Modeling of nursing care-associated airborne transmission of SARS-CoV-2 in a real-world hospital setting

• Published in: GeroScience 2022-04, Vol.44 (2), p.585-595
• Main Authors: Nagy, Attila, Horváth, Alpár, Farkas, Árpád, Füri, Péter, Erdélyi, Tamás, Madas, Balázs G., Czitrovszky, Aladár, Merkely, Béla, Szabó, Attila, Ungvári, Zoltán, Müller, Veronika
• Format: Article
• Language: English
• Subjects: Aerosols; Bedding; Biomedical and Life Sciences; Cell Biology; Coronaviruses; COVID-19; Disease transmission; Geriatrics/Gerontology; Health care; Hospitals; Humans; Hygiene; Influenza; Life Sciences; Molecular Medicine; Nursing care; Nursing homes; Original; Original Article; Pandemics; Parainfluenza; Pathogens; Patients; Respiratory diseases; Respiratory syncytial virus; Rhinovirus; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Therapeutic applications; Viruses
• ISSN: 2509-2715; 2509-2723; 2509-2723
• DOI: 10.1007/s11357-021-00512-0

  Respiratory transmission of SARS-CoV-2 from one older patient to another by airborne mechanisms in hospital and nursing home settings represents an important health challenge during the COVID-19 pandemic. However, the factors that influence the concentration of respiratory droplets and aerosols that potentially contribute to hospital- and nursing care-associated transmission of SARS-CoV-2 are not well understood. To assess the effect of health care professional (HCP) and patient activity on size and concentration of airborne particles, an optical particle counter was placed (for 24 h) in the head position of an empty bed in the hospital room of a patient admitted from the nursing home with confirmed COVID-19. The type and duration of the activity, as well as the number of HCPs providing patient care, were recorded. Concentration changes associated with specific activities were determined, and airway deposition modeling was performed using these data. Thirty-one activities were recorded, and six representative ones were selected for deposition modeling, including patient’s activities (coughing, movements, etc.), diagnostic and therapeutic interventions (e.g., diagnostic tests and drug administration), as well as nursing patient care (e.g., bedding and hygiene). The increase in particle concentration of all sizes was sensitive to the type of activity. Increases in supermicron particle concentration were associated with the number of HCPs ( r  = 0.66; p