Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, China
Identifieur interne : 000321 ( Pmc/Corpus ); précédent : 000320; suivant : 000322Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, China
Auteurs : Zhiliang Hu ; Ci Song ; Chuanjun Xu ; Guangfu Jin ; Yaling Chen ; Xin Xu ; Hongxia Ma ; Wei Chen ; Yuan Lin ; Yishan Zheng ; Jianming Wang ; Zhibin Hu ; Yongxiang Yi ; Hongbing ShenSource :
- Science China. Life Sciences [ 1674-7305 ] ; 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;
Supplementary material is available for this article at 10.1007/s11427-020-1661-4 and is accessible for authorized users.
Url:
DOI: 10.1007/s11427-020-1661-4
PubMed: NONE
PubMed Central: 7088568
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PMC:7088568Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, China</title><author><name sortKey="Hu, Zhiliang" sort="Hu, Zhiliang" uniqKey="Hu Z" first="Zhiliang" last="Hu">Zhiliang Hu</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.410745.3</institution-id><institution-id institution-id-type="ISNI">0000 0004 1765 1045</institution-id><institution>Nanjing Infectious Disease Center, the Second Hospital of Nanjing,</institution><institution>Nanjing University of Chinese Medicine,</institution></institution-wrap>Nanjing, 210003 China</nlm:aff></affiliation><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.89957.3a</institution-id><institution-id institution-id-type="ISNI">0000 0000 9255 8984</institution-id><institution>Department of Epidemiology, Center for Global Health, School of Public Health,</institution><institution>Nanjing Medical University,</institution></institution-wrap>Nanjing, 211166 China</nlm:aff></affiliation></author><author><name sortKey="Song, Ci" sort="Song, Ci" uniqKey="Song C" first="Ci" last="Song">Ci Song</name><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.89957.3a</institution-id><institution-id institution-id-type="ISNI">0000 0000 9255 8984</institution-id><institution>Department of Epidemiology, Center for Global Health, School of Public Health,</institution><institution>Nanjing Medical University,</institution></institution-wrap>Nanjing, 211166 China</nlm:aff></affiliation><affiliation><nlm:aff id="Aff3"><institution-wrap><institution-id institution-id-type="GRID">grid.89957.3a</institution-id><institution-id institution-id-type="ISNI">0000 0000 9255 8984</institution-id><institution>State Key Laboratory of Reproductive Medicine,</institution><institution>Nanjing Medical 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Nanjing,</institution><institution>Nanjing University of Chinese Medicine,</institution></institution-wrap>Nanjing, 210003 China</nlm:aff></affiliation></author><author><name sortKey="Xu, Xin" sort="Xu, Xin" uniqKey="Xu X" first="Xin" last="Xu">Xin Xu</name><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.89957.3a</institution-id><institution-id institution-id-type="ISNI">0000 0000 9255 8984</institution-id><institution>Department of Epidemiology, Center for Global Health, School of Public Health,</institution><institution>Nanjing Medical University,</institution></institution-wrap>Nanjing, 211166 China</nlm:aff></affiliation></author><author><name sortKey="Ma, Hongxia" sort="Ma, Hongxia" uniqKey="Ma H" first="Hongxia" last="Ma">Hongxia Ma</name><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.89957.3a</institution-id><institution-id institution-id-type="ISNI">0000 0000 9255 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Nanjing,</institution><institution>Nanjing University of Chinese Medicine,</institution></institution-wrap>Nanjing, 210003 China</nlm:aff></affiliation><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.89957.3a</institution-id><institution-id institution-id-type="ISNI">0000 0000 9255 8984</institution-id><institution>Department of Epidemiology, Center for Global Health, School of Public Health,</institution><institution>Nanjing Medical University,</institution></institution-wrap>Nanjing, 211166 China</nlm:aff></affiliation></author><author><name sortKey="Song, Ci" sort="Song, Ci" uniqKey="Song C" first="Ci" last="Song">Ci Song</name><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.89957.3a</institution-id><institution-id