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


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)
JournalJournal of Exposure Science and Environmental Epidemiology
Early online dateAug 18 2021
StateE-pub ahead of print - Aug 18 2021


  • SARS-CoV-2
  • human-generated aerosol
  • viral aerosol
  • aerosol transmission
  • COVID-19

ASJC Scopus subject areas

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


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