Evaluation for the Presence of SARS-CoV-2 in CO2 Laser Plume.

ImportanceSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly infectious virus that has been reported to be transmitted via aerosolization and other aerosol-generating activities. However, viral plumes from CO2 lasers have yet to be investigated.ObjectiveEvaluate the viability of SARS-CoV-2 in the CO2 laser plume in a porcine model for laryngeal surgery.DesignExperimental studies.SettingLaboratory.ParticipantsWild-type SARS-CoV-2 (Wt), Omicron SARS-CoV-2 (Omicron), and fluorescent SARS-CoV-2 (GFP).InterventionThree viral strains on porcine larynx exposed to CO2 laser setting-1.5, 7, and 15 W.Main Outcome MeasuresThe laser plume was collected during ablation. Dilutant of the plume was then applied to Vero E6 cells for culture; quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR) (in duplicate) and fluoroscopy were used to establish the presence of viable virus.ResultsWt, Omicron, and GFP strains were found to be present on the larynx before and after the application of the laser by qPCR copies (cp) per microliter (µl). After ablation with 1.5, 7.0, and 15 W with Wt, the plume samples were shown to be 0, 0, and <10 cp/µl, respectively. For GFP, at all intensity levels, the copies were less than 10 cp/µl. Omicron did not show any copies at any of the power levels. Cultures did not show the presence of viable Wt, Omicron, and GFP strains in any of the collected laser plumes.ConclusionThe CO2 laser plume of SARS-CoV-2 aerosolized minimal viral particles. None of the tested experimental conditions demonstrated a viable virus after laryngeal ablation with the CO2 laser.RelevanceCO2 laser use in the context of virus SARS-CoV-2 suggests minimal transmission risks associated with CO2 laser procedures when appropriate safety protocols are followed.