institution-id-type="ISNI">0000 0000 9255 8984</institution-id><institution>Department of Epidemiology, Center for Global Health, School of Public Health,</institution><institution>Nanjing Medical University,</institution></institution-wrap>Nanjing, 211166 China</nlm:aff></affiliation><affiliation><nlm:aff id="Aff3"><institution-wrap><institution-id institution-id-type="GRID">grid.89957.3a</institution-id><institution-id institution-id-type="ISNI">0000 0000 9255 8984</institution-id><institution>State Key Laboratory of Reproductive Medicine,</institution><institution>Nanjing Medical University,</institution></institution-wrap>Nanjing, 211166 China</nlm:aff></affiliation></author><author><name sortKey="Xu, Chuanjun" sort="Xu, Chuanjun" uniqKey="Xu C" first="Chuanjun" last="Xu">Chuanjun Xu</name><affiliation><nlm:aff id="Aff4"><institution-wrap><institution-id institution-id-type="GRID">grid.410745.3</institution-id><institution-id institution-id-type="ISNI">0000 0004 1765 1045</institution-id><institution>Department of Radiology, the Second Hospital of Nanjing,</institution><institution>Nanjing University of Chinese Medicine,</institution></institution-wrap>Nanjing, 210003 China</nlm:aff></affiliation></author><author><name sortKey="Jin, Guangfu" sort="Jin, Guangfu" uniqKey="Jin G" first="Guangfu" last="Jin">Guangfu Jin</name><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.89957.3a</institution-id><institution-id institution-id-type="ISNI">0000 0000 9255 8984</institution-id><institution>Department of Epidemiology, Center for Global Health, School of Public Health,</institution><institution>Nanjing Medical University,</institution></institution-wrap>Nanjing, 211166 China</nlm:aff></affiliation><affiliation><nlm:aff id="Aff3"><institution-wrap><institution-id institution-id-type="GRID">grid.89957.3a</institution-id><institution-id institution-id-type="ISNI">0000 0000 9255 8984</institution-id><institution>State Key Laboratory of Reproductive Medicine,</institution><institution>Nanjing Medical University,</institution></institution-wrap>Nanjing, 211166 China</nlm:aff></affiliation></author><author><name sortKey="Chen, Yaling" sort="Chen, Yaling" uniqKey="Chen Y" first="Yaling" last="Chen">Yaling Chen</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.410745.3</institution-id><institution-id institution-id-type="ISNI">0000 0004 1765 1045</institution-id><institution>Nanjing Infectious Disease Center, the Second Hospital of Nanjing,</institution><institution>Nanjing University of Chinese Medicine,</institution></institution-wrap>Nanjing, 210003 China</nlm:aff></affiliation></author><author><name sortKey="Xu, Xin" sort="Xu, Xin" uniqKey="Xu X" first="Xin" last="Xu">Xin Xu</name><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.89957.3a</institution-id><institution-id institution-id-type="ISNI">0000 0000 9255 8984</institution-id><institution>Department of Epidemiology, Center for Global Health, School of Public Health,</institution><institution>Nanjing Medical University,</institution></institution-wrap>Nanjing, 211166 China</nlm:aff></affiliation></author><author><name sortKey="Ma, Hongxia" sort="Ma, Hongxia" uniqKey="Ma H" first="Hongxia" last="Ma">Hongxia Ma</name><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.89957.3a</institution-id><institution-id institution-id-type="ISNI">0000 0000 9255 8984</institution-id><institution>Department of Epidemiology, Center for Global Health, School of Public Health,</institution><institution>Nanjing Medical University,</institution></institution-wrap>Nanjing, 211166 China</nlm:aff></affiliation><affiliation><nlm:aff id="Aff3"><institution-wrap><institution-id institution-id-type="GRID">grid.89957.3a</institution-id><institution-id institution-id-type="ISNI">0000 0000 9255 8984</institution-id><institution>State Key Laboratory of Reproductive Medicine,</institution><institution>Nanjing Medical University,</institution></institution-wrap>Nanjing, 211166 China</nlm:aff></affiliation></author><author><name sortKey="Chen, Wei" sort="Chen, Wei" uniqKey="Chen W" first="Wei" last="Chen">Wei Chen</name><affiliation><nlm:aff id="Aff5"><institution-wrap><institution-id