Modeling of aerosol transmission of airborne pathogens in ICU rooms of COVID-19 patients with acute respiratory failure

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Abstract

The COVID-19 pandemic has generated many concerns about cross-contamination risks, particularly in hospital settings and Intensive Care Units (ICU). Virus-laden aerosols produced by infected patients can propagate throughout ventilated rooms and put medical personnel entering them at risk. Experimental results found with a schlieren optical method have shown that the air flows generated by a cough and normal breathing were modified by the oxygenation technique used, especially when using High Flow Nasal Canulae, increasing the shedding of potentially infectious airborne particles. This study also uses a 3D Computational Fluid Dynamics model based on a Lattice Boltzmann Method to simulate the air flows as well as the movement of numerous airborne particles produced by a patient’s cough within an ICU room under negative pressure. The effects of different mitigation scenarii on the amount of aerosols potentially containing SARS-CoV-2 that are extracted through the ventilation system are investigated. Numerical results indicate that adequate bed orientation and additional air treatment unit positioning can increase by 40% the number of particles extracted and decrease by 25% the amount of particles deposited on surfaces 45s after shedding. This approach could help lay the grounds for a more comprehensive way to tackle contamination risks in hospitals, as the model can be seen as a proof of concept and be adapted to any room configuration.

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  1. SciScore for 10.1101/2020.12.11.20247551: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    No key resources detected.


    Results from OddPub: Thank you for sharing your data.


    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    However, the PIV analysis has some accuracy limitations when the contrast is not optimal49. Furthermore, only three young volunteers were used in the study, which does not represent the large variability in terms of manners of breathing and coughing. A first limitation to the numerical model is the small time interval that was simulated. Simplifying the model would help increase the duration of the simulation and yield more complete results. However, many simplifications have already been made: evaporation is not taken into account in the model, the bed is the only piece of furniture modeled, and the LBM method does not yield a full picture of the 3-dimensional behavior of each particle. Due to the limited test data available on the flow field behavior inside the room, only the difference of pressure between the corridor and the room can be compared. The simulation provides a delta of 14 Pa when the test provides 15 Pa. To go deeper in the validation, air velocity measurements and smoke visualization can be conducted. Furthermore, the results presented here are adequate for the one room taken as an example. The same approach would have to be reused for each and every room having to be analyzed for risk mitigation. A second limit to the model is that it assumes that every particle emitted by the patient contains virions. The virus has an elliptical shape, with a diameter ranging between 60 and 140 nm18,50. It can thus be present in micro-metric droplets, as long as their diame...

    Results from TrialIdentifier: We found the following clinical trial numbers in your paper:

    IdentifierStatusTitle
    NCT04344730Active, not recruitingDexamethasone and Oxygen Support Strategies in ICU Patients …


    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.


    Results from JetFighter: We did not find any issues relating to colormaps.


    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • No funding statement was detected.
    • No protocol registration statement was detected.

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