Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, China.
Identifieur interne : 000E54 ( Ncbi/Checkpoint ); précédent : 000E53; suivant : 000E55Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, China.
Auteurs : Zhiliang Hu [République populaire de Chine] ; Ci Song [République populaire de Chine] ; Chuanjun Xu [République populaire de Chine] ; Guangfu Jin [République populaire de Chine] ; Yaling Chen [République populaire de Chine] ; Xin Xu [République populaire de Chine] ; Hongxia Ma [République populaire de Chine] ; Wei Chen [République populaire de Chine] ; Yuan Lin [République populaire de Chine] ; Yishan Zheng [République populaire de Chine] ; Jianming Wang [République populaire de Chine] ; Zhibin Hu [République populaire de Chine] ; Yongxiang Yi [République populaire de Chine] ; Hongbing Shen [République populaire de Chine]Source :
- Science China. Life sciences [ 1869-1889 ] ; 2020.
Abstract
Previous studies have showed clinical characteristics of patients with the 2019 novel coronavirus disease (COVID-19) and the evidence of person-to-person transmission. Limited data are available for asymptomatic infections. This study aims to present the clinical characteristics of 24 cases with asymptomatic infection screened from close contacts and to show the transmission potential of asymptomatic COVID-19 virus carriers. Epidemiological investigations were conducted among all close contacts of COVID-19 patients (or suspected patients) in Nanjing, Jiangsu Province, China, from Jan 28 to Feb 9, 2020, both in clinic and in community. Asymptomatic carriers were laboratory-confirmed positive for the COVID-19 virus by testing the nucleic acid of the pharyngeal swab samples. Their clinical records, laboratory assessments, and chest CT scans were reviewed. As a result, none of the 24 asymptomatic cases presented any obvious symptoms while nucleic acid screening. Five cases (20.8%) developed symptoms (fever, cough, fatigue, etc.) during hospitalization. Twelve (50.0%) cases showed typical CT images of ground-glass chest and 5 (20.8%) presented stripe shadowing in the lungs. The remaining 7 (29.2%) cases showed normal CT image and had no symptoms during hospitalization. These 7 cases were younger (median age: 14.0 years; P=0.012) than the rest. None of the 24 cases developed severe COVID-19 pneumonia or died. The median communicable period, defined as the interval from the first day of positive nucleic acid tests to the first day of continuous negative tests, was 9.5 days (up to 21 days among the 24 asymptomatic cases). Through epidemiological investigation, we observed a typical asymptomatic transmission to the cohabiting family members, which even caused severe COVID-19 pneumonia. Overall, the asymptomatic carriers identified from close contacts were prone to be mildly ill during hospitalization. However, the communicable period could be up to three weeks and the communicated patients could develop severe illness. These results highlighted the importance of close contact tracing and longitudinally surveillance via virus nucleic acid tests. Further isolation recommendation and continuous nucleic acid tests may also be recommended to the patients discharged.