institution-id-type="GRID">grid.410745.3</institution-id><institution-id institution-id-type="ISNI">0000 0004 1765 1045</institution-id><institution>Department of Clinical Research Center, the Second Hospital of Nanjing,</institution><institution>Nanjing University of Chinese Medicine,</institution></institution-wrap>Nanjing, 210003 China</nlm:aff></affiliation></author><author><name sortKey="Lin, Yuan" sort="Lin, Yuan" uniqKey="Lin Y" first="Yuan" last="Lin">Yuan Lin</name><affiliation><nlm:aff id="Aff6"><institution-wrap><institution-id institution-id-type="GRID">grid.89957.3a</institution-id><institution-id institution-id-type="ISNI">0000 0000 9255 8984</institution-id><institution>Department of Maternal, Child and Adolescent Health, School of Public Health,</institution><institution>Nanjing Medical University,</institution></institution-wrap>Nanjing, 211166 China</nlm:aff></affiliation></author><author><name sortKey="Zheng, Yishan" sort="Zheng, Yishan" uniqKey="Zheng Y" first="Yishan" last="Zheng">Yishan Zheng</name><affiliation><nlm:aff id="Aff7"><institution-wrap><institution-id institution-id-type="GRID">grid.410745.3</institution-id><institution-id institution-id-type="ISNI">0000 0004 1765 1045</institution-id><institution>Department of Critical Medicine, the Second Hospital of Nanjing,</institution><institution>Nanjing University of Chinese Medicine,</institution></institution-wrap>Nanjing, 210003 China</nlm:aff></affiliation></author><author><name sortKey="Wang, Jianming" sort="Wang, Jianming" uniqKey="Wang J" first="Jianming" last="Wang">Jianming Wang</name><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.89957.3a</institution-id><institution-id institution-id-type="ISNI">0000 0000 9255 8984</institution-id><institution>Department of Epidemiology, Center for Global Health, School of Public Health,</institution><institution>Nanjing Medical University,</institution></institution-wrap>Nanjing, 211166 China</nlm:aff></affiliation></author><author><name sortKey="Hu, Zhibin" sort="Hu, Zhibin" uniqKey="Hu Z" first="Zhibin" last="Hu">Zhibin Hu</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.410745.3</institution-id><institution-id institution-id-type="ISNI">0000 0004 1765 1045</institution-id><institution>Nanjing Infectious Disease Center, the Second Hospital of Nanjing,</institution><institution>Nanjing University of Chinese Medicine,</institution></institution-wrap>Nanjing, 210003 China</nlm:aff></affiliation></author><author><name sortKey="Yi, Yongxiang" sort="Yi, Yongxiang" uniqKey="Yi Y" first="Yongxiang" last="Yi">Yongxiang Yi</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.410745.3</institution-id><institution-id institution-id-type="ISNI">0000 0004 1765 1045</institution-id><institution>Nanjing Infectious Disease Center, the Second Hospital of Nanjing,</institution><institution>Nanjing University of Chinese Medicine,</institution></institution-wrap>Nanjing, 210003 China</nlm:aff></affiliation></author><author><name sortKey="Shen, Hongbing" sort="Shen, Hongbing" uniqKey="Shen H" first="Hongbing" last="Shen">Hongbing Shen</name><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.89957.3a</institution-id><institution-id institution-id-type="ISNI">0000 0000 9255 8984</institution-id><institution>Department of Epidemiology, Center for Global Health, School of Public Health,</institution><institution>Nanjing Medical University,</institution></institution-wrap>Nanjing, 211166 China</nlm:aff></affiliation><affiliation><nlm:aff id="Aff3"><institution-wrap><institution-id institution-id-type="GRID">grid.89957.3a</institution-id><institution-id institution-id-type="ISNI">0000 0000 9255 8984</institution-id><institution>State Key Laboratory of Reproductive Medicine,</institution><institution>Nanjing Medical University,</institution></institution-wrap>Nanjing, 211166 China</nlm:aff></affiliation></author></analytic><series><title level="j">Science China. Life Sciences</title><idno type="ISSN">1674-7305</idno><idno type="eISSN">1869-1889</idno><imprint><date when="2020">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>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; <italic>P</italic>=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.