Real Asymptomatic SARS-CoV-2 Infection Might Be Rare: Importance of Careful Interviews and Follow-up.
Identifieur interne : 000142 ( Main/Curation ); précédent : 000141; suivant : 000143Real Asymptomatic SARS-CoV-2 Infection Might Be Rare: Importance of Careful Interviews and Follow-up.
Auteurs : Tae Heum Jeong [Corée du Sud] ; Chuiyong Pak [Corée du Sud] ; Minsu Ock [Corée du Sud] ; Seock Hwan Lee [Corée du Sud] ; Joung Sik Son [Corée du Sud] ; Young Jee Jeon [Corée du Sud]Source :
- Journal of Korean medical science [ 1598-6357 ] ; 2020.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Betacoronavirus (MeSH), Comorbidité (MeSH), Corée (épidémiologie), Diarrhée (épidémiologie), Femelle (MeSH), Fièvre (épidémiologie), Hospitalisation (MeSH), Humains (MeSH), Infections asymptomatiques (épidémiologie), Infections à coronavirus (épidémiologie), Myalgie (épidémiologie), Mâle (MeSH), Pandémies (MeSH), Pneumopathie virale (épidémiologie), Prévalence (MeSH), Réaction de polymérisation en chaine en temps réel (MeSH), Résultat thérapeutique (MeSH), Sujet âgé (MeSH), Toux (épidémiologie), Études rétrospectives (MeSH), Évaluation des symptômes (MeSH).
- MESH :
- épidémiologie : Corée, Diarrhée, Fièvre, Infections asymptomatiques, Infections à coronavirus, Myalgie, Pneumopathie virale, Toux.
- Adulte, Adulte d'âge moyen, Betacoronavirus, Comorbidité, Femelle, Hospitalisation, Humains, Mâle, Pandémies, Prévalence, Réaction de polymérisation en chaine en temps réel, Résultat thérapeutique, Sujet âgé, Études rétrospectives, Évaluation des symptômes.
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), Asymptomatic Infections (epidemiology), Betacoronavirus (MeSH), Comorbidity (MeSH), Coronavirus Infections (epidemiology), Cough (epidemiology), Diarrhea (epidemiology), Female (MeSH), Fever (epidemiology), Hospitalization (MeSH), Humans (MeSH), Korea (epidemiology), Male (MeSH), Middle Aged (MeSH), Myalgia (epidemiology), Pandemics (MeSH), Pneumonia, Viral (epidemiology), Prevalence (MeSH), Real-Time Polymerase Chain Reaction (MeSH), Retrospective Studies (MeSH), Symptom Assessment (MeSH), Treatment Outcome (MeSH).
- MESH :
- geographic , epidemiology : Korea.
- epidemiology : Asymptomatic Infections, Coronavirus Infections, Cough, Diarrhea, Fever, Myalgia, Pneumonia, Viral.
- Adult, Aged, Betacoronavirus, Comorbidity, Female, Hospitalization, Humans, Male, Middle Aged, Pandemics, Prevalence, Real-Time Polymerase Chain Reaction, Retrospective Studies, Symptom Assessment, Treatment Outcome.
Abstract
BACKGROUND
There is limited information on the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) who are asymptomatic or have mild symptoms.
METHODS
We performed a retrospective case series of patients with COVID-19 enrolled from February 22 to March 26, 2020. Forty cases of COVID-19 were confirmed using real-time reverse-transcription polymerase chain reaction among patients who underwent screening tests and were consecutively hospitalized at Ulsan University Hospital, Ulsan, Korea. The final follow-up date was May 19, 2020. All COVID-19 cases in Ulsan were included. Demographic and epidemiological information, comorbidities, clinical signs and symptoms, laboratory and radiologic findings, medications, treatments, outcomes, and main durations of patients with COVID-19 were compared according to supplemental oxygen requirement.
