Distribution of SARS-CoV-2 RNA Signal in a Home with COVID-19 Positive Occupants

Although many COVID-19 patients quarantine and recover at home, the dispersal of SARS-CoV-2 onto surfaces and dust within the home environment remains poorly understood. To investigate the distribution and persistence of SARS-CoV-2 in a quarantine home, samples were collected from a household with two confirmed COVID-19 cases (one adult and one child). Home surface swab and dust samples were collected two months after symptom onset (and one month after symptom resolution) in the household. The strength of the SARS-CoV-2 molecular signal in fomites varied as a function of sample location, surface material and cleaning practices. Notably, the SARS-CoV-2 RNA signal was detected at several locations throughout the household although cleaning appears to have attenuated the signal on many surfaces. Of the 24 surfaces sampled, 46% were SARS-CoV-2 positive at the time of sampling. The SARS-CoV-2 concentrations in dust recovered from floor and HVAC filter samples ranged from 104-105 N2 gene copies/g dust. While detection of viral RNA does not imply infectivity, this study confirms that the SARS-CoV-2 RNA signal can be detected at several locations within a COVID-19 quarantine home and can persist after symptoms have resolved. In addition, the concentration of SARS-CoV-2 (normalized per unit mass of dust) recovered in home HVAC filters may prove useful for estimating SARS-CoV-2 airborne levels in homes.This work was supported by Whole Communities-Whole Health, a research grand challenge at the University of Texas at Austin. In addition, the work that provided the basis for this publication was also supported by funding under an award TXHHU0046-18 with the U.S. Department of Housing and Urban Development.Office of the VP for Researc

Ten Questions Concerning the Built Environment and Mental Health

Most people spend the majority of their lives indoors. Research over the last thirty years has focused on investigating the mechanisms through which specific elements of the built environment, such as indoor air quality, influence the physical health of occupants. However, similar effort has not been expended in regard to mental health, a significant public health concern. One in five Americans has been diagnosed with a mental health disorder in the past year, and, in the United States, the number of suicide deaths are similar to the number of deaths due to breast cancer. Increases in mental health disorders in Western societies may be due, in part, to increased systemic inflammation, secondary to decreased exposures to a diverse microbial environment (i.e., the hygiene hypothesis, “Old Friends” hypothesis, “missing microbes” hypothesis, or biodiversity hypothesis), as well as increased environmental exposures that lead to chronic low-grade inflammation. In this review, we provide an assessment that integrates historical research across disciplines. We offer ten questions that highlight the importance of current lessons learned regarding the built environment and mental health, including a potential role for the microbiome of the built environment to influence mental health. Suggested areas for future investigation are also highlighted

Treatment of Produced Waters Using a Surfactant Modified Zeolite/Vapor Phase Bioreactor System

Co-produced water from the oil and gas industry accounts for a significant waste stream in the United States. It is by some estimates the largest single waste stream in the country, aside from nonhazardous industrial wastes. Characteristics of produced water include high total dissolved solids content, dissolved organic constituents such as benzene and toluene, an oil and grease component, and chemicals added during the oil-production process. While most of the produced water is disposed via reinjection, some of them must be treated to remove organic constituents before the water is discharged. Current treatment options are successful in reducing the organic content; however, they cannot always meet the levels of current or proposed regulations for discharged water. Therefore, an efficient, cost-effective treatment technology is needed. Surfactant-modified zeolite (SMZ) has been used successfully to treat contaminated ground water for organic and inorganic constituents. In addition, the low cost of natural zeolites makes their use attractive in water-treatment applications. Our previous DOE research work (DE-AC26-99BC15221) demonstrated that SMZ could successfully remove BTEX compounds from the produced water. In addition, SMZ could be regenerated through a simple air sparging process. The primary goal of this project is to develop a robust SMZ/VPB treatment system to efficiently remove the organic constituents from produced water in a cost-effective manner. This report summarizes work of this project from October 2002 to March 2003. In this starting stage of this study, we have continued our investigation of SMZ regeneration from our previous DOE project. Two saturation/stripping cycles have been completed for SMZ columns saturated with BTEX compounds. Preliminary results suggest that BTEX sorption actually increases with the number of saturation/regeneration cycles. Furthermore, the experimental vapor phase bioreactors for this project have been designed and are currently being assembled to treat the off-gas from the SMZ regeneration process

Longitudinal Homogenization of the Microbiome between Both Occupants and the Built Environment in a Cohort of United States Air Force Cadets

The microbiome of the built environment has important implications for human health and wellbeing; however, bidirectional exchange of microbes between occupants and surfaces can be confounded by lifestyle, architecture, and external environmental exposures. Here, we present a longitudinal study of United States Air Force Academy cadets (n = 34), which have substantial homogeneity in lifestyle, diet, and age, all factors that influence the human microbiome. We characterized bacterial communities associated with (1) skin and gut samples from roommate pairs, (2) four built environment sample locations inside the pairs’ dormitory rooms, (3) four built environment sample locations within shared spaces in the dormitory, and (4) room-matched outdoor samples from the window ledge of their rooms

