Asymptomatic and Presymptomatic Infectors: Hidden Sources of Coronavirus Disease 2019 (COVID-19)

Li, Guanjian; Li, Wei-ran; He, Xiaojin; Cao, Yunxia

doi:10.1093/cid/ciaa418

Cited by 55 publications

(52 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As viral RNA sheds in the upper respiratory tract, it has been proven that both asymptomatic and presymptomatic patients are contagious. Recently, one report revealed that the rates of virus infection through close contact with symptomatic patients and with asymptomatic patients were 6.30% and 4.11%, respectively [8]. Since the asymptomatic patients are more difficult to be identified and isolated than the symptomatic carriers, they might be one of the major drivers of the COVID-19 pandemic [9].…”

Section: Discussionmentioning

confidence: 99%

Characteristics of asymptomatic COVID-19 infection and progression: A multicenter, retrospective study

Zhou

Liu

et al. 2020

Virulence

View full text Add to dashboard Cite

Novel coronavirus disease 2019 (COVID-19), caused by novel coronavirus SARS-CoV-2, has spread globally since the end of 2019. Asymptomatic carriers are of great concern as they can undermine the interventions to stop the pandemic. However, there is limited information about the characteristics and outcomes of the asymptomatic patients. Therefore, we conducted this retrospective study and retrieved data of 79 asymptomatic COVID-19 patients at admission from three designated hospitals in Wuhan, China. The asymptomatic patients could happen at any age, ranged from 9 to 96 years. These patients also had lower levels of alanine aminotransferase and C-reactive protein. Patchy shadowing was the most common manifestation in computed tomography scan. Some asymptomatic carriers developed mild or moderate symptoms during hospitalization. Age and comorbidities, especially hypertension, may be predictive factors for symptom development in the initially asymptomatic carriers at admission. Early detection and treatment for these presymptomatic patients before symptom onset can shorten the communicable period for the coronavirus and reduce the occurrence of severe cases.

show abstract

Section: Discussionmentioning

confidence: 99%

Characteristics of asymptomatic COVID-19 infection and progression: A multicenter, retrospective study

Zhou

Liu

et al. 2020

Virulence

View full text Add to dashboard Cite

show abstract

“…Ultimately, an optimal view is asymptomatic cases may account for 60% of infections. However, recent research and case reports have confirmed that asymptomatic or pre-symptomatic cases can shed enough quantify of virus to be infectious [5][6][7][8]10]. Furthermore, if the infectivity of asymptomatic cases is similar to that of symptomatic cases, a faster epidemic will occur.…”

Section: Discussionmentioning

confidence: 99%

“…Two important factors may contribute a second wave of epidemic. First, unlike the 2003 SARS epidemic in which mainly symptomatic cases are infectious [4], asymptomatic infection of the SARS-CoV2 can transmit disease [5][6][7][8][9]. Studies have detected virus shedding in nasopharyngeal swap samples among asymptomatic cases [10].…”

Section: Introductionmentioning

confidence: 99%

“…After social activities are restored, both international and domestic travel ban will be lifted. Imported symptomatic and asymptomatic cases may kindle a second wave of epidemic in the community [6]. For example, despite Singapore has implemented possibly the most rigorous contact tracing, personal protection and social distancing measures, an unexpected surge of new cases has been observed, with daily newly confirmed cases doubled from 142 in April 7 to 287 in April 8, and still 334 in April 14 (https://www.gov.sg/article/covid-19-cases-in-singapore).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Modeling Return of the Epidemic: Impact of Population Structure, Asymptomatic Infection, Case Importation and Personal Contacts

2020

Preprint

View full text Add to dashboard Cite

Background: Proactive interventions have halted the pandemic of coronavirus infected disease in some regions. However, without reaching herd immunity, the return of epidemic is possible.We investigate the impact of population structure, case importation, asymptomatic cases, and the number of contacts on a possible second wave of epidemic through mathematical modelling.Methods: we built a modified Susceptible-exposed-Infectious-Removed (SEIR) model with parameters mirroring those of the COVID-19 pandemic and reported simulated characteristics of epidemics for incidence, hospitalizations and deaths under different scenarios. Results:A larger percent of old people leads to higher number of hospitalizations, while a large percent of prior infection will effectively curb the epidemic. The number of imported cases and the speed of importation have small impact on the epidemic progression. However, a higher percent of asymptomatic cases slows the epidemic down and reduces the number of hospitalizations and deaths at the epidemic peak. Finally, reducing the number of contacts among young people alone has moderate effects on themselves, but little effects on the old population.However, reducing the number of contacts among old people alone can mitigate the epidemic significantly in both groups, even though young people remain active within themselves.

show abstract

“…Since December 2019, the novel Severe Acute Respiratory Syndrome associated coronavirus (SARS CoV2) (Zhu et al, 2020) has infected over 3 million people and claimed more than 216,000 lives worldwide (https://coronavirus.jhu.edu/, accessed on April 28, 2020). Unlike the 2003 SARS virus that had limited transmissibility before symptom onset (Peiris, Yuen, Osterhaus, & Stohr, 2003), the novel SARS CoV2 can be transmitted from pre-symptomatic and asymptomatic patients (Bai et al, 2020;Li, Li, He, & Cao, 2020) and cause sudden symptom exacerbation among mildly symptomatic patients, often leading to cytokine storm and acute respiratory distress syndrome (ARDS) (Guan et al, 2020;C. Huang et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Health service inequalities during the COVID-19 pandemic among elderly people living in large urban and non-urban areas in Florida, US

2020

Preprint

View full text Add to dashboard Cite

Background: Health disparities were often overlooked during the emerging epidemic.Objectives: This study examined geographic differences in the rates of health care use and deaths among elderly patients.Methods: Based on individual patient records, multivariate Poisson and logistic models were used to calculate adjusted incidences of COVID-19 and probabilities of emergency department (ED) visits, hospitalizations and deaths.Results: Of 8,203 elderly patients, 11% died. Elderly people living in small metropolitan areas were half as likely to be diagnosed with COVID-19. Elderly female patients living in small metropolitan areas had much lower rates of ED visits (23% vs. 34%; Odds Ratio (OR): 0.58; 95%confidence interval (CI): 0.41-0.81; p=0.002) and hospitalizations (22% vs. 31%; OR: 0.62; 95%CI: 0.44 -0.87; p=0.006) than those living in large metropolitan areas. Furthermore, those living in non-metropolitan areas were more likely to be hospitalized than those living in large metropolitan areas (44% vs. 33%; OR: 1.46; 95%CI: 1.07-1.99; p=0.016), especially among elderly men (51% vs. 35%; OR:1.86; 95%CI: 1.18-2.93; p=0.008). Finally, there was a significant linear trend in hospitalization rates among elderly male patients (p for trend = 0.01).

show abstract

Asymptomatic and Presymptomatic Infectors: Hidden Sources of Coronavirus Disease 2019 (COVID-19)

Cited by 55 publications

References 8 publications

Characteristics of asymptomatic COVID-19 infection and progression: A multicenter, retrospective study

Characteristics of asymptomatic COVID-19 infection and progression: A multicenter, retrospective study

Modeling Return of the Epidemic: Impact of Population Structure, Asymptomatic Infection, Case Importation and Personal Contacts

Health service inequalities during the COVID-19 pandemic among elderly people living in large urban and non-urban areas in Florida, US

Contact Info

Product

Resources

About