RESULTS
Forty patients were included (median age, 30 years; interquartile range [IQR], 25-57 years; 58% female). Six (15%) patients required supplemental oxygen. The prevalence of asymptomatic severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection was 5% and that of presymptomatic infection was 13%. Cough, fever, myalgia, rhinorrhea or nasal congestion, and diarrhea were the screening criteria for diagnosing symptomatic and presymptomatic SARS-CoV-2 infections. Sputum production, chest discomfort, a large number of symptoms, abnormal procalcitonin and C-reactive protein levels, and abnormal chest X-ray or chest computed tomography findings were more common in patients requiring supplemental oxygen than in those not requiring supplemental oxygen. Overall mortality rate was 3% (1/40). Four patients (10%) were readmitted after testing positive by reverse-transcription polymerase chain reaction again. Incubation period was 5 days (IQR, 4-6 days), and the duration of viral shedding was 21 days (IQR, 14-28 days; maximum, 51 days).
CONCLUSION
The prevalence of asymptomatic SARS-CoV-2 infection was 5%, which is much lower than that previously reported. This finding suggests that careful interviews and follow-ups should be performed to identify SARS-CoV-2 infections. Cough, fever, myalgia, rhinorrhea or nasal congestion, and diarrhea are adequate screening criteria for covering all symptoms of SARS-CoV-2 infection. Further evaluation is required to create representative screening criteria for COVID-19.
DOI: 10.3346/jkms.2020.35.e333
PubMed: 32959547
PubMed Central: PMC7505732
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pubmed:32959547Le document en format XML
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term>
<term>Aged (MeSH)</term>
<term>Asymptomatic Infections (epidemiology)</term>
<term>Betacoronavirus (MeSH)</term>
<term>Comorbidity (MeSH)</term>
<term>Coronavirus Infections (epidemiology)</term>
<term>Cough (epidemiology)</term>
<term>Diarrhea (epidemiology)</term>
<term>Female (MeSH)</term>
<term>Fever (epidemiology)</term>
<term>Hospitalization (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Korea (epidemiology)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Myalgia (epidemiology)</term>
<term>Pandemics (MeSH)</term>
<term>Pneumonia, Viral (epidemiology)</term>
<term>Prevalence (MeSH)</term>
<term>Real-Time Polymerase Chain Reaction (MeSH)</term>
<term>Retrospective Studies (MeSH)</term>
<term>Symptom Assessment (MeSH)</term>
<term>Treatment Outcome (MeSH)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term>
<term>Adulte d'âge moyen (MeSH)</term>
<term>Betacoronavirus (MeSH)</term>
<term>Comorbidité (MeSH)</term>
<term>Corée (épidémiologie)</term>
<term>Diarrhée (épidémiologie)</term>
<term>Femelle (MeSH)</term>
<term>Fièvre (épidémiologie)</term>
<term>Hospitalisation (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Infections asymptomatiques (épidémiologie)</term>
<term>Infections à coronavirus (épidémiologie)</term>
<term>Myalgie (épidémiologie)</term>
<term>Mâle (MeSH)</term>
<term>Pandémies (MeSH)</term>
<term>Pneumopathie virale (épidémiologie)</term>
<term>Prévalence (MeSH)</term>
<term>Réaction de polymérisation en chaine en temps réel (MeSH)</term>
<term>Résultat thérapeutique (MeSH)</term>
<term>Sujet âgé (MeSH)</term>
<term>Toux (épidémiologie)</term>
<term>Études rétrospectives (MeSH)</term>
<term>Évaluation des symptômes (MeSH)</term>
</keywords>
<keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Korea</term>
</keywords>
<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Asymptomatic Infections</term>
<term>Coronavirus Infections</term>
<term>Cough</term>
<term>Diarrhea</term>
<term>Fever</term>
<term>Myalgia</term>
<term>Pneumonia, Viral</term>
</keywords>
<keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Corée</term>
<term>Diarrhée</term>
<term>Fièvre</term>
<term>Infections asymptomatiques</term>
<term>Infections à coronavirus</term>
<term>Myalgie</term>
<term>Pneumopathie virale</term>
<term>Toux</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adult</term>
<term>Aged</term>
<term>Betacoronavirus</term>
<term>Comorbidity</term>
<term>Female</term>
<term>Hospitalization</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Pandemics</term>
<term>Prevalence</term>
<term>Real-Time Polymerase Chain Reaction</term>
<term>Retrospective Studies</term>
<term>Symptom Assessment</term>
<term>Treatment Outcome</term>
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<term>Adulte d'âge moyen</term>
<term>Betacoronavirus</term>
