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Exhaled aerosol increases with COVID-19 infection, age, and obesity

Author(s)
Edwards, David A.; Ausiello, Dennis; Salzman, Jonathan; Devlin, Tom; Langer, Robert S; Beddingfield, Brandon J.; Fears, Alyssa C.; Doyle-Meyers, Lara A.; Redmann, Rachel K.; Killeen, Stephanie Z.; Maness, Nicholas J.; Roy, Chad J.; ... Show more Show less
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Abstract
COVID-19 transmits by droplets generated from surfaces of airway mucus during processes of respiration within hosts infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. We studied respiratory droplet generation and exhalation in human and nonhuman primate subjects with and without COVID-19 infection to explore whether SARS-CoV-2 infection, and other changes in physiological state, translate into observable evolution of numbers and sizes of exhaled respiratory droplets in healthy and diseased subjects. In our observational cohort study of the exhaled breath particles of 194 healthy human subjects, and in our experimental infection study of eight nonhuman primates infected, by aerosol, with SARS-CoV-2, we found that exhaled aerosol particles vary between subjects by three orders of magnitude, with exhaled respiratory droplet number increasing with degree of COVID-19 infection and elevated BMI-years. We observed that 18% of human subjects (35) accounted for 80% of the exhaled bioaerosol of the group (194), reflecting a superspreader distribution of bioaerosol analogous to a classical 20:80 superspreader of infection distribution. These findings suggest that quantitative assessment and control of exhaled aerosol may be critical to slowing the airborne spread of COVID-19 in the absence of an effective and widely disseminated vaccine.
Date issued
2021-02
URI
https://hdl.handle.net/1721.1/130144
Department
Massachusetts Institute of Technology. Department of Chemical Engineering; Massachusetts Institute of Technology. Department of Biological Engineering
Journal
Proceedings of the National Academy of Sciences
Publisher
Proceedings of the National Academy of Sciences
Citation
Edwards, David A. et al. "Exhaled aerosol increases with COVID-19 infection, age, and obesity." Proceedings of the National Academy of Sciences 118, 8 (February 2021): e2021830118. © 2021 National Academy of Sciences
Version: Final published version
ISSN
1091-6490

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