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

Lednicky, John A.; Lauzardo, Michael; Hugh Fan, Z.; Jutla, Antarpreet; Tilly, Trevor B.; Gangwar, Mayank; Usmani, Moiz; Shankar, Sripriya Nannu; Mohamed, Karim; Eiguren-Fernandez, Arantza; Stephenson, Caroline J.; Alam, Md. Mahbubul; Elbadry, Maha A.; Loeb, Julia C.; Subramaniam, Kuttinchantran; Waltzek, Thomas B.; Cherabuddi, Kartikeya; Glenn Morris, J.; Wu, Chang-Yu

OBJECTIVES: Because detection of SARS-CoV-2 RNA in aerosols but failure to isolate viable (infectious) virus are commonly reported, there is substantial controversy whether SARS-CoV-2 can be transmitted through aerosols. This conundrum occurs because common air samplers can inactivate virions through their harsh collection processes. We sought to resolve the question whether viable SARS-CoV-2 can occur in aerosols using VIVAS air samplers that operate on a gentle water-vapor condensation principle. METHODS: Air samples collected in the hospital room of two COVID-19 patients, one ready for discharge, the other newly admitted, were subjected to RT-qPCR and virus culture. The genomes of the SARS-CoV-2 collected from the air and isolated in cell culture were sequenced. RESULTS: Viable SARS-CoV-2 was isolated from air samples collected 2 to 4.8 m 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 newly admitted patient. Estimates of viable viral concentrations ranged from 6 to 74 TCID(50) units/L of air. CONCLUSIONS: 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.