Risk of dispersion or aerosol generation and infection transmission with nasopharyngeal and oropharyngeal swabs for detection of COVID-19: a systematic review.


Journal

BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874

Informations de publication

Date de publication:
17 03 2021
Historique:
entrez: 19 3 2021
pubmed: 20 3 2021
medline: 24 3 2021
Statut: epublish

Résumé

SARS-CoV-2-related disease, referred to as COVID-19, has emerged as a global pandemic since December 2019. While there is growing recognition regarding possible airborne transmission, particularly in the setting of aerosol-generating procedures and treatments, whether nasopharyngeal and oropharyngeal swabs for SARS-CoV-2 generate aerosols remains unclear. Systematic review. We searched Ovid MEDLINE and EMBASE up to 3 November 2020. We also searched the China National Knowledge Infrastructure, Chinese Medical Journal Network, medRxiv and ClinicalTrials.gov up to 29 March 2020. All comparative and non-comparative studies that evaluated dispersion or aerosolisation of viable airborne organisms, or transmission of infection associated with nasopharyngeal or oropharyngeal swab testing. Of 7702 citations, only one study was deemed eligible. Using a dedicated sampling room with negative pressure isolation room, personal protective equipment including N95 or higher masks, strict sterilisation protocols, structured training with standardised collection methods and a structured collection and delivery system, a tertiary care hospital proved a 0% healthcare worker infection rate among eight nurses conducting over 11 000 nasopharyngeal swabs. No studies examining transmissibility with other safety protocols, nor any studies quantifying the risk of aerosol generation with nasopharyngeal or oropharyngeal swabs for detection of SARS-CoV-2, were identified. There is limited to no published data regarding aerosol generation and risk of transmission with nasopharyngeal and oropharyngeal swabs for the detection of SARS-CoV-2. Field experiments to quantify this risk are warranted. Vigilance in adhering to current standards for infection control is suggested.

Identifiants

pubmed: 33737418
pii: bmjopen-2020-040616
doi: 10.1136/bmjopen-2020-040616
pmc: PMC7977073
doi:

Substances chimiques

Aerosols 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

e040616

Subventions

Organisme : World Health Organization
ID : 001
Pays : International

Informations de copyright

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

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Auteurs

Arnav Agarwal (A)

Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.

Shannon M Fernando (SM)

Division of Critical Care, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada.

Kimia Honarmand (K)

Division of Critical Care, Department of Medicine, Western University, London, Ontario, Canada.

Layla Bakaa (L)

Faculty of Science, McMaster University, Hamilton, Ontario, Canada.

Sonia Brar (S)

School of Medicine and Biomedical Sciences, University of Buffalo, Buffalo, New York, USA.

David Granton (D)

Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.

Dipayan Chaudhuri (D)

Department of Medicine, McMaster University, Hamilton, Ontario, Canada.

Devin Chetan (D)

Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
Division of Cardiology, Labatt Family Heart Centre, Hospital for Sick Children, Toronto, Ontario, Canada.

Malini Hu (M)

Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.

John Basmaji (J)

Division of Critical Care, Department of Medicine, Western University, London, Ontario, Canada.

Fiona Muttalib (F)

Center for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada.

Bram Rochwerg (B)

Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.

Neill K J Adhikari (NKJ)

Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada.

Francois Lamontagne (F)

Centre de recherche due CHU de Sherbrooke, Université de Sherbrooke, Sherbrooke, Quebec, Canada.
Département de Médecine, Université de Sherbrooke, Sherbrooke, Quebec, Canada.

Srinivas Murthy (S)

Faculty of Medicine, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.

David S Hui (DS)

Department of Medicine and Therapeutics, Chinese University of Hong Kong, Shatin, Hong Kong.
Stanley Ho Center for Emerging Infectious Diseases, Chinese University of Hong Kong, Shatin, Hong Kong.

Charles D Gomersall (CD)

Department of Anaesthesia and Intensive Care, Chinese University of Hong Kong, Shatin, Hong Kong.

Samira Mubareka (S)

Division of Infectious Diseases, University of Toronto, Toronto, Ontario, Canada.
Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.

Janet Diaz (J)

Pacific Medical Center, San Francisco, California, USA.
World Health Organization, Geneva, Switzerland.

Karen Ea Burns (KE)

Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada.
Division of Critical Care, Unity Health Toronto - St. Michael's Hospital, Toronto, Ontario, Canada.
Li Ka Shing Knowledge Institute, Unity Health Toronto - St. Michael's Hospital, Toronto, Ontario, Canada.

Rachel Couban (R)

Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada.

Per O Vandvik (PO)

MAGIC Evidence Ecosystem Foundation, Oslo, Norway per.vandvik@gmail.com.

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