DOI: 10.1007/s11427-020-1661-4
PubMed: 32146694
Affiliations:
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<author><name sortKey="Ma, Hongxia" sort="Ma, Hongxia" uniqKey="Ma H" first="Hongxia" last="Ma">Hongxia Ma</name>
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<author><name sortKey="Chen, Wei" sort="Chen, Wei" uniqKey="Chen W" first="Wei" last="Chen">Wei Chen</name>
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<author><name sortKey="Lin, Yuan" sort="Lin, Yuan" uniqKey="Lin Y" first="Yuan" last="Lin">Yuan Lin</name>
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<author><name sortKey="Yi, Yongxiang" sort="Yi, Yongxiang" uniqKey="Yi Y" first="Yongxiang" last="Yi">Yongxiang Yi</name>
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<front><div type="abstract" xml:lang="en">Previous studies have showed clinical characteristics of patients with the 2019 novel coronavirus disease (COVID-19) and the evidence of person-to-person transmission. Limited data are available for asymptomatic infections. This study aims to present the clinical characteristics of 24 cases with asymptomatic infection screened from close contacts and to show the transmission potential of asymptomatic COVID-19 virus carriers. Epidemiological investigations were conducted among all close contacts of COVID-19 patients (or suspected patients) in Nanjing, Jiangsu Province, China, from Jan 28 to Feb 9, 2020, both in clinic and in community. Asymptomatic carriers were laboratory-confirmed positive for the COVID-19 virus by testing the nucleic acid of the pharyngeal swab samples. Their clinical records, laboratory assessments, and chest CT scans were reviewed. As a result, none of the 24 asymptomatic cases presented any obvious symptoms while nucleic acid screening. Five cases (20.8%) developed symptoms (fever, cough, fatigue, etc.) during hospitalization. Twelve (50.0%) cases showed typical CT images of ground-glass chest and 5 (20.8%) presented stripe shadowing in the lungs. The remaining 7 (29.2%) cases showed normal CT image and had no symptoms during hospitalization. These 7 cases were younger (median age: 14.0 years; P=0.012) than the rest. None of the 24 cases developed severe COVID-19 pneumonia or died. The median communicable period, defined as the interval from the first day of positive nucleic acid tests to the first day of continuous negative tests, was 9.5 days (up to 21 days among the 24 asymptomatic cases). Through epidemiological investigation, we observed a typical asymptomatic transmission to the cohabiting family members, which even caused severe COVID-19 pneumonia. Overall, the asymptomatic carriers identified from close contacts were prone to be mildly ill during hospitalization. However, the communicable period could be up to three weeks and the communicated patients could develop severe illness. These results highlighted the importance of close contact tracing and longitudinally surveillance via virus nucleic acid tests. Further isolation recommendation and continuous nucleic acid tests may also be recommended to the patients discharged.</div>
</front>
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<name sortKey="Chen, Wei" sort="Chen, Wei" uniqKey="Chen W" first="Wei" last="Chen">Wei Chen</name>
<name sortKey="Chen, Yaling" sort="Chen, Yaling" uniqKey="Chen Y" first="Yaling" last="Chen">Yaling Chen</name>
<name sortKey="Hu, Zhibin" sort="Hu, Zhibin" uniqKey="Hu Z" first="Zhibin" last="Hu">Zhibin Hu</name>
<name sortKey="Jin, Guangfu" sort="Jin, Guangfu" uniqKey="Jin G" first="Guangfu" last="Jin">Guangfu Jin</name>
<name sortKey="Lin, Yuan" sort="Lin, Yuan" uniqKey="Lin Y" first="Yuan" last="Lin">Yuan Lin</name>
<name sortKey="Ma, Hongxia" sort="Ma, Hongxia" uniqKey="Ma H" first="Hongxia" last="Ma">Hongxia Ma</name>
<name sortKey="Shen, Hongbing" sort="Shen, Hongbing" uniqKey="Shen H" first="Hongbing" last="Shen">Hongbing Shen</name>
<name sortKey="Song, Ci" sort="Song, Ci" uniqKey="Song C" first="Ci" last="Song">Ci Song</name>
<name sortKey="Wang, Jianming" sort="Wang, Jianming" uniqKey="Wang J" first="Jianming" last="Wang">Jianming Wang</name>
<name sortKey="Xu, Chuanjun" sort="Xu, Chuanjun" uniqKey="Xu C" first="Chuanjun" last="Xu">Chuanjun Xu</name>
<name sortKey="Xu, Xin" sort="Xu, Xin" uniqKey="Xu X" first="Xin" last="Xu">Xin Xu</name>
<name sortKey="Yi, Yongxiang" sort="Yi, Yongxiang" uniqKey="Yi Y" first="Yongxiang" last="Yi">Yongxiang Yi</name>
<name sortKey="Zheng, Yishan" sort="Zheng, Yishan" uniqKey="Zheng Y" first="Yishan" last="Zheng">Yishan Zheng</name>
</country>
</tree>
</affiliations>
</record>
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