COVID-19 in Space: Possible Health Risks and Preparedness Guidelines

Background The COVID-19 pandemic of 2020 resulted in over 705 million infections and more than 7 million deaths worldwide. The virus primarily spreads through aerosol droplets released during breathing, coughing, or sneezing, leading to symptoms ranging from mild fever and cough to severe outcomes, including death. Given the high risk associated with COVID-19, understanding its behaviour in diverse geographical and environmental conditions is critical. Space exploration and tourism represent an emerging industry, projected to reach a market value of $1.8 trillion. With numerous space missions planned by space agencies such as NASA, SpaceX, and ISRO, it is vital to address potential health risks for astronauts and space tourists.

With the expansion of human exploration into space, there is an urgent need to assess the risks posed by COVID-19 in extraterrestrial environments. This study reviews existing literature on airborne infections in space, identifies key knowledge gaps, and enhances preparedness for potential COVID-19 outbreaks during space missions.

A systematic literature review was conducted to identify studies examining airborne infectious diseases in space and their health effects under microgravity. Databases searched included PubMed and NASA’s Open Data Portal. To compare these findings with Earth-based data, additional systematic reviews were performed to analyze the known effects of these diseases on Earth, using Pathogen Safety Data Sheets. A separate systematic review was conducted using PubMed to explore similarities between COVID-19 and the selected airborne infectious diseases. Using a comparative approach, disease effects observed on Earth and in space were analyzed to predict COVID-19’s potential behavior in microgravity. Existing guidelines for managing airborne diseases in space and on Earth were reviewed and compared to develop a set of preparedness recommendations for COVID-19 in space.

The airborne infectious diseases occurring in space found in this study include Aspergillus fumigatus, Beauveria bassiana, Epstein-Barr Virus (EBV), Escherichia coli, Klebsiella pneumoniae infections, Pseudomonas aeruginosa, Roseolovirus (Human Herpesvirus 6 & 7), Salmonella Typhimurium infection, Serratia marcescens infection, Staphylococcus aureus, Staphylococcus epidermidis, and Varicella-Zoster Virus (VZV). The relationship between the aforementioned diseases and COVID-19 was used in regard to theorizing the effects of COVID-19 in space. Six Tentative effects of COVID-19 in a microgravity environment could be theorized in this study. Along with that, recommendations to improve the current space travel health guidelines have also been referred to.

The results of this study will change the course of human space exploration by assisting in the protection of space travelers and guiding the development of new designs for spacecraft that include extra safety features. Competing Interest Statement The authors have declared no competing interest. Footnotes We plan to submit this manuscript to the Interactive Journal of Medical Research and restructure its abstract and reference style to fit the journal format. In addition, we rephrased the grand acknowledgment and provided its number.