The enlightenment from two cases of asymptomatic infection with SARS-CoV-2: is it safe after 14 days of isolation?
Identifieur interne : 000889 ( Pmc/Corpus ); précédent : 000888; suivant : 000890The enlightenment from two cases of asymptomatic infection with SARS-CoV-2: is it safe after 14 days of isolation?
Auteurs : Zhi-Qun Mao ; Ren Wan ; Li-Yi He ; Yue-Chun Hu ; Wei ChenSource :
- International Journal of Infectious Diseases [ 1201-9712 ] ; 2020.
Abstract
There may be virus carriers in asymptomatic population. After 14 days of isolation, asymptomatic infection may still carry the virus. Asymptomatic infection present a new challenge to home isolation.
Url:
DOI: 10.1016/j.ijid.2020.03.041
PubMed: 32251796
PubMed Central: 7128755
Links to Exploration step
PMC:7128755Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">The enlightenment from two cases of asymptomatic infection with SARS-CoV-2: is it safe after 14 days of isolation?</title><author><name sortKey="Mao, Zhi Qun" sort="Mao, Zhi Qun" uniqKey="Mao Z" first="Zhi-Qun" last="Mao">Zhi-Qun Mao</name><affiliation><nlm:aff id="aff0005">Department of Radiology, Hunan Provincial People’s Hospital(the First Affiliate Hospital of Hunan Normal University), Changsha, 410005, Hunan Province, China</nlm:aff></affiliation></author><author><name sortKey="Wan, Ren" sort="Wan, Ren" uniqKey="Wan R" first="Ren" last="Wan">Ren Wan</name><affiliation><nlm:aff id="aff0005">Department of Radiology, Hunan Provincial People’s Hospital(the First Affiliate Hospital of Hunan Normal University), Changsha, 410005, Hunan Province, China</nlm:aff></affiliation></author><author><name sortKey="He, Li Yi" sort="He, Li Yi" uniqKey="He L" first="Li-Yi" last="He">Li-Yi He</name><affiliation><nlm:aff id="aff0005">Department of Radiology, Hunan Provincial People’s Hospital(the First Affiliate Hospital of Hunan Normal University), Changsha, 410005, Hunan Province, China</nlm:aff></affiliation></author><author><name sortKey="Hu, Yue Chun" sort="Hu, Yue Chun" uniqKey="Hu Y" first="Yue-Chun" last="Hu">Yue-Chun Hu</name><affiliation><nlm:aff id="aff0010">Department of Radiology, The center hospital of Loudi city, Loudi, 417000, Hunan Province, 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="aff0015">The Academician workstation of Loudi Central Hospital, Loudi, 417000, Hunan Province, China</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">32251796</idno><idno type="pmc">7128755</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7128755</idno><idno type="RBID">PMC:7128755</idno><idno type="doi">10.1016/j.ijid.2020.03.041</idno><date when="2020">2020</date><idno type="wicri:Area/Pmc/Corpus">000889</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000889</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">The enlightenment from two cases of asymptomatic infection with SARS-CoV-2: is it safe after 14 days of isolation?</title><author><name sortKey="Mao, Zhi Qun" sort="Mao, Zhi Qun" uniqKey="Mao Z" first="Zhi-Qun" last="Mao">Zhi-Qun Mao</name><affiliation><nlm:aff id="aff0005">Department of Radiology, Hunan Provincial People’s Hospital(the First Affiliate Hospital of Hunan Normal University), Changsha, 410005, Hunan Province, China</nlm:aff></affiliation></author><author><name sortKey="Wan, Ren" sort="Wan, Ren" uniqKey="Wan R" first="Ren" last="Wan">Ren Wan</name><affiliation><nlm:aff id="aff0005">Department of Radiology, Hunan Provincial People’s Hospital(the First Affiliate Hospital of Hunan Normal University), Changsha, 410005, Hunan Province, China</nlm:aff></affiliation></author><author><name sortKey="He, Li Yi" sort="He, Li Yi" uniqKey="He L" first="Li-Yi" last="He">Li-Yi He</name><affiliation><nlm:aff id="aff0005">Department of Radiology, Hunan Provincial People’s Hospital(the First Affiliate Hospital of Hunan Normal University), Changsha, 410005, Hunan Province, China</nlm:aff></affiliation></author><author><name sortKey="Hu, Yue Chun" sort="Hu, Yue Chun" uniqKey="Hu Y" first="Yue-Chun" last="Hu">Yue-Chun Hu</name><affiliation><nlm:aff id="aff0010">Department of Radiology, The center hospital of Loudi city, Loudi, 417000, Hunan Province, 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="aff0015">The Academician workstation of Loudi Central Hospital, Loudi, 417000, Hunan Province, China</nlm:aff></affiliation></author></analytic><series><title level="j">International Journal of Infectious Diseases</title><idno type="ISSN">1201-9712</idno><idno type="eISSN">1878-3511</idno><imprint><date when="2020">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Highlights</title><p><list list-type="simple" id="lis0005"><list-item id="lsti0005"><label>•</label><p id="par0005">There may be virus carriers in asymptomatic population.</p></list-item><list-item id="lsti0010"><label>•</label><p id="par0010">After 14 days of isolation, asymptomatic infection may still carry the virus.</p></list-item><list-item id="lsti0015"><label>•</label><p id="par0015">Asymptomatic infection present a new challenge to home isolation.