The size and culturability of patient-generated SARS-CoV-2 aerosol

Joshua L. Santarpia, Vicki L. Herrera, Danielle N. Rivera, Shanna Ratnesar-Shumate, St Patrick Reid, Daniel N. Ackerman, Paul W. Denton, Jacob W.S. Martens, Ying Fang, Nicholas Conoan, Michael V. Callahan, James V. Lawler, David M. Brett-Major, John J. Lowe

Research output: Contribution to journalArticlepeer-review

65 Scopus citations


Background: Aerosol transmission of COVID-19 is the subject of ongoing policy debate. Characterizing aerosol produced by people with COVID-19 is critical to understanding the role of aerosols in transmission. Objective: We investigated the presence of virus in size-fractioned aerosols from six COVID-19 patients admitted into mixed acuity wards in April of 2020. Methods: Size-fractionated aerosol samples and aerosol size distributions were collected from COVID-19 positive patients. Aerosol samples were analyzed for viral RNA, positive samples were cultured in Vero E6 cells. Serial RT-PCR of cells indicated samples where viral replication was likely occurring. Viral presence was also investigated by western blot and transmission electron microscopy (TEM). Results: SARS-CoV-2 RNA was detected by rRT-PCR in all samples. Three samples confidently indicated the presence of viral replication, all of which were from collected sub-micron aerosol. Western blot indicated the presence of viral proteins in all but one of these samples, and intact virions were observed by TEM in one sample. Significance: Observations of viral replication in the culture of submicron aerosol samples provides additional evidence that airborne transmission of COVID-19 is possible. These results support the use of efficient respiratory protection in both healthcare and by the public to limit transmission.

Original languageEnglish (US)
Pages (from-to)706-711
Number of pages6
JournalJournal of Exposure Science and Environmental Epidemiology
Issue number5
StatePublished - Sep 2022


  • SARS-CoV-2
  • aerosol transmission
  • human-generated aerosol
  • viral aerosol

ASJC Scopus subject areas

  • Epidemiology
  • Toxicology
  • Pollution
  • Public Health, Environmental and Occupational Health


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