Risk Management and Healthcare Policy (Nov 2021)
The Environmental Deposition of Severe Acute Respiratory Syndrome Coronavirus 2 in Nosocomial Settings: Role of the Aerosolized Hydrogen Peroxide
Abstract
Amani Alnimr,1 Aisha Alamri,2 Khaled F Salama,3 Mahmoud Radi,4 Huda Bukharie,4 Bashayer Alshehri,5 Ali A Rabaan,6,7 Mohammed Alshahrani8 1Department of Microbiology, College of Medicine & King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 3Department of Environmental Health, College of Public Health & King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 4Department of Infection Control, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia; 5Microbiology Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; 6Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; 7Department of Public Health and Nutrition, The University of Haripur, Haripur, Pakistan; 8Emergency and Critical Care Department, College of Medicine & King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi ArabiaCorrespondence: Amani Alnimr Email [email protected]: Data on the role of aerosolized hydrogen peroxide (AHP) systems in the control of the COVID-19 pandemic are still emerging. This study provides evidence of the environmental shedding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the hospital environment, and the efficacy of AHP to eliminate it.Methods: A total of 324 environmental sites (224 surfaces and 100 air samples) belonging to 54 patient rooms were contextually collected and tested for genes of SARS-CoV-2 using RT-PCR assays and Xpert® Xpress SARS-CoV-2.Results: The SARS-CoV-2 viral genome was detected in seven sites (2.5%) of three patients’ rooms, including six highly touched surfaces and one air sample. Viral shedding was directly related to the distance from the patient, with 1, 1.9, and 3.5% of samples testing positive at 3, 2, and 1 meter, respectively (P-value=0.02). None of the sites showed the viral genome following application of 6% AHP. Of note, the viral genome was detected at 2 meters of a mildly symptomatic case on a face mask in the absence of aerosol generating procedures.Conclusion: Our data support the possible role of the hospital environment as a source of infection, and the efficacy of AHP to eliminate the virus. Further studies are needed to address the viability of the pathogen in these nosocomial sites and the cost-effectiveness of routine hospital disinfection procedures using AHP for SARS-CoV-2.Keywords: aerosolized hydrogen peroxide, AHP, SARS-CoV-2, environmental, COVID-19, decontamination, disinfection