<term>Comorbidité</term>
<term>Femelle</term>
<term>Hospitalisation</term>
<term>Humains</term>
<term>Mâle</term>
<term>Pandémies</term>
<term>Prévalence</term>
<term>Réaction de polymérisation en chaine en temps réel</term>
<term>Résultat thérapeutique</term>
<term>Sujet âgé</term>
<term>Études rétrospectives</term>
<term>Évaluation des symptômes</term>
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<front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b>
</p>
<p>There is limited information on the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) who are asymptomatic or have mild symptoms.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHODS</b>
</p>
<p>We performed a retrospective case series of patients with COVID-19 enrolled from February 22 to March 26, 2020. Forty cases of COVID-19 were confirmed using real-time reverse-transcription polymerase chain reaction among patients who underwent screening tests and were consecutively hospitalized at Ulsan University Hospital, Ulsan, Korea. The final follow-up date was May 19, 2020. All COVID-19 cases in Ulsan were included. Demographic and epidemiological information, comorbidities, clinical signs and symptoms, laboratory and radiologic findings, medications, treatments, outcomes, and main durations of patients with COVID-19 were compared according to supplemental oxygen requirement.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>Forty patients were included (median age, 30 years; interquartile range [IQR], 25-57 years; 58% female). Six (15%) patients required supplemental oxygen. The prevalence of asymptomatic severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection was 5% and that of presymptomatic infection was 13%. Cough, fever, myalgia, rhinorrhea or nasal congestion, and diarrhea were the screening criteria for diagnosing symptomatic and presymptomatic SARS-CoV-2 infections. Sputum production, chest discomfort, a large number of symptoms, abnormal procalcitonin and C-reactive protein levels, and abnormal chest X-ray or chest computed tomography findings were more common in patients requiring supplemental oxygen than in those not requiring supplemental oxygen. Overall mortality rate was 3% (1/40). Four patients (10%) were readmitted after testing positive by reverse-transcription polymerase chain reaction again. Incubation period was 5 days (IQR, 4-6 days), and the duration of viral shedding was 21 days (IQR, 14-28 days; maximum, 51 days).</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSION</b>
</p>
<p>The prevalence of asymptomatic SARS-CoV-2 infection was 5%, which is much lower than that previously reported. This finding suggests that careful interviews and follow-ups should be performed to identify SARS-CoV-2 infections. Cough, fever, myalgia, rhinorrhea or nasal congestion, and diarrhea are adequate screening criteria for covering all symptoms of SARS-CoV-2 infection. Further evaluation is required to create representative screening criteria for COVID-19.</p>
</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32959547</PMID>
<DateCompleted><Year>2020</Year>
<Month>10</Month>
<Day>05</Day>
</DateCompleted>
<DateRevised><Year>2020</Year>
<Month>10</Month>
<Day>05</Day>
</DateRevised>
<Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1598-6357</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>35</Volume>
<Issue>37</Issue>
<PubDate><Year>2020</Year>
<Month>Sep</Month>
<Day>21</Day>
</PubDate>
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<Title>Journal of Korean medical science</Title>
<ISOAbbreviation>J Korean Med Sci</ISOAbbreviation>
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<ArticleTitle>Real Asymptomatic SARS-CoV-2 Infection Might Be Rare: Importance of Careful Interviews and Follow-up.</ArticleTitle>
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<Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">There is limited information on the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) who are asymptomatic or have mild symptoms.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">We performed a retrospective case series of patients with COVID-19 enrolled from February 22 to March 26, 2020. Forty cases of COVID-19 were confirmed using real-time reverse-transcription polymerase chain reaction among patients who underwent screening tests and were consecutively hospitalized at Ulsan University Hospital, Ulsan, Korea. The final follow-up date was May 19, 2020. All COVID-19 cases in Ulsan were included. Demographic and epidemiological information, comorbidities, clinical signs and symptoms, laboratory and radiologic findings, medications, treatments, outcomes, and main durations of patients with COVID-19 were compared according to supplemental oxygen requirement.