Indoor transmission of SARS-CoV-2

Indoor Air. 2021 May;31(3):639-645. doi: 10.1111/ina.12766. Epub 2020 Nov 20.


It is essential to understand where and how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is transmitted. Case reports were extracted from the local Municipal Health Commissions of 320 prefectural municipalities in China (not including Hubei Province). We identified all outbreaks involving three or more cases and reviewed the major characteristics of the enclosed spaces in which the outbreaks were reported and their associated indoor environmental aspects. Three hundred and eighteen outbreaks with three or more cases were identified, comprising a total of 1245 confirmed cases in 120 prefectural cities. Among the identified outbreaks, 53.8% involved three cases, 26.4% involved four cases, and only 1.6% involved ten or more cases. Home-based outbreaks were the dominant category (254 of 318 outbreaks; 79.9%), followed by transport-based outbreaks (108; 34.0%), and many outbreaks occurred in more than one category of venue. All identified outbreaks of three or more cases occurred in indoor environments, which confirm that sharing indoor spaces with one or more infected persons is a major SARS-CoV-2 infection risk.

Keywords: COVID-19; SARS-CoV-2; crowding; indoor environments; indoor hygiene; outbreak.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Air Microbiology
  • Air Pollution, Indoor / analysis*
  • Built Environment
  • COVID-19 / transmission*
  • China / epidemiology
  • Disease Outbreaks / statistics & numerical data*
  • Disease Transmission, Infectious / statistics & numerical data*
  • Humans
  • SARS-CoV-2*