Introduction
In early 2020, the pandemic of the coronavirus disease 2019 (COVID-19) surprised health professionals as it was a newly emerged variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This new variant revealed high mortality and severity due to having a higher infectious rate, making viral infection more contagious, transmissibility, and severity. SARS-CoV-2 mutated to an additional variant called omicron (B.1.1.529) [1-4], which was considerably more infectious and transmissible than the previous deadly delta variant [5]. The World Health Organization (WHO) technical advisory group stated omicron is a concerning variant [6]. SARS-CoV-2 transmits via direct or indirect impact, and person-to-person spread is the early mode of virus transmission, mainly via respiratory droplets. The main pathways are respiratory aerosol and close contact, virus-contaminated substances, droplet transmission in locked environments, urine aerosol, feces, or touching the base in toilets [7]. 
However, the essential route of spreading COVID-19 is directly contacting an infected person or via respiratory droplets. Droplets cannot transfer more than six feet, remain intact in the air, and are contagious for a limited time. The virus transmits via envelopes in the internal or stick to the surface of respiratory aerosols and droplets. Aerosols are generated when the surface tension of fluid lining the respiratory tract is overcome by force. The required forces can be created by rapid shearing air flows, vocal cord movement, and the opening and closing of terminal airways, all of which are influenced by the type and force of respiratory activity. Heavy breathing, coughing, talking, and singing generate aerosols, causing an exhalation plume of respiratory particles of varying sizes containing potentially infective viral material. The high viral loads in the pharynx early in COVID-19 make these aerosols a plausible cause of both pre-symptomatic and asymptomatic transmission, which is effective in fueling outbreaks and challenging to control. The fluid droplets can cover and absorb greater aerosol elements in the open air. The spread of aerosols and surface viruses is also potential since they can endure viable and transmissible for hours or several days. In poor ventilation locations, viral infection particles <0.1 μm in size can persist in the atmosphere as secondary particles [8]. Studies have indicated that environmental aspects intensely influence the SARS-CoV-2 transmission. SARS-CoV-2 has been demonstrated in the environment, including water, air, surfaces, and soil. SARS-COV-2 is also found in the sink and toilet bowl; however, indoor and outdoor air was free from COVID-19 after daily room cleaning. Depending on the surface properties, the subsistence time of COVID-19 differs less absorbent, such as steel and plastic. In addition, various environmental issues may influence the quantity of air and the humidity in the rooms [9]. It is possible to become infected by touching surfaces or objects with the virus and then bringing the hands toward the mouth, nose, or eyes. The virus can persist on different surfaces for hours or days in ideal conditions. The surfaces most exposed to this transmission type include door handles, lift or light buttons, mobile phones, and public transport handholds [10]. Recently, the SARS-CoV-2 virus has been released in wastewater sources and indicated that the virus can persist in sewage for a long time. This outcome could be a thoughtful tool for following and monitoring the lifecycle of COVID families inside populations. The persistence of COVID in water sources depends upon various environmental aspects, such as sunlight, temperature, and organic combinations where the virus can certainly adsorb and protect itself against antagonistic circumstances, such as pathogenic microorganisms [11]. As informed by WHO, no confirmation of COVID family spread over contaminated drinking water exists. Normally, enveloped viruses are less biologically satisfactory and are more sensitive to oxidizing mediators. For example, SARS-CoV-2 is probably more quickly deactivated in interaction with chlorine than human intestinal non-enveloped viruses [12]. According to the studies conducted on the presence of coronavirus in the air, water, wastewater, and environmental surfaces, this review article investigates the existence of SARS-CoV-2 in the air, wastewater, and environmental surfaces.

