Respiratory system-the port of entry of SARS-COV-2 with special reference to aerosol management

The outbreak of novel coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has led to a global pandemic of unprecedented proportions. Management of patients infected with COVID-19 has led to a great risk of hospital-based transmission of infection to health-care professionals (HCPs). The HCPs at various levels in a multispecialty health-care setup are at risk of contracting the virus. Those who are involved with performing or assisting in aerosol-generating procedures (AGPs) have a potentially higher risk of developing the infection. The AGPs involve a wide range of procedures such as pulmonary function testing, high-flow oxygen administration, endotracheal intubation, nebulization, application of ventilators, weaning and extubation, bronchoscopy, tracheostomy, and cardiopulmonary resuscitation. Hence, understanding the overall nature of the disease is of vital importance to develop preventive strategies to reduce transmission of the virus through aerosols. This review article intends to elucidate the port of entry associated with SARS-CoV-2 infection and its spread through the AGPs. We also intend to focus on methods to prevent aerosol-related transmission of infection to HCPs by illustrating clinically practiced evidence-based protocol followed in our multispecialty health-care setup.