In this context the Italian National Healthcare Service was close to collapse. The mortality rate in this region alone with a total of 16,579 deaths, is currently greater than that of China (4646 total deaths Regione Lombardia, 2020 WHO, 2020c). In the following days, in Lombardy, there was a rapid increase in the number of cases. The pandemic broke out and was mainly located in northern Italy with the first Italian COVID-19 patient hospitalized on 21 February 2020 at Codogno Hospital, Lodi (Lombardy-Italy) ( Indolfi and Spaccarotella, 2020). Italy was the first European nation to be affected by COVID-19 with 238,720 confirmed total cases and 34,657 deaths to date ( Fig. On 11 March 2020 the WHO declared the COVID-19 outbreak a global pandemic ( WHO, 2020a). Due to the global spread of COVID-19 various international concerns declared a State of Emergency as COVID-19 was considered to be the third highest pathogenic human coronavirus that had emerged in the last two decades ( WHO, 2020a). Then on 11 February 2020 the World Health Organization (WHO) announced a name for the new coronavirus disease: COVID-19. Subsequently, on 7 January 2020, Chinese authorities confirmed that they had identified a novel virus belonging to the same family of coronaviruses as Severe Acute Respiratory Syndrome (SARS). The chronology of COVID-19 infections is as follows: On 31 December 2019 the coronavirus disease was first reported as a cluster of pneumonia cases of unknown etiology by the Wuhan Municipal Health Commission in Wuhan City, Hubei Province China ( WHO, 2020a). The novel coronavirus, named Severe Acute Respiratory Syndrome Coravirus 2 (SARS-CoV-2), has rapidly progressed worldwide, and the impact on health systems, science, and society is unprecedented ( Torri and Nollo, 2020). These results showed that environmental contamination did not involve clean areas, but the results also support the need for strict disinfection, hand hygiene and protective measures for healthcare workers as well as the need for airborne isolation precautions. All the air samples collected from the contaminated area, namely the intensive care unit and corridor, were positive while viral RNA was not detected in either semi-contaminated or clean areas. The most contaminated surfaces were hand sanitizer dispensers (100.0%), medical equipment (50.0%), medical equipment touch screens (50.0%), shelves for medical equipment (40.0%), bedrails (33.3%), and door handles (25.0%). Thus, the positivity rate was higher in contaminated (35.0%) and semi-contaminated (50.0%) areas than in clean areas (0.0% P<0.05). Overall, 24.3% of swab samples were positive, but none of these were collected in the clean area. SARS-CoV-2 RNA detection was performed using real time reverse transcription polymerase chain reaction. A total of 42 air and surface samples were collected inside five different zones of the ward including contaminated (COVID-19 patients' area), semi-contaminated (undressing room), and clean areas. This study evaluated the contamination of the air and surfaces by SARS-CoV-2 RNA in the COVID-19 isolation ward of a hospital in Milan, Italy. Despite efforts to clarify the virus transmission, especially in indoor scenarios, several aspects of SARS-CoV-2 spread are still rudimentary. Italy is one of the countries hardest hit by the pandemic, resulting in healthcare facilities bearing heavy burdens and severe restrictive measures. The COVID-19 outbreak has rapidly progressed worldwide finding the health system, scientists and society unprepared to face a little-known, fast spreading, and extremely deadly virus.
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