Multi-Modal Data Collection for Measuring Health, Behavior, and Living Environment of Large-Scale Participant Cohorts: Conceptual Framework and Findings from Deployments

As mobile technologies become ever more sensor-rich, portable, and ubiquitous, data captured by smart devices are lending rich insights into users' daily lives with unprecedented comprehensiveness, unobtrusiveness, and ecological validity. A number of human-subject studies have been conducted in the past decade to examine the use of mobile sensing to uncover individual behavioral patterns and health outcomes. While understanding health and behavior is the focus for most of these studies, we find that minimal attention has been placed on measuring personal environments, especially together with other human-centric data modalities. Moreover, the participant cohort size in most existing studies falls well below a few hundred, leaving questions open about the reliability of findings on the relations between mobile sensing signals and human outcomes. To address these limitations, we developed a home environment sensor kit for continuous indoor air quality tracking and deployed it in conjunction with established mobile sensing and experience sampling techniques in a cohort study of up to 1584 student participants per data type for 3 weeks at a major research university in the United States. In this paper, we begin by proposing a conceptual framework that systematically organizes human-centric data modalities by their temporal coverage and spatial freedom. Then we report our study design and procedure, technologies and methods deployed, descriptive statistics of the collected data, and results from our extensive exploratory analyses. Our novel data, conceptual development, and analytical findings provide important guidance for data collection and hypothesis generation in future human-centric sensing studies.This work was supported by Whole Communities—Whole Health, a research grand challenge at the University of Texas at Austin, and National Science Foundation Award SES-1758835.Office of the VP for Researc

Treatment of Produced Waters Using a Surfactant Modified Zeolite/Vapor Phase Bioreactor System

This report summarizes work performed on this project from April 2005 through September 2005. In previous work, a series of laboratory scale experiments were conducted to determine the feasibility of using a SMZ system coupled with a VPB to remove and ultimately destroy the organic pollutants found in produced water. Based on the laboratory scale data, a field test of the process was conducted at the McGrath Salt Water Disposal facility in July and August of 2005. The system performed well over repeated feed and regeneration cycles demonstrating the viability of the process for long term operation. Of the BTEX components present in the produced water, benzene had the lowest adsorption affinity for the SMZ and thus controlled the sorption cycle length. Regeneration of the SMZ using air sparging was found to be sufficient in the field to maintain the SMZ adsorption capacity and to allow continuous operation of the system. As expected, the BTEX concentrations in the regeneration off gas stream were initially very high in a given regeneration cycle. However, a granular activated carbon buffering column placed upstream of the VPB reduced the peak BTEX concentrations to acceptable levels for the VPB. In this way, the VPB was able to maintain stable performance over the entire SMZ regeneration period despite the intermittent nature of the feed

Treatment of Produced Water Using a Surfactant Modified Zeolite/Vapor Phase Bioreactor System

Co-produced water from the oil and gas industry accounts for a significant waste stream in the United States. Produced waters typically contain a high total dissolved solids content, dissolved organic constituents such as benzene and toluene, an oil and grease component as well as chemicals added during the oil-production process. It has been estimated that a total of 14 billion barrels of produced water were generated in 2002 from onshore operations (Veil, 2004). Although much of this produced water is disposed via reinjection, environmental and cost considerations can make surface discharge of this water a more practical means of disposal. In addition, reinjection is not always a feasible option because of geographic, economic, or regulatory considerations. In these situations, it may be desirable, and often necessary from a regulatory viewpoint, to treat produced water before discharge. It may also be feasible to treat waters that slightly exceed regulatory limits for re-use in arid or drought-prone areas, rather than losing them to reinjection. A previous project conducted under DOE Contract DE-AC26-99BC15221 demonstrated that surfactant modified zeolite (SMZ) represents a potential treatment technology for produced water containing BTEX. Laboratory and field experiments suggest that: (1) sorption of benzene, toluene, ethylbenzene and xylenes (BTEX) to SMZ follows linear isotherms in which sorption increases with increasing solute hydrophobicity; (2) the presence of high salt concentrations substantially increases the capacity of the SMZ for BTEX; (3) competitive sorption among the BTEX compounds is negligible; and, (4) complete recovery of the SMZ sorption capacity for BTEX can be achieved by air sparging the SMZ. This report summarizes research for a follow on project to optimize the regeneration process for multiple sorption/regeneration cycles, and to develop and incorporate a vapor phase bioreactor (VPB) system for treatment of the off-gas generated during air sparging. To this end, we conducted batch and column laboratory SMZ and VPB experiments with synthetic and actual produced waters. Based on the results of the laboratory testing, a pilot scale study was designed and conducted to evaluate the combined SMZ/VPB process. An economic and regulatory feasibility analysis was also completed as part of the current study to assess the viability of the process for various water re-use options

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570