Materials and Methods
This study followed the preferred reporting items for systematic reviews (PRISMA) guidelines. This study investigated SARS-CoV-2 in different surfaces, water, wastewater, and air from 2021 to 2023. Today, in addition to PRISMA, the Sinatex strategy is also used. Plain syntax instructions used by the search engine. These syntax rules are conducted whether they are a) Entering words in the main search box under “easy search” on the main page or in the field boxes under the “structured search” option, or b) Combining words with exact field codes in the “expert search” option. For example, we performed a systematic literature search from 2022 to 2023 in the following databases: PubMed (MEDLINE), Scopus, and Web of Science (ISI). We used the following terms to conduct the search: “Environmental surface AND SARS coronavirus,” “Air AND SARS coronavirus,” “water AND SARS coronavirus,” “wastewater AND SARS coronavirus,” “surface AND SARS coronavirus,” “environmental surface AND SARS-COV-2,” “air AND SARS-COV-2,” “water AND SARS-COV-2,” “wastewater AND SARS-COV-2,” “environmental surface AND COVID-19,” “air AND COVID-19,” “water AND COVID -19,” “wastewater AND COVID-19.” We imposed the English language restriction on the search. Additional related articles were retrieved manually from Google Scholar and were critically evaluated. All articles were imported to Endnote software, version 20 (Thompson and Reuters, Philadelphia, USA), and duplicates were removed.

Inclusion and exclusion criteria
In collecting the data, attention was paid to the following items: a) Original articles; b) Studies published in English; c) Articles with the keywords mentioned above, such as articles focusing on environmental surface sustainability, air sustainability, water sustainability, and on wastewater sustainability.
Meanwhile, excluded items are as follows: Full-text review articles (n=73), book reviews (n=9), guidelines (n=56), book chapters (n=5), short communications (n=17), conference papers (n=24), oral presentations (n=16), commentaries (n=12). Some included studies investigated the presence of SARS-CoV-2 in several media (such as air, surfaces, etc.); Therefore, the sum is more than 30 articles.

Data extraction 
After screening published articles for eligibility, relevant data and information from each eligible study were entered. Co-authors independently collated data from all eligible studies and independently evaluated the data. Then, information, such as first author’s name, publication year, country, sustainability in air, sustainability in environmental surface, disinfectant/concentration, sustainability in wastewater, sustainability in water, sampling method, humidity, temperature, media, sample volume processed, ventilation system type, gen target for reverse transcription-quantitative polymerase chain reaction (RT-qPCR), sampling conditions, rate of positivity, number of positive samples, and number of the test was extracted.

Results
Study characteristics
The search on electronic databases identified a total of 2049 articles. Following the removal of duplicate articles and a critical appraisal of article titles and abstracts, 249 potentially relevant articles were identified for full-text evaluation (Figure 1). After applying the eligibility criteria, 30 articles were included in the synthesis (Table 1).








Then, the included articles were investigated in detail and considered independently according to the environmental stability of coronaviruses to survive in different environmental conditions.
Among the evaluated articles, 12 articles are related to the presence of the coronavirus in the air or considering the conditions mentioned in the tables. Meanwhile, 15 articles are associated with the presence of the coronavirus at the surface and 4 articles are related to the presence of the coronavirus in the water. Finally, 13 articles are associated with the presence of this virus in wastewater. 

Discussion
COVID-19 was detected on December 31, 2019, in the Wuhan City, Hubei Province, China. The world faced an emergency condition. This study confirmed the presence of SARS-CoV-2 in indoor air, open air, environmental surfaces, water, and wastewater. Such studies provide valuable evidence about contamination and the risk of virus transmission between healthy individuals and patients. There are unalike thoughts about the transmission and presence of SARS-CoV-2 in environmental studies. A direct assessment between results from studies that evaluated the SARS-CoV-2 transmissibility and existence is not possible due to differences in sampling technique, investigational approaches, the number of samples, features of hospital architecture and cleaning staff service. At the beginning of the pandemic, the WHO and many studies mainly highlighted that the main transmission routes are person-to-person, and people should observe their physical distance. Over the past years, COVID-19 has had profound detrimental effects on everyone worldwide. Such effects have been compounded by the lockdown that has affected all activities and caused global economic disruption. Airborne transmission is the main route for infectious agents, such as viruses. Accordingly, airborne transmission of SARS-CoV-2 has been proven, and caution is taken to prevent and control the airway. To this end, evaluating the possible airborne transmission of SARS-CoV-2 is essential. In this study, we conducted a general literature search for original studies on airborne transmission of SARS-CoV-2.
In the indoor air environment, after examining the collected literature and conducting an in-depth analysis, we included 12 eligible studies (Table 2).


