The Spread of COVID-19 Through Aerosolization

As of September 1, 2020, this article/literature list is no longer being actively updated.  If noteworthy studies are released in the future, those may be posted on a case-by-case basis. If you have any questions please contact Kaitlyn Sevarino at

Under no circumstances should this list be viewed as AAOS concurring with or endorsing of the study findings, nor has AAOS conducted a systematic review of all surgical literature relevant to COVID-19. The study authors, designs, and data have not been assessed for risk of bias, quality, or accuracy, respectively. Healthcare providers should rely on their own clinical judgment in review and use of these materials.

  1. Bianco F, Incollingo P, Grossi U, Gallo G. Preventing transmission among operating room staff during COVID-19 pandemic: the role of the aerosol box and other personal protective equipment. Updates Surg.
  2. Martin C, Kloka J, Lotz G, Zacharowski K, Raimann FJ. The Frankfurt COVid aErosol pRotEction Dome – COVERED - a consideration for personal protective equipment improvement and technical note. Anaesth Crit Care Pain Med.
  3. Soma M, Jacobson I, Brewer J, Blondin A, Davidson G, Singham S. Operative team checklist for aerosol generating procedures to minimise exposure of healthcare workers to SARS-CoV-2. Int J Pediatr Otorhinolaryngol. 2020;134.
  4. Anon, J. B., Denne, C., Rees, D. Patient-Worn Enhanced Protection Face Shield for Flexible Endoscopy. Otolaryngol Head Neck Surg 2020; 0: 194599820934777
  5. Bryant, J., Tobias, J. D. Enclosure with augmented airflow to decrease risk of exposure to aerosolized pathogens including coronavirus during endotracheal intubation. Can the reduction in aerosolized particles be quantified?. Paediatr Anaesth 2020; 0:
  6. Chen, J. X., Workman, A. D., Chari, D. A., Jung, D. H., Kozin, E., Lee, D. J., Welling, D. B., Bleier, B. S., Quesnel, A. M. Demonstration and mitigation of aerosol and particle dispersion during mastoidectomy relevant to the COVID-19 era. Otol Neurotol 2020; 0:
  7. Lai, Y. Y., Chang, C. M. A carton-made protective shield for suspicious/confirmed COVID-19 intubation and extubation during surgery. 2020; 0:
  8. Leonard, Scott, Atwood, Charles W., Walsh, Brian K., DeBellis, Ronald J., Dungan, George C., Strasser, Wayne, Whittle, Jessica S. Preliminary Findings of Control of Dispersion of Aerosols and Droplets during High Velocity Nasal Insufflation Therapy Using a Simple Surgical Mask: Implications for High Flow Nasal Cannula. Chest 2020; 0:
  9. Liu, Yuan, Ning, Zhi, Chen, Yu, Guo, Ming, Liu, Yingle, Gali, Nirmal Kumar, Sun, Li, Duan, Yusen, Cai, Jing, Westerdahl, Dane, Liu, Xinjin, Xu, Ke, Ho, Kin-fai, Kan, Haidong, Fu, Qingyan, Lan, Ke Aerodynamic analysis of SARS-CoV-2 in two Wuhan hospitals. Nature 2020; 0:
  10. Tran, K., Cimon, K., Severn, M., Pessoa-Silva, C. L., Conly, J. Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: a systematic review. PLoS One 2012; 4: e35797
  11. Workman, A. D., Welling, D. B., Carter, B. S., Curry, W. T., Holbrook, E. H., Gray, S. T., Scangas, G. A., Bleier, B. S. Endonasal instrumentation and aerosolization risk in the era of COVID-19: simulation, literature review, and proposed mitigation strategies. Int Forum Allergy Rhinol 2020; 0: