Impact of HVAC-Systems on the Dispersion of Infectious Aerosols in a Cardiac Intensive Care Unit

Int J Environ Res Public Health. 2020 Sep 10;17(18):6582. doi: 10.3390/ijerph17186582.


At the end of 2019, a variation of a coronavirus, named SARS-CoV-2, has been identified as being responsible for a respiratory illness disease (COVID-19). Since ventilation is an important factor that influences airborne transmission, we proposed to study the impact of heating, ventilation and air-conditioning (HVAC) with a variable air volume (VAV) primary air system, on the dispersion of infectious aerosols, in a cardiac intensive care unit, using a transient simulation with computational fluid dynamics (CFD), based on the finite element method (FEM). We analyzed three scenarios that followed the dispersion of pathogen carrying expiratory droplets particles from coughing, from patients possibly infected with COVID-19, depending on the location of the patients in the intensive care unit. Our study provides the mechanism for spread of infectious aerosols, and possibly of COVID-19 infection, by air conditioning systems and also highlights important recommendations for disease control and optimization of ventilation in intensive care units, by increasing the use of outdoor air and the rate of air change, decreasing the recirculation of air and using high-efficiency particulate air (HEPA) filters. The CFD-FEM simulation approach that was applied in our study could also be extended to other targets, such as public transport, theaters, philharmonics and amphitheaters from educational units.

Keywords: COVID-19; air conditioning systems; airborne transmission; hospital-acquired infections; intensive care unit; risk factors.

MeSH terms

  • Aerosols*
  • Air Conditioning*
  • Betacoronavirus
  • Coronavirus Infections / transmission*
  • Heating*
  • Humans
  • Intensive Care Units*
  • Pandemics
  • Pneumonia, Viral / transmission*
  • Ventilation*


  • Aerosols

Supplementary concepts

  • COVID-19
  • severe acute respiratory syndrome coronavirus 2