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Real Asymptomatic SARS-CoV-2 Infection Might Be Rare: Importance of Careful Interviews and Follow-up.

Identifieur interne : 000291 ( Main/Exploration ); précédent : 000290; suivant : 000292

Real 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 :

RBID : pubmed:32959547

Descripteurs français

English descriptors

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


Affiliations:


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Le document en format XML

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<term>Betacoronavirus (MeSH)</term>
<term>Comorbidity (MeSH)</term>
<term>Coronavirus Infections (epidemiology)</term>
<term>Cough (epidemiology)</term>
<term>Diarrhea (epidemiology)</term>
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<term>Fever (epidemiology)</term>
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<term>Korea (epidemiology)</term>
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<term>Middle Aged (MeSH)</term>
<term>Myalgia (epidemiology)</term>
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<term>Prevalence (MeSH)</term>
<term>Real-Time Polymerase Chain Reaction (MeSH)</term>
<term>Retrospective Studies (MeSH)</term>
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<term>Comorbidité (MeSH)</term>
<term>Corée (épidémiologie)</term>
<term>Diarrhée (épidémiologie)</term>
<term>Femelle (MeSH)</term>
<term>Fièvre (épidémiologie)</term>
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<term>Infections asymptomatiques (épidémiologie)</term>
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<term>Myalgie (épidémiologie)</term>
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<term>Réaction de polymérisation en chaine en temps réel (MeSH)</term>
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<term>Coronavirus Infections</term>
<term>Cough</term>
<term>Diarrhea</term>
<term>Fever</term>
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<term>Pneumonia, Viral</term>
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<term>Diarrhée</term>
<term>Fièvre</term>
<term>Infections asymptomatiques</term>
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<term>Comorbidity</term>
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<term>Middle Aged</term>
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<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>
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<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>
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<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>
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<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>
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<DescriptorName UI="D015897" MajorTopicYN="N">Comorbidity</DescriptorName>
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<DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName>
<QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName>
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<MeshHeading>
<DescriptorName UI="D003371" MajorTopicYN="N">Cough</DescriptorName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
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