Differential aerosol shedding of SARS-CoV-2 Delta and Omicron variants during respiratory activities (preprint)

Data on the viral loads in respiratory aerosols from patients infected with Delta and Omicron variants are limited. In this study, we used an exhaled breath bioaerosol collector to collect aerosol samples in coarse (> 5µm) and fine (≤ 5µm) fractions from COVID-19 patients infected with these VOCs while doing various respiratory activities. Samples were tested via SARS-CoV-2 RT-qPCR and virus culture. Nine patients (4 Delta and 5 Omicron) were included. Viral RNA was detectable in seven participants, with greater viral loads in fine aerosols. Notably SARS-CoV-2 RNA was consistently detectable in respiratory samples of all Omicron patients despite them being fully vaccinated and mostly asymptomatic in contrast with Delta patients. Singing and talking without mask generated the greatest viral loads underscoring the transmission potential of SARS-CoV-2 and its variants via respiratory aerosols. The more consistent detection of viral RNA in Omicron-infected patients may account for its greater transmissibility.

Viral Load of SARS-CoV-2 in Respiratory Aerosols Emitted by COVID-19 Patients while Breathing, Talking, and Singing (preprint)

Background: Multiple SARS-CoV-2 superspreading events suggest that aerosols play an important role in driving the COVID-19 pandemic. However, the detailed roles of coarse (>5m) and fine ([≤]5m) respiratory aerosols produced when breathing, talking, and singing are not well-understood. Methods: Using a G-II exhaled breath collector, we measured viral RNA in coarse and fine respiratory aerosols emitted by COVID-19 patients during 30 minutes of breathing, 15 minutes of talking, and 15 minutes of singing. Results: Among the 22 study participants, 13 (59%) emitted detectable levels of SARS-CoV-2 RNA in respiratory aerosols, including 3 asymptomatic patients and 1 presymptomatic patient. Viral loads ranged from 63 - 5,821 N gene copies per expiratory activity. Patients earlier in illness were more likely to emit detectable RNA, and loads differed significantly between breathing, talking, and singing. The largest proportion of SARS-CoV-2 RNA copies was emitted by singing (53%), followed by talking (41%) and breathing (6%). Overall, fine aerosols constituted 85% of the viral load detected in our study. Virus cultures were negative. Conclusions: Fine aerosols produced by talking and singing contain more SARS-CoV-2 copies than coarse aerosols and may play a significant role in the transmission of SARS-CoV-2. Exposure to fine aerosols should be mitigated, especially in indoor environments where airborne transmission of SARS-CoV-2 is likely to occur. Isolating viable SARS-CoV-2 from respiratory aerosol samples remains challenging, and whether this can be more easily accomplished for emerging SARS-CoV-2 variants is an important enquiry for future studies.