Asymptomatic SARS-CoV-2 Infection in Household Contacts of a Healthcare Provider, Wuhan, China

Luo, Yang; Trevathan, Edwin; Qian, Zhengmin; Li, Yirong; Jin, Li; Xiao, Wei; Tu, Ning; Zeng, Zhikun; Mo, Pingzheng; Xiong, Yong; Ye, Guangming

doi:10.3201/eid2608.201016

Cited by 73 publications

(67 citation statements)

References 10 publications

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“…47,48 Some community cases may reflect close contacts or an epidemiological link with congregate settings, for example, members of households of people who work or volunteer in facilities. 49,50 Thus, alongside fewer contacts outside of households in the community, 51 the epidemic may have concentrated in congregate settings and in community households, with additional work needed to discern connections between networks.…”

Section: Discussionmentioning

confidence: 99%

Heterogeneity in testing, diagnosis and outcome in SARS-CoV-2 infection across outbreak settings in the Greater Toronto Area, Canada: an observational study

Wang

Yiu

et al. 2020

cmajo

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Large urban centres such as the Greater Toronto Area (GTA) shouldered the highest burden. 2 By May 20, the 16 490 cases detected in the GTA's population of 6.8 million 3 represented 21% of cases in the country, more than two-thirds of cases in Ontario and a diagnosis per capita rate 1.5 times that of Ontario overall. 1,2 As in past outbreaks of respiratory virus, 4 congregate settings were disproportionately affected by COVID-19 globally 5 and across Canada. 6-9 Settings such as long-term care homes and homeless shelters were vulnerable partly owing to design barriers (e.g., shared living quarters and communal spaces) to physical distancing, and underresourcing of infection prevention and control measures. 10-14 Lessons from past epidemics suggest that disproportionate risks across settings contribute to the spread and outcomes of infection. 15 Thus, a key feature of an epidemic response is

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Section: Discussionmentioning

confidence: 99%

Heterogeneity in testing, diagnosis and outcome in SARS-CoV-2 infection across outbreak settings in the Greater Toronto Area, Canada: an observational study

Wang

Yiu

et al. 2020

cmajo

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“…Irrespective of the frequency of asymptomatic carriers, they are considered to be important for the transmission of the disease [47]. Various studies reported SARS-CoV-2 infections, originating from asymptomatic carriers during close contacts such as household contacts or residents of a long-term care skilled nursing facility [43,[48][49][50][51][52]. Importantly, several studies have reported that viral RNA loads in pre-symptomatic, asymptomatic and symptomatic patients do not differ significantly [53][54][55].…”

Section: Epidemiological Relevance Of Asymptomatic Sars-cov-2 Casesmentioning

confidence: 99%

Potential sources, modes of transmission and effectiveness of prevention measures against SARS-CoV-2

Kampf

Brüggemann

Kaba

et al. 2020

Journal of Hospital Infection

131

121

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Early research findings suggest that SARS-Cov-2 may primarily spread through aerosol droplets [8]. which can be respired by asymptomatic/pre-symptomatic persons [9]; thus, indicators of latent infection are of crucial interest. Entry of SARS-CoV-2 into cells involves spike (S) protein binding to angiotensin-converting enzyme 2 (ACE2) along with host proteases, principally transmembrane serine protease 2 (TMPRSS2).…”

Section: Introductionmentioning

confidence: 99%

Reduced odor detection and hedonic changes in asymptomatic university students as SARS-CoV-2 emerged locally

Walsh‐Messinger

Kaouk

Manis

et al. 2020

Preprint

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Background Anosmia is a recognized symptom of COVID-19, but the relationship of SARS-CoV-2 exposure with olfactory dysfunction remains enigmatic. This report adds unique data from healthy students tested as the virus emerged locally. Methods Psychometrically validated measures assessed odor detection, identification and hedonics in healthy university students. Data from asymptomatic students (N=22), tested as SARS-CoV-2 unknowingly emerged locally, were compared to students tested just prior to local virus transmission (N=25), and our normative sample (N=272) tested over the previous 4 years. Results The exposed cohort demonstrated significantly reduced odor detection sensitivity compared to the students in the prior group (P=.01; d=0.77; CI 0.17, 1.36), with a distribution skewed towards less detection sensitivity (P=.03). Categorically, the exposed group was significantly more likely to have hyposmia (OR=7.7; CI, 3.1, 19.4), particularly the subset assessed in the final week before campus closure (OR=13.6; CI, 3.4, 35.7). The exposed group also rated odors as less unpleasant (P<.001, CLES=0.77, CI, 0.51, 1.56) and showed a similarly skewed distribution (P=.005). The groups had similar odor identification performance. Conclusion Psychometric measures of odor detection sensitivity and hedonics may detect early SARS-CoV-2 exposure in asymptomatic and pre-symptomatic persons with normal odor identification. Viral detection by nasal associated lymphoid tissue is known to trigger systemic immune effects, but its activation may also reduce smell sensitivity and shift perception of the environment towards unpleasant, increasing the social isolation that may mitigate viral infection or transmission. Regular testing of odor detection and hedonics may have value for identifying regional viral exposure.

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Asymptomatic SARS-CoV-2 Infection in Household Contacts of a Healthcare Provider, Wuhan, China

Cited by 73 publications

References 10 publications

Heterogeneity in testing, diagnosis and outcome in SARS-CoV-2 infection across outbreak settings in the Greater Toronto Area, Canada: an observational study

Heterogeneity in testing, diagnosis and outcome in SARS-CoV-2 infection across outbreak settings in the Greater Toronto Area, Canada: an observational study

Potential sources, modes of transmission and effectiveness of prevention measures against SARS-CoV-2

Reduced odor detection and hedonic changes in asymptomatic university students as SARS-CoV-2 emerged locally

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