Detection of Severe Acute Respiratory Syndrome Coronavirus 2 RNA on Surfaces in Quarantine Rooms

Fa-Chun Jiang; Xiao-Lin Jiang; Zhao-Guo Wang; Zhao-Hai Meng; Shou-Feng Shao; Benjamin D. Anderson; Mai-Juan Ma

Emerging Infectious Diseases. 2020;26(9):2162-2164.

Abstract and Introduction

Abstract

We investigated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) environmental contamination in 2 rooms of a quarantine hotel after 2 presymptomatic persons who stayed there were laboratory-confirmed as having coronavirus disease. We detected SARS-CoV-2 RNA on 8 (36%) of 22 surfaces, as well as on the pillow cover, sheet, and duvet cover.

Introduction

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread globally and, as of May 2, 2020, had caused >3 million confirmed coronavirus disease cases.^[1] Although SARS-CoV-2 transmission through respiratory droplets and direct contact is clear, the potential for transmission through contact with surfaces or objects contaminated with SARS-CoV-2 is poorly understood.^[2] The virus can be detected on various surfaces in the contaminated environment from symptomatic and paucisymptomatic patients.^[3,4] Moreover, we recently reported detection of SARS-CoV-2 RNA on environmental surfaces of a symptomatic patient's household.^[5] Because SARS-CoV-2 remains viable and infectious from hours to days on surfaces,^[6,7] contact with a contaminated surface potentially could be a medium for virus transmission. In addition, high viral load in throat swab specimens at symptom onset^[8,9] and peak infectiousness at 0–2 days for presymptomatic patients^[8] suggest that presymptomatic patients may easily contaminate the environment. However, data are limited on environmental contamination of SARS-CoV-2 by patients who may be presymptomatic. Therefore, to test this hypothesis, we examined the presence of SARS-CoV-2 RNA in collected environmental surface swab specimens from 2 rooms of a centralized quarantine hotel where 2 presymptomatic patients had stayed.

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Next Section

Abstract and Introduction
The Study
Conclusions
References

Table 1. Timeline from return to China by 2 persons with presymptomatic SARS-CoV-2 infection to results of environmental sampling of their rooms at a centralized quarantine hotel, 2020*
Characteristic	Patient A	Patient B
Date returned to China	19 Mar	20 Mar
Date entered quarantine	19 Mar	21 Mar
Date of SARS-CoV-2 RNA–positive detection	20 Mar	22 Mar
Date of environmental surface sampling	20 Mar	22 Mar
Symptoms at hospital admission	None	None
C_t for clinical samples at admission†
Nasopharyngeal swab	24.72	27.87
Sputum	28.61	23.23
Fecal swab	33.12	NA
Symptoms during hospitalization	Fever, chills, cough	Fever, cough, sputum, sore throat
Disease severity	Mild	Moderate

*C_t, cycle threshold; NA, not available; rRT-PCR, real-time reverse transcription PCR; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.
†A lower C_t indicates a higher viral load. Only C_t values for open reading frame1ab (ORFab1) gene of SARS-CoV-2 were provided in the table because the Ct values for nucleoprotein were similar to values of ORFab1.

Table 2. Results of environmental sampling of 2 rooms at a centralized quarantine hotel occupied by 2 presymptomatic SARS-CoV-2–infected patients, China, 2020*
Environmental source†	Values‡
Environmental source†	Patient A's room	Patient B's room
Door handle	0/1	0/1
Light switch	1/1 (37.59)	0/1
Faucet	0/1	1/1 (28.75)
Bathroom door handle	1/1 (36.02)	0/1
Toilet seat, flush handle	0/1	0/1
Thermometer	0/1	0/1
TV remote	0/1	0/1
Pillow cover	1/1 (28.98)	1/1 (34.57)
Duvet cover	1/1 (35.64)	0/1
Sheet	1/1 (30.58)	0/1
Towel	1/1 (36.98)	0/1
Total, no. (%)	6/11 (54.5)	2/11 (18.2)

*Values are no. positive/total (C_t) except as indicated. C_t, cycle threshold; rRT-PCR, real-time reverse transcription PCR; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.
†One swab was taken from each site except the light switch, from which 2 swabs were taken.
‡All samples taken from patients A and B after disinfection were negative and not included in this table. A lower C_t indicates a higher viral load. Only C_t values for open reading frame 1ab (ORFab1) gene of SARS-CoV-2 were provided because the C_t values for nucleoprotein were similar to those of ORFab1.