Department of Applied and Nonlinear Optics, Wigner Research Centre for Physics, Konkoly-Thege Miklós st. 29-33, Budapest, Hungary.
Department of Pulmonology, Semmelweis University, Budapest, Hungary.
Geroscience. 2022 Apr;44(2):585-595. doi: 10.1007/s11357-021-00512-0. Epub 2022 Jan 5.
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 < 0.05) and the duration of activity (r = 0.82; p < 0.05), while submicron particles increased with all activities, mainly during the daytime. Based on simulations, the number of particles deposited in unit time was the highest in the acinar region, while deposition density rate (number/cm/min) was the highest in the upper airways. In conclusion, even short periods of HCP-patient interaction and minimal patient activity in a hospital room or nursing home bedroom may significantly increase the concentration of submicron particles mainly depositing in the acinar regions, while mainly nursing activities increase the concentration of supermicron particles depositing in larger airways of the adjacent bed patient. Our data emphasize the need for effective interventions to limit hospital- and nursing care-associated transmission of SARS-CoV-2 and other respiratory pathogens (including viral pathogens, such as rhinoviruses, respiratory syncytial virus, influenza virus, parainfluenza virus and adenoviruses, and bacterial and fungal pathogens).
在 COVID-19 大流行期间,SARS-CoV-2 通过医院和养老院环境中的空气传播机制从一位老年患者传播给另一位老年患者,这是一个重要的健康挑战。然而,影响可能导致 SARS-CoV-2 医院和护理相关传播的呼吸飞沫和气溶胶浓度的因素尚不清楚。为了评估医护人员(HCP)和患者活动对空气中颗粒大小和浓度的影响,将光学粒子计数器放置(24 小时)在从养老院确诊 COVID-19 转入的患者的医院病房空床上的头部位置。记录活动的类型和持续时间,以及提供患者护理的 HCP 人数。确定与特定活动相关的浓度变化,并使用这些数据进行气道沉积建模。记录了 31 项活动,选择了 6 项代表性活动进行沉积建模,包括患者的活动(咳嗽、运动等)、诊断和治疗干预(例如,诊断测试和药物给药)以及护理患者的护理(例如,床上用品和卫生)。所有大小的颗粒浓度增加都对活动类型敏感。超微米颗粒浓度的增加与 HCP 人数(r=0.66;p<0.05)和活动持续时间(r=0.82;p<0.05)相关,而亚微米颗粒则随着所有活动的增加而增加,主要发生在白天。基于模拟,单位时间内沉积的颗粒数量在腺泡区域最高,而沉积密度率(每厘米/分钟的颗粒数)在大气道最高。总之,即使是在医院病房或养老院卧室中与 HCP 和患者的短暂互动以及最小的患者活动也可能显著增加亚微米颗粒的浓度,主要沉积在腺泡区域,而主要的护理活动则会增加上呼吸道中与相邻床位患者相邻的较大气道中颗粒的浓度。我们的数据强调需要采取有效的干预措施来限制 SARS-CoV-2 和其他呼吸道病原体(包括病毒病原体,如鼻病毒、呼吸道合胞病毒、流感病毒、副流感病毒和腺病毒,以及细菌和真菌病原体)的医院和护理相关传播。
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