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Review

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

1
Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
2
Health Service Department, State Police, Ministry of Interior, 20125 Milan, Italy
3
Local Healthcare Unit Roma 2, 00155 Roma, Italy
4
Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON M3J 1P3, Canada
5
Department of Woman/Child & Public Health, Fondazione Policlinico A. Gemelli IRCCS, 00168 Roma, Italy
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(17), 6052; https://doi.org/10.3390/ijerph17176052
Received: 21 July 2020 / Revised: 10 August 2020 / Accepted: 18 August 2020 / Published: 20 August 2020
(This article belongs to the Special Issue The COVID-19 Pandemic in Europe: Response to Challenges)
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. View Full-Text
Keywords: outbreak; airborne transmission; SARS-CoV-1; MERS-CoV; SARS-CoV-2; ventilation; prevention; safety; workplace outbreak; airborne transmission; SARS-CoV-1; MERS-CoV; SARS-CoV-2; ventilation; prevention; safety; workplace
MDPI and ACS Style

Chirico, F.; Sacco, A.; Bragazzi, N.L.; Magnavita, N. Can Air-Conditioning Systems Contribute to the Spread of SARS/MERS/COVID-19 Infection? Insights from a Rapid Review of the Literature. Int. J. Environ. Res. Public Health 2020, 17, 6052. https://doi.org/10.3390/ijerph17176052

AMA Style

Chirico F, Sacco A, Bragazzi NL, Magnavita N. Can Air-Conditioning Systems Contribute to the Spread of SARS/MERS/COVID-19 Infection? Insights from a Rapid Review of the Literature. International Journal of Environmental Research and Public Health. 2020; 17(17):6052. https://doi.org/10.3390/ijerph17176052

Chicago/Turabian Style

Chirico, Francesco, Angelo Sacco, Nicola Luigi Bragazzi, and 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" International Journal of Environmental Research and Public Health 17, no. 17: 6052. https://doi.org/10.3390/ijerph17176052

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