</p><sec><title>Electronic Supplementary Material</title><p>Supplementary material is available for this article at 10.1007/s11427-020-1661-4 and is accessible for authorized users.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Chan, Jfw" uniqKey="Chan J">JFW Chan</name></author><author><name sortKey="Yuan, S" uniqKey="Yuan S">S Yuan</name></author><author><name sortKey="Kok, Kh" uniqKey="Kok K">KH Kok</name></author><author><name sortKey="To, Kkw" uniqKey="To K">KKW To</name></author><author><name sortKey="Chu, H" uniqKey="Chu H">H Chu</name></author><author><name sortKey="Yang, J" uniqKey="Yang J">J Yang</name></author><author><name sortKey="Xing, F" uniqKey="Xing F">F Xing</name></author><author><name sortKey="Liu, J" uniqKey="Liu J">J Liu</name></author><author><name sortKey="Yip, Ccy" uniqKey="Yip 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Sci China Life Sci</journal-id><journal-id journal-id-type="iso-abbrev">Sci China Life Sci</journal-id><journal-title-group><journal-title>Science China. Life Sciences</journal-title></journal-title-group><issn pub-type="ppub">1674-7305</issn><issn pub-type="epub">1869-1889</issn><publisher><publisher-name>Science China Press</publisher-name><publisher-loc>Beijing</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmc">7088568</article-id><article-id pub-id-type="publisher-id">1661</article-id><article-id pub-id-type="doi">10.1007/s11427-020-1661-4</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Paper</subject></subj-group></article-categories><title-group><article-title>Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, China</article-title></title-group><contrib-group><contrib contrib-type="author" equal-contrib="yes"><name><surname>Hu</surname><given-names>Zhiliang</given-names></name><xref ref-type="aff" rid="Aff1">1</xref><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author" equal-contrib="yes"><name><surname>Song</surname><given-names>Ci</given-names></name><xref ref-type="aff" rid="Aff2">2</xref><xref ref-type="aff" rid="Aff3">3</xref></contrib><contrib contrib-type="author" equal-contrib="yes"><name><surname>Xu</surname><given-names>Chuanjun</given-names></name><xref ref-type="aff" rid="Aff4">4</xref></contrib><contrib contrib-type="author" equal-contrib="yes"><name><surname>Jin</surname><given-names>Guangfu</given-names></name><xref ref-type="aff" rid="Aff2">2</xref><xref ref-type="aff" rid="Aff3">3</xref></contrib><contrib contrib-type="author"><name><surname>Chen</surname><given-names>Yaling</given-names></name><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Xu</surname><given-names>Xin</given-names></name><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Ma</surname><given-names>Hongxia</given-names></name><xref ref-type="aff" rid="Aff2">2</xref><xref ref-type="aff" rid="Aff3">3</xref></contrib><contrib contrib-type="author"><name><surname>Chen</surname><given-names>Wei</given-names></name><xref ref-type="aff" rid="Aff5">5</xref></contrib><contrib contrib-type="author"><name><surname>Lin</surname><given-names>Yuan</given-names></name><xref ref-type="aff" rid="Aff6">6</xref></contrib><contrib contrib-type="author"><name><surname>Zheng</surname><given-names>Yishan</given-names></name><xref ref-type="aff" rid="Aff7">7</xref></contrib><contrib contrib-type="author"><name><surname>Wang</surname><given-names>Jianming</given-names></name><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Hu</surname><given-names>Zhibin</given-names></name><address><email>zhibin_hu@njmu.edu.cn</email></address><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Yi</surname><given-names>Yongxiang</given-names></name><address><email>ian0126@126.com</email></address><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Shen</surname><given-names>Hongbing</given-names></name><xref ref-type="aff" rid="Aff2">2</xref><xref ref-type="aff" rid="Aff3">3</xref></contrib><aff id="Aff1"><label>1</label><institution-wrap><institution-id institution-id-type="GRID">grid.410745.3</institution-id><institution-id institution-id-type="ISNI">0000 0004 1765 1045</institution-id><institution>Nanjing Infectious Disease Center, the Second Hospital