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">Forty patients were included (median age, 30 years; interquartile range [IQR], 25-57 years; 58% female). Six (15%) patients required supplemental oxygen. The prevalence of asymptomatic severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection was 5% and that of presymptomatic infection was 13%. Cough, fever, myalgia, rhinorrhea or nasal congestion, and diarrhea were the screening criteria for diagnosing symptomatic and presymptomatic SARS-CoV-2 infections. Sputum production, chest discomfort, a large number of symptoms, abnormal procalcitonin and C-reactive protein levels, and abnormal chest X-ray or chest computed tomography findings were more common in patients requiring supplemental oxygen than in those not requiring supplemental oxygen. Overall mortality rate was 3% (1/40). Four patients (10%) were readmitted after testing positive by reverse-transcription polymerase chain reaction again. Incubation period was 5 days (IQR, 4-6 days), and the duration of viral shedding was 21 days (IQR, 14-28 days; maximum, 51 days).</AbstractText>
<AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">The prevalence of asymptomatic SARS-CoV-2 infection was 5%, which is much lower than that previously reported. This finding suggests that careful interviews and follow-ups should be performed to identify SARS-CoV-2 infections. Cough, fever, myalgia, rhinorrhea or nasal congestion, and diarrhea are adequate screening criteria for covering all symptoms of SARS-CoV-2 infection. Further evaluation is required to create representative screening criteria for COVID-19.</AbstractText>
<CopyrightInformation>© 2020 The Korean Academy of Medical Sciences.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y" EqualContrib="Y"><LastName>Jeong</LastName>
<ForeName>Tae Heum</ForeName>
<Initials>TH</Initials>
<Identifier Source="ORCID">https://orcid.org/0000-0001-7994-6242</Identifier>
<AffiliationInfo><Affiliation>Department of Family Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea. jeongth@uuh.ulsan.kr.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y" EqualContrib="Y"><LastName>Pak</LastName>
<ForeName>Chuiyong</ForeName>
<Initials>C</Initials>
<Identifier Source="ORCID">https://orcid.org/0000-0001-6390-0098</Identifier>
<AffiliationInfo><Affiliation>Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Ock</LastName>
<ForeName>Minsu</ForeName>
<Initials>M</Initials>
<Identifier Source="ORCID">https://orcid.org/0000-0001-9949-9224</Identifier>
<AffiliationInfo><Affiliation>Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Lee</LastName>
<ForeName>Seock Hwan</ForeName>
<Initials>SH</Initials>
<Identifier Source="ORCID">https://orcid.org/0000-0002-0638-643X</Identifier>
<AffiliationInfo><Affiliation>Department of Family Medicine, Daegu Medical Center, Daegu, Korea.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Son</LastName>
<ForeName>Joung Sik</ForeName>
<Initials>JS</Initials>
<Identifier Source="ORCID">https://orcid.org/0000-0003-2460-3378</Identifier>
<AffiliationInfo><Affiliation>Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Jeon</LastName>
<ForeName>Young Jee</ForeName>
<Initials>YJ</Initials>
<Identifier Source="ORCID">https://orcid.org/0000-0002-8070-2453</Identifier>
<AffiliationInfo><Affiliation>Department of Family Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2020</Year>
<Month>09</Month>
<Day>21</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>Korea (South)</Country>
<MedlineTA>J Korean Med Sci</MedlineTA>
<NlmUniqueID>8703518</NlmUniqueID>
<ISSNLinking>1011-8934</ISSNLinking>
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<SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName>
<SupplMeshName Type="Organism" UI="C000656484">severe acute respiratory syndrome coronavirus 2</SupplMeshName>
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<CitationSubset>IM</CitationSubset>
<MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D058345" MajorTopicYN="N">Asymptomatic Infections</DescriptorName>
<QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="N">Betacoronavirus</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D015897" MajorTopicYN="N">Comorbidity</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName>
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