Health Technology Assessment Directorate, Health Information and Quality Authority, Dublin, Ireland.
National Virus Reference Laboratory, University College Dublin, Dublin, Ireland.
Rev Med Virol. 2021 May;31(3):e2184. doi: 10.1002/rmv.2184. Epub 2020 Oct 26.
A key consideration in the Covid-19 pandemic is the dominant modes of transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. The objective of this review was to synthesise the evidence for the potential airborne transmission of SARS-CoV-2 via aerosols. Systematic literature searches were conducted in PubMed, Embase, Europe PMC and National Health Service UK evidence up to 27 July 2020. A protocol was published and Cochrane guidance for rapid review methodology was adhered to throughout. Twenty-eight studies were identified. Seven out of eight epidemiological studies suggest aerosol transmission may occur, with enclosed environments and poor ventilation noted as possible contextual factors. Ten of the 16 air sampling studies detected SARS-CoV-2 ribonucleic acid; however, only three of these studies attempted to culture the virus with one being successful in a limited number of samples. Two of four virological studies using artificially generated aerosols indicated that SARS-CoV-2 is viable in aerosols. The results of this review indicate there is inconclusive evidence regarding the viability and infectivity of SARS-CoV-2 in aerosols. Epidemiological studies suggest possible transmission, with contextual factors noted. Viral particles have been detected in air sampling studies with some evidence of clinical infectivity, and virological studies indicate these particles may represent live virus, adding further plausibility. However, there is uncertainty as to the nature and impact of aerosol transmission of SARS-CoV-2, and its relative contribution to the Covid-19 pandemic compared with other modes of transmission.
在 COVID-19 大流行中，一个关键的考虑因素是严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）病毒的主要传播方式。本综述的目的是综合 SARS-CoV-2 通过气溶胶潜在空气传播的证据。系统检索了 PubMed、Embase、Europe PMC 和英国国家卫生服务系统截至 2020 年 7 月 27 日的文献。制定了方案，并始终遵循 Cochrane 快速审查方法指南。确定了 28 项研究。8 项流行病学研究中有 7 项表明可能发生气溶胶传播，封闭环境和通风不良被认为是可能的环境因素。16 项空气采样研究中有 10 项检测到了 SARS-CoV-2 核糖核酸；然而，只有 3 项研究试图培养病毒，其中 1 项在有限数量的样本中成功。使用人工生成气溶胶的 4 项病毒学研究中的 2 项表明，SARS-CoV-2 在气溶胶中具有生存能力。本综述的结果表明，关于 SARS-CoV-2 在气溶胶中的生存能力和传染性的证据尚无定论。流行病学研究表明存在可能的传播，并注意到环境因素。空气采样研究中检测到了病毒颗粒，并有一些临床感染性的证据，病毒学研究表明这些颗粒可能代表活病毒，这进一步增加了其可能性。然而，对于 SARS-CoV-2 的气溶胶传播的性质和影响，以及与其他传播方式相比其对 COVID-19 大流行的相对贡献，仍然存在不确定性。
