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Spatial and temporal effects on SARS-CoV-2 contamination of the healthcare environment.

BACKGROUND
The spatial and temporal extent of SARS-CoV-2 environmental contamination has not been precisely defined. We sought to elucidate contamination of different surface types and how contamination changes over time.


METHODS
We sampled surfaces longitudinally within COVID-19 patient rooms, performed quantitative RT-PCR for the detection of SARS-CoV-2 RNA, and modeled distance, time, and severity of illness on the probability of detecting SARS-CoV-2 using a mixed-effects binomial model.


RESULTS
The probability of detecting SARS-CoV-2 RNA in a patient room did not vary with distance. However, we found that surface type predicted probability of detection, with floors and high-touch surfaces having the highest probability of detection (floors odds ratio (OR) 67.8 (95% CrI 36.3 to 131); high-touch elevated OR 7.39 (95% CrI 4.31 to 13.1)). Increased surface contamination was observed in room where patients required high-flow oxygen, positive airway pressure, or mechanical ventilation (OR 1.6 (95% CrI 1.03 to 2.53)). The probability of elevated surface contamination decayed with prolonged hospitalization, but the probability of floor detection increased with duration of the local pandemic wave.


CONCLUSIONS
Distance from patient's bed did not predict SARS-CoV-2 RNA deposition in patient rooms, but surface type, severity of illness, and time from local pandemic wave predicted surface deposition.