Viable SARS-CoV-2 in the air of a hospital room with COVID-19 patients

Int J Infect Dis. 2020 Nov;100:476-482. doi: 10.1016/j.ijid.2020.09.025. Epub 2020 Sep 16.


Objectives: Because the detection of SARS-CoV-2 RNA in aerosols but failure to isolate viable (infectious) virus are commonly reported, there is substantial controversy whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be transmitted through aerosols. This conundrum occurs because common air samplers can inactivate virions through their harsh collection processes. We sought to resolve the question whether viable SARS-CoV-2 can occur in aerosols using VIVAS air samplers that operate on a gentle water vapor condensation principle.

Methods: Air samples collected in the hospital room of two coronavirus disease-2019 (COVID-19) patients, one ready for discharge and the other newly admitted, were subjected to RT-qPCR and virus culture. The genomes of the SARS-CoV-2 collected from the air and isolated in cell culture were sequenced.

Results: Viable SARS-CoV-2 was isolated from air samples collected 2 to 4.8 m away from the patients. The genome sequence of the SARS-CoV-2 strain isolated from the material collected by the air samplers was identical to that isolated from the newly admitted patient. Estimates of viable viral concentrations ranged from 6 to 74 TCID50 units/L of air.

Conclusions: Patients with respiratory manifestations of COVID-19 produce aerosols in the absence of aerosol-generating procedures that contain viable SARS-CoV-2, and these aerosols may serve as a source of transmission of the virus.

MeSH terms

  • Aerosols
  • Air Microbiology*
  • Betacoronavirus / isolation & purification*
  • COVID-19
  • Coronavirus Infections / transmission
  • Coronavirus Infections / virology*
  • Hospitals
  • Humans
  • Pandemics
  • Pneumonia, Viral / transmission
  • Pneumonia, Viral / virology*
  • SARS-CoV-2


  • Aerosols