ABSTRACT
Introduction: Current epidemiologic predictions of COVID- 19 suggest SARS-CoV-2 mitigation strategies must be implemented long term. In-office aerosol-generating procedures (AGPs) pose a risk to staff and patients while also necessitating exam room shutdown to allow aerosol decontamination by indwelling ventilation. This review summarizes the current state of knowledge on portable high-efficiency particulate air (HEPA) purifiers' effectiveness in eliminating airborne SARSCoV- 2 from indoor environments. Method: Medline, Embase, Cochrane databases, and the World Health Organization COVID-19 Global literature on coronavirus disease were systematically searched for original English-language published studies on (“HEPA” OR “Purifier” OR “Filter” OR “Cleaner” OR 'Filtration) AND (“COVID” OR “COVID-19” OR “SARS-CoV-2” OR “Coronavirus”) indexed up to January 14, 2021. Additional relevant studies were identified by searching the reference lists of included articles. Two authors (D.T.L. and A.R.S.) independently reviewed abstracts and full-text studies. Results: Ten published studies have evaluated the effectiveness of portable HEPA purifiers in eliminating airborne SARS-CoV-2 using relevantly sized surrogate particles. Nine studies evaluated aerosols and submicron particles similar in size to SARS-CoV-2 virions, while 1 study evaluated particles with diameters up to the submillimeter range. In all studies, portable HEPA purifiers were able to significantly reduce airborne SARS-CoV-2-surrogate particles. The addition of portable HEPA purifiers augmented other decontamination strategies such as ventilation. Conclusion: Experimental studies provide evidence for portable HEPA air purifiers' potential to eliminate airborne SARS-CoV-2 and augment primary decontamination strategies such as ventilation. Based on filtration rates, additional air exchanges provided by portable HEPA purifiers may be calculated and room shutdown times after AGPs potentially reduced.