Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, China.
Identifieur interne : 000727 ( PubMed/Curation ); précédent : 000726; suivant : 000728Clinical 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
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University of Chinese Medicine, Nanjing, 210003, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Nanjing Infectious Disease Center, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 210003</wicri:regionArea></affiliation></author><author><name sortKey="Song, Ci" sort="Song, Ci" uniqKey="Song C" first="Ci" last="Song">Ci Song</name><affiliation wicri:level="1"><nlm:affiliation>Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166</wicri:regionArea></affiliation></author><author><name sortKey="Xu, Chuanjun" sort="Xu, Chuanjun" uniqKey="Xu C" first="Chuanjun" last="Xu">Chuanjun Xu</name><affiliation wicri:level="1"><nlm:affiliation>Department of Radiology, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 210003, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Radiology, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 210003</wicri:regionArea></affiliation></author><author><name sortKey="Jin, Guangfu" sort="Jin, Guangfu" uniqKey="Jin G" first="Guangfu" last="Jin">Guangfu Jin</name><affiliation wicri:level="1"><nlm:affiliation>Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166</wicri:regionArea></affiliation></author><author><name sortKey="Chen, Yaling" sort="Chen, Yaling" uniqKey="Chen Y" first="Yaling" last="Chen">Yaling Chen</name><affiliation wicri:level="1"><nlm:affiliation>Nanjing Infectious Disease Center, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 210003, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Nanjing Infectious Disease Center, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 210003</wicri:regionArea></affiliation></author><author><name sortKey="Xu, Xin" sort="Xu, Xin" uniqKey="Xu X" first="Xin" last="Xu">Xin Xu</name><affiliation wicri:level="1"><nlm:affiliation>Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166</wicri:regionArea></affiliation></author><author><name sortKey="Ma, Hongxia" sort="Ma, Hongxia" uniqKey="Ma H" first="Hongxia" last="Ma">Hongxia Ma</name><affiliation wicri:level="1"><nlm:affiliation>Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166</wicri:regionArea></affiliation></author><author><name sortKey="Chen, Wei" sort="Chen, Wei" uniqKey="Chen W" first="Wei" last="Chen">Wei Chen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Research Center, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 210003, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Clinical Research Center, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 210003</wicri:regionArea></affiliation></author><author><name sortKey="Lin, Yuan" sort="Lin, Yuan" uniqKey="Lin Y" first="Yuan" last="Lin">Yuan Lin</name><affiliation wicri:level="1"><nlm:affiliation>Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, 211166</wicri:regionArea></affiliation></author><author><name sortKey="Zheng, Yishan" sort="Zheng, Yishan" uniqKey="Zheng Y" first="Yishan" last="Zheng">Yishan Zheng</name><affiliation wicri:level="1"><nlm:affiliation>Department of Critical Medicine, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 210003, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Critical Medicine, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 210003</wicri:regionArea></affiliation></author><author><name sortKey="Wang, Jianming" sort="Wang, Jianming" uniqKey="Wang J" first="Jianming" last="Wang">Jianming Wang</name><affiliation wicri:level="1"><nlm:affiliation>Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166</wicri:regionArea></affiliation></author><author><name sortKey="Hu, Zhibin" sort="Hu, Zhibin" uniqKey="Hu Z" first="Zhibin" last="Hu">Zhibin Hu</name><affiliation wicri:level="1"><nlm:affiliation>Nanjing Infectious Disease Center, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 210003, China. zhibin_hu@njmu.edu.cn.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Nanjing Infectious Disease Center, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 210003</wicri:regionArea></affiliation></author><author><name sortKey="Yi, Yongxiang" sort="Yi, Yongxiang" uniqKey="Yi Y" first="Yongxiang" last="Yi">Yongxiang Yi</name><affiliation wicri:level="1"><nlm:affiliation>Nanjing Infectious Disease Center, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 210003, China. ian0126@126.com.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Nanjing Infectious Disease Center, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 210003</wicri:regionArea></affiliation></author><author><name sortKey="Shen, Hongbing" sort="Shen, Hongbing" uniqKey="Shen H" first="Hongbing" last="Shen">Hongbing Shen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166</wicri:regionArea></affiliation></author></analytic><series><title level="j">Science China. Life sciences</title><idno type="eISSN">1869-1889</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><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></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">32146694</PMID><DateRevised><Year>2020</Year><Month>03</Month><Day>08</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1869-1889</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Mar</Month><Day>04</Day></PubDate></JournalIssue><Title>Science China. Life sciences</Title><ISOAbbreviation>Sci China Life Sci</ISOAbbreviation></Journal><ArticleTitle>Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, China.</ArticleTitle><ELocationID EIdType="doi" ValidYN="Y">10.1007/s11427-020-1661-4</ELocationID><Abstract><AbstractText>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.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Hu</LastName><ForeName>Zhiliang</ForeName><Initials>Z</Initials><AffiliationInfo><Affiliation>Nanjing Infectious Disease Center, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 210003, China.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Song</LastName><ForeName>Ci</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Xu</LastName><ForeName>Chuanjun</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Radiology, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 210003, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jin</LastName><ForeName>Guangfu</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chen</LastName><ForeName>Yaling</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Nanjing Infectious Disease Center, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 210003, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Xu</LastName><ForeName>Xin</ForeName><Initials>X</Initials><AffiliationInfo><Affiliation>Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ma</LastName><ForeName>Hongxia</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chen</LastName><ForeName>Wei</ForeName><Initials>W</Initials><AffiliationInfo><Affiliation>Department of Clinical Research Center, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 210003, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lin</LastName><ForeName>Yuan</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zheng</LastName><ForeName>Yishan</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Department of Critical Medicine, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 210003, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wang</LastName><ForeName>Jianming</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hu</LastName><ForeName>Zhibin</ForeName><Initials>Z</Initials><AffiliationInfo><Affiliation>Nanjing Infectious Disease Center, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 210003, China. zhibin_hu@njmu.edu.cn.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yi</LastName><ForeName>Yongxiang</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Nanjing Infectious Disease Center, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 210003, China. ian0126@126.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Shen</LastName><ForeName>Hongbing</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>03</Month><Day>04</Day></ArticleDate></Article><MedlineJournalInfo><Country>China</Country><MedlineTA>Sci China Life Sci</MedlineTA><NlmUniqueID>101529880</NlmUniqueID><ISSNLinking>1674-7305</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">China</Keyword><Keyword MajorTopicYN="N">asymptomatic infections</Keyword><Keyword MajorTopicYN="N">close contact</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>02</Month><Day>27</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>03</Month><Day>03</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>3</Month><Day>9</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>3</Month><Day>9</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>3</Month><Day>9</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>aheadofprint</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32146694</ArticleId><ArticleId IdType="doi">10.1007/s11427-020-1661-4</ArticleId><ArticleId IdType="pii">10.1007/s11427-020-1661-4</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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