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      Viable SARS-CoV-2 in the air of a hospital room with COVID-19 patients

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Summary

          Background

          There currently is substantial controversy about the role played by SARS-CoV-2 in aerosols in disease transmission, due in part to detections of viral RNA but failures to isolate viable virus from clinically generated aerosols.

          Methods

          Air samples were collected in the room of two COVID-19 patients, one of whom had an active respiratory infection with a nasopharyngeal (NP) swab positive for SARS-CoV-2 by RT-qPCR. By using VIVAS air samplers that operate on a gentle water-vapor condensation principle, material was collected from room air and subjected to RT-qPCR and virus culture. The genomes of the SARS-CoV-2 collected from the air and of virus isolated in cell culture from air sampling and from a NP swab from a newly admitted patient in the room were sequenced.

          Findings

          Viable virus was isolated from air samples collected 2 to 4.8m away from the patients. The genome sequence of the SARS-CoV-2 strain isolated from the material collected by the air samplers was identical to that isolated from the NP swab from the patient with an active infection. Estimates of viable viral concentrations ranged from 6 to 74 TCID 50 units/L of air.

          Interpretation

          Patients with respiratory manifestations of COVID-19 produce aerosols in the absence of aerosol-generating procedures that contain viable SARS-CoV-2, and these aerosols may serve as a source of transmission of the virus.

          Funding

          Partly funded by Grant No. 2030844 from the National Science Foundation and by award 1R43ES030649 from the National Institute of Environmental Health Sciences of the National Institutes of Health, and by funds made available by the University of Florida Emerging Pathogens Institute and the Office of the Dean, University of Florida College of Medicine.

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          Clinical Characteristics of Coronavirus Disease 2019 in China

          Wei-jie Guan, Zheng-yi Ni, Yu Hu … (2020)
          Abstract Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients. Methods We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in mainland China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. Results The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission. Conclusions During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.)
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            A Novel Coronavirus from Patients with Pneumonia in China, 2019

            Na Zhu, Dingyu Zhang, Wenling Wang … (2020)
            Summary In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A previously unknown betacoronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed a clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. Different from both MERS-CoV and SARS-CoV, 2019-nCoV is the seventh member of the family of coronaviruses that infect humans. Enhanced surveillance and further investigation are ongoing. (Funded by the National Key Research and Development Program of China and the National Major Project for Control and Prevention of Infectious Disease in China.)
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              Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia

              Qun Li, Xuhua Guan, Peng Wu … (2020)
              Abstract Background The initial cases of novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the first 425 confirmed cases in Wuhan to determine the epidemiologic characteristics of NCIP. Methods We collected information on demographic characteristics, exposure history, and illness timelines of laboratory-confirmed cases of NCIP that had been reported by January 22, 2020. We described characteristics of the cases and estimated the key epidemiologic time-delay distributions. In the early period of exponential growth, we estimated the epidemic doubling time and the basic reproductive number. Results Among the first 425 patients with confirmed NCIP, the median age was 59 years and 56% were male. The majority of cases (55%) with onset before January 1, 2020, were linked to the Huanan Seafood Wholesale Market, as compared with 8.6% of the subsequent cases. The mean incubation period was 5.2 days (95% confidence interval [CI], 4.1 to 7.0), with the 95th percentile of the distribution at 12.5 days. In its early stages, the epidemic doubled in size every 7.4 days. With a mean serial interval of 7.5 days (95% CI, 5.3 to 19), the basic reproductive number was estimated to be 2.2 (95% CI, 1.4 to 3.9). Conclusions On the basis of this information, there is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019. Considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere. Measures to prevent or reduce transmission should be implemented in populations at risk. (Funded by the Ministry of Science and Technology of China and others.)
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                Author and article information

                Journal
                Journal ID (nlm-ta): medRxiv
                Journal ID (publisher-id): MEDRXIV
                Title: medRxiv
                Publisher: Cold Spring Harbor Laboratory
                Publication date (Electronic): 04 August 2020
                Electronic Location Identifier: 2020.08.03.20167395
                Affiliations
                [1 ]Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, USA
                [2 ]Emerging Pathogens Institute, University of Florida, USA
                [3 ]Division of Infectious Diseases and Global Medicine, Department of Medicine, College of Medicine, University of Florida, USA
                [4 ]Department of Mechanical & Aerospace Engineering, College of Engineering, University of Florida, USA
                [5 ]J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, USA
                [6 ]Department of Environmental Engineering Sciences, College of Engineering, University of Florida, USA
                [7 ]Aerosol Dynamics Inc., Berkeley, California, USA
                [8 ]Department of Infectious Diseases and Immunology, College of Veterinary Medicine, University of Florida, USA
                Author notes
                [* ]Corresponding author: John A. Lednicky, PhD, Dept. of Environmental and Global Health, College of Public Health and Health Professions, University of Florida – Gainesville, Box 100188, Gainesville, FL, USA 32610-0188, Tel: (1) 352-273-9204; Fax: (1) 352-273-6070; jlednicky@ 123456phhp.ufl.edu

                Contributors

                JAL, ML, ZHF, AJ, AEF, KC, JGM Jr, and C-YW conceived and designed the study. JAL, ML, KC, JG M Jr, and C-YW curated the data. JAL, ML, JGM Jr, and C-YW performed formal analyses of the data. JAL, ML, ZHF, AJ, JGM Jr. obtained funding for the work; JAL, TBT, MG, MU, SNS, KM, CJS, MMA, MAE, JCL, KS, and TBW performed experiments; JAL, M L, TBT, SNS, CJS, JCL, KS, TBW, JGM Jr, and C-YW established methods; JAL, ML, JCL, JGM Jr, and C-YW administered the project; JAL, ML, ZHF, AJ, JGM Jr, and C-YW provided resources; JAL, ML, JCL, JGM Jr, and C-YW supervised the project; JAL, JGM Jr., and C-Y Wu wrote the original manuscript draft; all authors revised the manuscript critically. All authors read and approved the final version of the manuscript.

                Article
                DOI: 10.1101/2020.08.03.20167395
                PMC ID: 7418726
                PubMed ID: 32793914
                SO-VID: 61079035-f8ca-4480-95c7-dcbdbc2fbb7c
                License:

                It is made available under a CC-BY-ND 4.0 International license.

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