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Summary: Background: The coronavirus disease 2019 (COVID-19) continues to spread around the world. In addition to community-acquired infections, nosocomial infections are also a major social concern. The likelihood of environmental contamination and transmission of the virus based on disease severity is unknown. Methods: We collected nasopharyngeal, environmental and air samples from patients with COVID-19 admitted to the National Centre for Global Health and Medicine between January 29th and February 29th, 2020. The patients were classified by severity of disease. The collected samples were tested using severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) real-time reverse transcription polymerase chain reaction (real-time RT-PCR). Results: SARS-CoV-2 was not detected in a subset of 11 air samples. Of the 141 environmental samples collected from three patient bays and two single rooms, four samples tested positive for SARS-CoV-2 by real-time RT-PCR. Detections were made on the surface of a stethoscope used in the care of a patient with severe disease, on the intubation tube of a patient classified as critical (and on ventilator management), and on the surface of a gown worn by the nurse providing care. Conclusions: Regardless of the patients' disease severity, SARS-CoV-2 was detected on very few environmental surfaces. However, detection of SARS-CoV-2 on stethoscopes used in the care of multiple patients and on the surface of gowns worn by clinical staff indicates that medical devices may be linked to the spread of infection.

Summary: Introduction: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has spready globally. This report describes the person-to-person transmission of the virus in a hospital setting. Presentation of case: A 63-year-old man with pneumonia and a 70-year-old man without symptoms were admitted to a tertiary hospital with SARS-CoV-2 infection. Both men were accompanied by their wives, who stayed with their husbands during their hospitalisation. The wives of Patient 1 and Patient 2 tested positive and negative for SARS-CoV-2, respectively. Of the environmental samples tested, 1/21 and 0/25 from the rooms of Patient 1 and Patient 2, respectively, tested positive for SARS-CoV-2. Patient 1’s wife appeared to have acquired infection during her husband’s hospitalisation. Discussion: The study had several limitations, including methodology inconsistencies. Additionally, a viral culture was not performed to demonstrate the viability of the virus identified in the environmental sample. Finally, the wife of Patient 1 stayed on the Diamond Princess cruise ship for 4 days before being transferred to the hospital and may have been infected on the ship and not while in the hospital. Conclusion: Our study suggests that airborne transmission of SARS-CoV-2 may be limited. However, owing to the abovementioned limitations, the results should be interpreted with caution.