Among the 12 included studies, seven eligible studies were experimental and reported different findings on positive or negative detection of SARS-CoV-2 airborne transmission in indoor air. Among them, five studies (Dohla et al. 2022 [21]; Vosoughi et al. 2021 [23]; Razzini et al. 2020 [24]; Cheng et al. 2020 [25]) indicated that all indoor air samples in the hospital were negative, thus confirming that SARS-CoV-2 is transmitted by air. Unlike the results of these studies, other included experimental studies reported positive results that confirmed transmission of the virus through the air. In this context, in 2020, Kenarkoohi et al. and Razzini et al. [41, 24] indicated that air samples were PCR positive for viral RNA in the hospital’s indoor air environment of the intensive care unit (Table 2). Furthermore, Chia et al. [38] confirmed that, despite 12 air change rate isolation rooms for airborne infections in the hospital, SARS-CoV-2 PCR-positive were 2 out of 3 airborne infection isolation rooms. The outcomes of the studies in the experimental section disclose a high possibility of airborne transmission of SARS-CoV-2 in indoor air in hospital environments, even with a ventilation rate of 12 air changes per hour. Therefore, it is necessary that the air exchange rate is more effective and takes into reason what was reported in the included study. In 2020, Faridi et al. [42] showed that all air samples collected in the selected large hospital indoor air were PCR negative; however, we recommend more in vivo investigations focused on using definite patient coughing, sneezing, and breathing (Table 2). Aerosols in instruction to show the possibility of generation and the viable portion of the surrounded virus in those carrier aerosols. Transmission through respiratory droplets and contacts is considered the primary transmission route in SARS-CoV-2. 
Airborne infection with COVID-19 has remained controversial since the beginning. Several researchers have appealed to the different motivations and relevant national/international cooperation to recognize airborne transmission as another probable dominant route for spreading SARS-CoV-2 [43]. Airborne viruses’ Transmission and infectivity depend on the size and quantity of aerosols generated, which regulate the amount (dose) and pattern for deposited particle dose rate [44]. Vosoughi et al. [23] maintained that a comprehensive understanding of the risk of the transmission pathways of SARS-CoVs could allow for a better preventative program.
Such pathways include the airborne transmission path, which triggers the discussion that the virus goes far outside 1 m reported by WHO [45]. This should be observed as a distance protection, especially in general medical settings. International case studies have established that the behavior change of the SARS-CoVs virus has been unprecedented in an environment with most likely persistence and probability viable rates in the air. Atzrodt et al. [46] tested a mix of environmental factors on Cho persistence, especially two temperatures typical of the two extreme indoor atmospheric conditions in temperate countries (6°C and 20°C) and three relative humidity demonstrating low (30%), medium (50%), and high (80%) conditions in both indoor and outdoor environments. Based on the obtained results, the presence of the coronavirus in the air and its transmission through aerosols is possible; however, the existence of the coronavirus has not been proven in some hospital air, which is in agreement with the study of Revilla Pacheco et al. in 2021. SARS-CoV-2 can be presented in wastewater by various pathways, such as hand washing, sputum aerosolized particles resulting in vomiting [47], and mainly via viral RNA shedding with gastrointestinal symptoms [48]. Thus, the viruses may enter the water systems through several paths, including fecal contamination from hospitals and home isolation and quarantine for COVID-19 [49]. Also, from houses and habitats of buildings frequented by an infected person, whether patients were more likely to be non-symptomatic [50]. Conventional wastewater treatment processes commonly accept that this method, depending on the process and operational conditions, usually at a secondary or tertiary level, may be sufficient to eliminate. Meanwhile, studies [4] have indicated that all the different parts of Ardabil City and Khalkhal City, Iran, wastewater treatment plants the white (lower risk of COVID-19) and red (high risk of COVID-19) conditions were positive, which shows that following coronavirus through sewage as a tool for the COVID-19 pandemic detection. 
Sewage surveillance is an early warning system because people with COVID-19 and common symptoms can be identified with people without symptoms in different areas [51]. 
Due to the water resources in various types and different conditions, the persistence of viruses is not always in a similar condition. Rivers usually provide an unstable condition for viruses due to the difference between stable and unstable substrates and physical disturbance. Still, the formation of viral aerosols is more likely than in lakes [52] (Table 3).


