Abstract
At the end of 2019, a variation of a coronavirus, named SARS-CoV-2, has been identified as being responsible for a respiratory illness disease (COVID-19). Since ventilation is an important factor that influences airborne transmission, we proposed to study the impact of heating, ventilation and air-conditioning (HVAC) with a variable air volume (VAV) primary air system, on the dispersion of infectious aerosols, in a cardiac intensive care unit, using a transient simulation with computational fluid dynamics (CFD), based on the finite element method (FEM). We analyzed three scenarios that followed the dispersion of pathogen carrying expiratory droplets particles from coughing, from patients possibly infected with COVID-19, depending on the location of the patients in the intensive care unit. Our study provides the mechanism for spread of infectious aerosols, and possibly of COVID-19 infection, by air conditioning systems and also highlights important recommendations for disease control and optimization of ventilation in intensive care units, by increasing the use of outdoor air and the rate of air change, decreasing the recirculation of air and using high-efficiency particulate air (HEPA) filters. The CFD-FEM simulation approach that was applied in our study could also be extended to other targets, such as public transport, theaters, philharmonics and amphitheaters from educational units.
Highlights
Hospital-acquired respiratory tract infections, known as nosocomial respiratory tract infections, have proven to be a challenge and sometimes a tragic problem for the practitioner
Considering the small number of studies that evaluated the severe acute respiratory syndrome (SARS)-CoV-2 transmission in medical departments, we aimed to evaluate the impact of heating, ventilation and air-conditioning (HVAC) systems on the dispersion of infectious aerosols, and possibly of COVID-19 transmission, in a cardiac intensive care unit
Considering the worldwide spread of the SARS-CoV-2 infection, the large number of infected people and deaths, we consider that it is critical to understand the modes of transmission of SARS-CoV-2, in order to develop effective prevention and control strategies. In this clinical and epidemiological context, we proposed to study the impact of heating, ventilation and air-conditioning with a variable air volume (VAV) primary air system on the dispersion of infectious aerosols, and possibly on COVID-19 transmission, in a cardiac intensive care unit
Summary
Hospital-acquired respiratory tract infections, known as nosocomial respiratory tract infections, have proven to be a challenge and sometimes a tragic problem for the practitioner. They can be caused by a variety of viruses that spread through three different routes: contact (direct and indirect), droplet and aerosol transmission [1,2]. Transmission by direct contact means that, from an infected patient to a susceptible person, the virus spreads through contaminated hands, for example. The virus can be transmitted via the air, droplets or aerosols [3,4,5].
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