of Nanjing,</institution><institution>Nanjing University of Chinese Medicine,</institution></institution-wrap>Nanjing, 210003 China</aff><aff id="Aff2"><label>2</label><institution-wrap><institution-id institution-id-type="GRID">grid.89957.3a</institution-id><institution-id institution-id-type="ISNI">0000 0000 9255 8984</institution-id><institution>Department of Epidemiology, Center for Global Health, School of Public Health,</institution><institution>Nanjing Medical University,</institution></institution-wrap>Nanjing, 211166 China</aff><aff id="Aff3"><label>3</label><institution-wrap><institution-id institution-id-type="GRID">grid.89957.3a</institution-id><institution-id institution-id-type="ISNI">0000 0000 9255 8984</institution-id><institution>State Key Laboratory of Reproductive Medicine,</institution><institution>Nanjing Medical University,</institution></institution-wrap>Nanjing, 211166 China</aff><aff id="Aff4"><label>4</label><institution-wrap><institution-id institution-id-type="GRID">grid.410745.3</institution-id><institution-id institution-id-type="ISNI">0000 0004 1765 1045</institution-id><institution>Department of Radiology, the Second Hospital of Nanjing,</institution><institution>Nanjing University of Chinese Medicine,</institution></institution-wrap>Nanjing, 210003 China</aff><aff id="Aff5"><label>5</label><institution-wrap><institution-id institution-id-type="GRID">grid.410745.3</institution-id><institution-id institution-id-type="ISNI">0000 0004 1765 1045</institution-id><institution>Department of Clinical Research Center, the Second Hospital of Nanjing,</institution><institution>Nanjing University of Chinese Medicine,</institution></institution-wrap>Nanjing, 210003 China</aff><aff id="Aff6"><label>6</label><institution-wrap><institution-id institution-id-type="GRID">grid.89957.3a</institution-id><institution-id institution-id-type="ISNI">0000 0000 9255 8984</institution-id><institution>Department of Maternal, Child and Adolescent Health, School of Public Health,</institution><institution>Nanjing Medical University,</institution></institution-wrap>Nanjing, 211166 China</aff><aff id="Aff7"><label>7</label><institution-wrap><institution-id institution-id-type="GRID">grid.410745.3</institution-id><institution-id institution-id-type="ISNI">0000 0004 1765 1045</institution-id><institution>Department of Critical Medicine, the Second Hospital of Nanjing,</institution><institution>Nanjing University of Chinese Medicine,</institution></institution-wrap>Nanjing, 210003 China</aff></contrib-group><pub-date pub-type="epub"><day>4</day><month>3</month><year>2020</year></pub-date><fpage>1</fpage><lpage>6</lpage><history><date date-type="received"><day>27</day><month>2</month><year>2020</year></date><date date-type="accepted"><day>3</day><month>3</month><year>2020</year></date></history><permissions><copyright-statement>© Science China Press and Springer-Verlag GmbH Germany, part of Springer Nature 2020</copyright-statement><license><license-p>This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.</license-p></license></permissions><abstract id="Abs1"><p>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; <italic>P</italic>=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.</p><sec><title>Electronic Supplementary Material</title><p>Supplementary material is available for this article at 10.1007/s11427-020-1661-4 and is accessible for authorized users.</p></sec></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>COVID-19</kwd><kwd>asymptomatic infections</kwd><kwd>close contact</kwd><kwd>China</kwd></kwd-group></article-meta></front><body><sec sec-type="supplementary-material"><title>Electronic supplementary material</title><sec id="Sec1"><p><supplementary-material content-type="local-data" id="MOESM1"><media xlink:href="11427_2020_1661_MOESM1_ESM.pdf"><caption><p>Supplementary material, approximately 467 KB.</p></caption></media></supplementary-material></p></sec></sec></body><back><fn-group><fn><p>Contributed equally to this work</p></fn></fn-group><ack><title>Acknowledgements</title><p>The authors would like to thank the patients and the supporting staff in this study. 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