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)
Pages (from-to)706-711
Number of pages6
JournalJournal of Exposure Science and Environmental Epidemiology
Issue number5
Early online dateAug 18 2021
StatePublished - Sep 2022


  • 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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