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Can Air-Conditioning Systems Contribute to the Spread of SARS/MERS/COVID-19 Infection? Insights from a Rapid Review of the Literature

Author

Listed:
  • Francesco Chirico

    (Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
    Health Service Department, State Police, Ministry of Interior, 20125 Milan, Italy)

  • Angelo Sacco

    (Local Healthcare Unit Roma 2, 00155 Roma, Italy)

  • Nicola Luigi Bragazzi

    (Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON M3J 1P3, Canada)

  • Nicola Magnavita

    (Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
    Department of Woman/Child & Public Health, Fondazione Policlinico A. Gemelli IRCCS, 00168 Roma, Italy)

Abstract

The airborne transmission of SARS-CoV-2 is still debated. The aim of this rapid review is to evaluate the COVID-19 risk associated with the presence of air-conditioning systems. Original studies (both observational and experimental researches) written in English and with no limit on time, on the airborne transmission of SARS-CoV, MERS-CoV, and SARS-CoV-2 coronaviruses that were associated with outbreaks, were included. Searches were made on PubMed/MEDLINE, PubMed Central (PMC), Google Scholar databases, and medRxiv. A snowball strategy was adopted to extend the search. Fourteen studies reporting outbreaks of coronavirus infection associated with the air-conditioning systems were included. All studies were carried out in the Far East. In six out the seven studies on SARS, the role of Heating, Ventilation, and Air Conditioning (HVAC) in the outbreak was indirectly proven by the spatial and temporal pattern of cases, or by airflow-dynamics models. In one report on MERS, the contamination of HVAC by viral particles was demonstrated. In four out of the six studies on SARS-CoV-2, the diffusion of viral particles through HVAC was suspected or supported by computer simulation. In conclusion, there is sufficient evidence of the airborne transmission of coronaviruses in previous Asian outbreaks, and this has been taken into account in the guidelines released by organizations and international agencies for controlling the spread of SARS-CoV-2 in indoor environments. However, the technological differences in HVAC systems prevent the generalization of the results on a worldwide basis. The few COVID-19 investigations available do not provide sufficient evidence that the SARS-CoV-2 virus can be transmitted by HVAC systems.

Suggested Citation

  • Francesco Chirico & Angelo Sacco & Nicola Luigi Bragazzi & Nicola Magnavita, 2020. "Can Air-Conditioning Systems Contribute to the Spread of SARS/MERS/COVID-19 Infection? Insights from a Rapid Review of the Literature," IJERPH, MDPI, vol. 17(17), pages 1-11, August.
  • Handle: RePEc:gam:jijerp:v:17:y:2020:i:17:p:6052-:d:401509
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    Citations

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    Cited by:

    1. Nicola Magnavita & Paolo Maurizio Soave & Walter Ricciardi & Massimo Antonelli, 2020. "Occupational Stress and Mental Health among Anesthetists during the COVID-19 Pandemic," IJERPH, MDPI, vol. 17(21), pages 1-14, November.
    2. Zhuona Zhang & Xia Li & Qin Wang & Xiaoning Zhao & Jin Xu & Qinqin Jiang & Sili Jiang & Jiayun Lyu & Shiqiang Liu & Ling Ye & Jun Yuan & Wenru Feng & Jiamin Xie & Qiuling Chen & Haoming Zou & Dongqun , 2022. "Simulation Studies Provide Evidence of Aerosol Transmission of SARS-CoV-2 in a Multi-Story Building via Air Supply, Exhaust and Sanitary Pipelines," IJERPH, MDPI, vol. 19(3), pages 1-11, January.
    3. Nicola Magnavita & Paolo Maurizio Soave & Massimo Antonelli, 2021. "A One-Year Prospective Study of Work-Related Mental Health in the Intensivists of a COVID-19 Hub Hospital," IJERPH, MDPI, vol. 18(18), pages 1-12, September.
    4. Mehran Alijanzadeh & Daniel Kwasi Ahorsu & Zainab Alimoradi & Narges Mahmoudi & Mark D. Griffiths & Chung-Ying Lin & Hsien-Kuan Liu & Amir H. Pakpour, 2021. "Fear of COVID-19 and Trust in the Healthcare System Mediates the Association between Individual’s Risk Perception and Preventive COVID-19 Behaviours among Iranians," IJERPH, MDPI, vol. 18(22), pages 1-9, November.
    5. Simon Li, 2023. "Review of Engineering Controls for Indoor Air Quality: A Systems Design Perspective," Sustainability, MDPI, vol. 15(19), pages 1-46, September.

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