyrholriise sarscov2intheairsurroundingpatientsduringnebulizertherapy
AT madelenfosssmedholen sarscov2intheairsurroundingpatientsduringnebulizertherapy
AT mariusdybwad sarscov2intheairsurroundingpatientsduringnebulizertherapy