Physical, chemical, and biological conditions associated with the lake may help to inactivate the viruses [4]. SARS-CoV-2 can persist in a surrounding matrix to an infected discharge of untreated wastewater. Among the 4 included water studies, all studies were negative detection of SARS-CoV-2 transmission in water, thus concluding that there is low evidence that SARS-CoV-2 is transmitted by water (Table 4).


The viability of SARS-CoV-2 on dry surfaces seems identical to that of SARS-CoV-2 and MERS [54]. However, the main difference between SARS-CoV-2 and other viruses is the higher transmission rate, which is currently attributed to individuals carrying the virus asymptomatically. Despite laboratory studies showing the presence of the virus on various surfaces, they had some practical limitations [55]. According to the study of Seif et al. in year 2021 [56], due to the high transmissibility of SARS-CoV-2, investigation of fomites and environmental surfaces to determine the fomite transmission risk of COVID-19 infection is essential. We included 15 eligible studies. Among the 15 included studies, 14 eligible studies were experimental and reported different findings on positive or negative detection of SARS-CoV-2 transmission in environmental surfaces. Among them, one study indicated were negative [57]. To guarantee data uniformity and allow comparison of virus survival studies, we recommend the definition of a reference study protocol for all laboratories investigating this topic. For example, it is essential to assess viral viability until it is completely inactivated. Further, more homogeneous studies assessing coronavirus survival on fomites are needed to fill data gaps. Although prolonged survival of SARS-CoV-2 on surfaces has been proved, evidence of transmission from contaminated dry surfaces is still needed, while direct person-to-person transmission remains the main confirmed route (Table 5).


The positive point of our article is the presence of SARS on different surfaces depends on various factors, for example, in the air, on specific humidity and temperature conditions, in water and waste, on the flow rate, biofilm formed, the formation of vesicular structures in the virus, and on surfaces, it depends on the type of surfaces and temperature and humidity conditions which causes contradictions in different articles.

Conclusion 
SARS-CoV-2 detection in air, environmental surface, and wastewater samples in a building with clinically confirmed COVID-19 cases suggests that the RNA genomic of the virus, speared by an infected patient, can be traced in the environment. This study provides essential awareness of the persistence of SARS coronaviruses at different environmental surfaces, air, water, and wastewater, consistent with the results of current related research. It showed that several samples taken from hospital surfaces, such as cupboards, light switches, and door handles, were positive. However, the possibility of infection from numerous surfaces in hospital wards remains threatening. This study has elevated significant demands about virus persistence and its relationship with the various conditions of the environment. Appropriate protective strategies such as physical distancing, hand hygiene, and wearing masks are essential to control the COVID-19 pandemic. Despite this, more studies should be done to get more information about the persistence of COVID-19 on different surfaces, water, sewage, and air.

Ethical Considerations
Compliance with ethical guidelines
This study was approved by the Ethics Committee of the Ardabil University of Medical Sciences (Code: IR.ARUMS.REC.1401.018).

Funding
This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors.

Authors' contributions
Conceptualization and supervision: Parisa Javanbakht, Abdullah Dargahi and Chiman Karami; Data collection: Parisa Javanbakht; Study design and data analysis: Parisa Javanbakht, Zahra Noorimotlagh and Chiman Karami; Drafting the manuscript: All authors; Final approval: Mehdi Vosoghi and Zahra Noorimotlagh.

Conflict of interest
The authors declared no conflict of interest

Acknowledgments
The authors would like to thank Ardabil University of Medical Sciences.


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