Detection of human coronavirus RNA in surgical smoke generated by surgical devices

<p>Many surgeons use surgical energy devices; high-frequency electrical currents and ultrasonic vibration devices during surgery. Surgical smoke, a gaseous byproduct of the thermal decomposition of tissue by these devices, can be potentially harmful to operating room staff. In fact, numerous studies have indicated that surgical smoke contains toxic substances such as carcinogens, bacteria, malignant cells, and viruses. Coronavirus infection 2019 (COVID-19) caused by coronavirus SARS-CoV-2 is a pandemic, as viral RNA has been detected in respiratory, fecal, and serum samples from the patients, surgeons of all types may be exposed to this virus during surgery exposure to the virus. This virus can be transmitted via surgical smoke aerosol, however there is currently insufficient information to assess the risk of SARS-CoV-2 transmission via surgical smoke. Therefore, we demonstrated the presence and infectivity of human coronavirus RNA in surgical smoke in a model experiment and evaluate the possibility of reducing the risk of infection by filtration with surgical masks. In our model, 1/10⁶ to 1/10⁵ of the viral RNA in the incision target was detected in the surgical smoke collected. Viruses in the smoke were also unable to induce plaque formation in cultured cells, however the surgical smoke generated by the ultrasonic scalpel retained human coronavirus RNA in the culture supernatant, with some infectivity observed. Filtering surgical smoke with surgical masks effectively reduced the amount of viral RNA by more than 99.80%. This study demonstrated that surgical mask filtration should provide adequate additional protection against potential transmission of coronaviruses, including SARS-CoV-2, facilitated by surgical smoke.</p>