Airborne transmission of SARS-CoV-2 is the dominant route of transmission: droplets and aerosols

Rabaan AA 1 , Al-Ahmed SH 2 , Al-Malkey M 3 , Alsubki R 4 , Ezzikouri S 5 , Al-Hababi FH 6 Show all authors , Sah R 7 , Al Mutair A 8 , Alhumaid S 9 , Al-Tawfiq JA 10 , Al-Omari A 11 , Al-Qaaneh AM 12 , Al-Qahtani M 13 , Tirupathi R 14 , Al Hamad MA 15 , Al-Baghli NA 16 , Sulaiman T 17 , Alsubait A 18 , Mehta R 19 , Abass E 20 , Alawi M 21 , Alshahrani F 22 , Shrestha DB 23 , Karobari MI 24 , Pecho-Silva S 25 , Arteaga-Livias K 26 , Bonilla-Aldana DK 27 , Rodriguez-Morales AJ 28

Affiliations 

  • 1 Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
  • 2 Specialty Paediatric Medicine, Qatif Central Hospital, Qatif, Saudi Arabia
  • 3 Tropical Biological Research Unit, College of Science, University of Baghdad, Baghdad, Iraq
  • 4 Department of Clinical Laboratory Sciences, Chair of Medical and Molecular Genetics Research, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
  • 5 Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco
  • 6 Virology Department, Riyadh Regional Laboratory, Riyadh, Saudi Arabia
  • 7 Department of Microbiology, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
  • 8 School of Nursing, Wollongong University, Australia; Research Center, Almoosa Specialist Hospital, Alahsa, Saudi Arabia
  • 9 Administration of Pharmaceutical Care, Ministry of Health, Alahsa, Saudi Arabia
  • 10 Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
  • 11 School of Medicine, Critical Care and Infection Control Department, Al-Faisal University, Riyadh, Saudi Arabia; Dr. Sulaiman Al-Habib Medical Group, Riyadh, Saudi Arabia
  • 12 Department of Genetic Research, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; Clinical Pharmacy Services Division, Pharmacy Services Department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
  • 13 Department of Medicine, Royal Medical Services, Bahrain Defence Force Hospital, Manamah, Bahrain; Department of Medicine, Royal College of Surgeons in Ireland-Bahrain Medical University, Manamah, Bahrain
  • 14 Penn State University School of Medicine, Hershey, PA, USA; Wellspan Chambersburg and Waynesboro (Pa.) Hospitals, Chambersburg, PA, USA; Department of Pathology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
  • 15 Department of Pathology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
  • 16 Directorate of Health Affairs, Ministry of Health, Dammam, Saudi Arabia
  • 17 King Fahad Medical City, Riyadh, Saudi Arabia
  • 18 King Abdullah international medical research center, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs
  • 19 National Public Health Laboratory, Kathmandu, Nepal
  • 20 Department of Clinical Laboratory Science, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
  • 21 Department of Medical Microbiology and Parasitology, King Abdulaziz University, Jeddah, Saudi Arabia; Infection Control and Environmental Health Unit, King Abdulaziz University Hospital, Faculty of Medicine. Jeddah, Saudi Arabia
  • 22 Division Of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
  • 23 Department of Emergency Medicine, General Practice, Mangalbare Hospital, Urlabari-03, Morang, Nepal
  • 24 Conservative Dentistry Unit, School of Dental Sciences, University Sains Malaysia, Health Campus, Kelantan, Malaysia
  • 25 Pneumology Service, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru; Master in Clinical Epidemiology and Biostatistics, Universidad Cientifica del Sur, Lima, Peru
  • 26 Faculty of Medicine, Universidad Nacional Hermilio Valdizan, Huanuco, Peru; Hospital II Huanuco, EsSalud, Huanuco, Peru; Facultad de Ciencias de la Salud, Universidad Cientifica del Sur, Lima, Peru
  • 27 Semillero de Investigacion en Zoonosis (SIZOO), Grupo de Investigacion BIOECOS, Fundacion Universitaria Autonoma de las Americas, Sede Pereira, Pereira, Risaralda, Colombia; Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnologica de Pereira, Pereira, Colombia
  • 28 Master in Clinical Epidemiology and Biostatistics, Universidad Cientificadel Sur, Lima, Peru; Facultad de Ciencias de la Salud, Universidad Cientifica del Sur, Lima, Peru; Public Health and infection Research Group, Faculty of Health Sciences, Universidad Tecnologica de Pereira, Pereira, Risaralda, Colombia; Grupo de Investigacion Biomedicina, Faculty of Medicine, Fundacion Universitaria Autonoma de las Americas, Pereira, Risaralda, Colombia
Infez Med, 2021 03 01;29(1):10-19.
PMID: 33664169

Abstract

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a pandemic worldwide. On a daily basis the number of deaths associated with COVID-19 is rapidly increasing. The main transmission route of SARS-CoV-2 is through the air (airborne transmission). This review details the airborne transmission of SARS-CoV-2, the aerodynamics, and different modes of transmission (e.g. droplets, droplet nuclei, and aerosol particles). SARS-CoV-2 can be transmitted by an infected person during activities such as expiration, coughing, sneezing, and talking. During such activities and some medical procedures, aerosols and droplets contaminated with SARS-CoV-2 particles are formed. Depending on their sizes and the environmental conditions, such particles stay viable in the air for varying time periods and can cause infection in a susceptible host. Very few studies have been conducted to establish the mechanism or the aerodynamics of virus-loaded particles and droplets in causing infection. In this review we discuss the various forms in which SARS-CoV-2 virus particles can be transmitted in air and cause infections.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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