</p></list-item></list></p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Li, Q" uniqKey="Li Q">Q Li</name></author><author><name sortKey="Guan, X" uniqKey="Guan X">X Guan</name></author><author><name sortKey="Wu, P" uniqKey="Wu P">P Wu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Marc Lipsitch, D" uniqKey="Marc Lipsitch D">D. Marc Lipsitch</name></author><author><name sortKey="David, L" uniqKey="David L">L. David</name></author><author><name sortKey="Swerdlow" uniqKey="Swerdlow">Swerdlow</name></author><author><name sortKey="Lyn Finelli, M D" uniqKey="Lyn Finelli M">M.D. Lyn Finelli</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Zou, Lirong" uniqKey="Zou L">Lirong Zou</name></author><author><name sortKey="Feng Ruan, M Med" uniqKey="Feng Ruan M">M.Med Feng Ruan</name></author><author><name sortKey="Mingxing Huang, Ph D" uniqKey="Mingxing Huang P">Ph.D Mingxing Huang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Who" uniqKey="Who">WHO</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bai, Yan" uniqKey="Bai Y">Yan Bai</name></author><author><name sortKey="Yao, Lingsheng" uniqKey="Yao L">Lingsheng Yao</name></author><author><name sortKey="Wei, Tao" uniqKey="Wei T">Tao Wei</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hoehl, Sebastian" uniqKey="Hoehl S">Sebastian Hoehl</name></author><author><name sortKey="Rabenau, Holger" uniqKey="Rabenau H">Holger Rabenau</name></author><author><name sortKey="Berger, Annemarie" uniqKey="Berger A">Annemarie Berger</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="brief-report"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Int J Infect Dis</journal-id><journal-id journal-id-type="iso-abbrev">Int. J. Infect. Dis</journal-id><journal-title-group><journal-title>International Journal of Infectious Diseases</journal-title></journal-title-group><issn pub-type="ppub">1201-9712</issn><issn pub-type="epub">1878-3511</issn><publisher><publisher-name>The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">32251796</article-id><article-id pub-id-type="pmc">7128755</article-id><article-id pub-id-type="publisher-id">S1201-9712(20)30173-9</article-id><article-id pub-id-type="doi">10.1016/j.ijid.2020.03.041</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>The enlightenment from two cases of asymptomatic infection with SARS-CoV-2: is it safe after 14 days of isolation?</article-title></title-group><contrib-group><contrib contrib-type="author" id="aut0005"><name><surname>Mao</surname><given-names>Zhi-Qun</given-names></name><xref rid="aff0005" ref-type="aff">a</xref></contrib><contrib contrib-type="author" id="aut0010"><name><surname>Wan</surname><given-names>Ren</given-names></name><email>wanrenradiology@163.com</email><xref rid="aff0005" ref-type="aff">a</xref><xref rid="cor0005" ref-type="corresp">⁎</xref></contrib><contrib contrib-type="author" id="aut0015"><name><surname>He</surname><given-names>Li-Yi</given-names></name><xref rid="aff0005" ref-type="aff">a</xref></contrib><contrib contrib-type="author" id="aut0020"><name><surname>Hu</surname><given-names>Yue-Chun</given-names></name><xref rid="aff0010" ref-type="aff">b</xref></contrib><contrib contrib-type="author" id="aut0025"><name><surname>Chen</surname><given-names>Wei</given-names></name><xref rid="aff0015" ref-type="aff">c</xref></contrib></contrib-group><aff id="aff0005"><label>a</label>Department of Radiology, Hunan Provincial People’s Hospital(the First Affiliate Hospital of Hunan Normal University), Changsha, 410005, Hunan Province, China</aff><aff id="aff0010"><label>b</label>Department of Radiology, The center hospital of Loudi city, Loudi, 417000, Hunan Province, China</aff><aff id="aff0015"><label>c</label>The Academician workstation of Loudi Central Hospital, Loudi, 417000, Hunan Province, China</aff><author-notes><corresp id="cor0005"><label>⁎</label>Corresponding author at: Department of Radiology, Hunan Provincial People’s Hospital(the First Affiliate Hospital of Hunan Normal University), No.61 JieFangXi Road, Changsha, 410005, Hunan Province, China. <email>wanrenradiology@163.com</email></corresp></author-notes><pub-date pub-type="pmc-release"><day>3</day><month>4</month><year>2020</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="epub"><day>3</day><month>4</month><year>2020</year></pub-date><elocation-id></elocation-id><history><date date-type="received"><day>28</day><month>2</month><year>2020</year></date><date date-type="rev-recd"><day>14</day><month>3</month><year>2020</year></date><date date-type="accepted"><day>17</day><month>3</month><year>2020</year></date></history><permissions><copyright-statement>© 2020 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.</copyright-statement><copyright-year>2020</copyright-year><copyright-holder></copyright-holder><license><license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p></license></permissions><abstract abstract-type="author-highlights" id="abs0005"><title>Highlights</title><p><list list-type="simple" id="lis0005"><list-item id="lsti0005"><label>•</label><p id="par0005">There may be virus carriers in asymptomatic population.</p></list-item><list-item id="lsti0010"><label>•</label><p id="par0010">After 14 days of isolation, asymptomatic infection may still carry the virus.</p></list-item><list-item id="lsti0015"><label>•</label><p id="par0015">Asymptomatic infection present a new challenge to home isolation.</p></list-item></list></p></abstract><abstract id="abs0010"><p>From 78 laboratory-confirmed cases, we found 2 asymptomatic infections. One patient was discharged within 14 days after treatment. Another patient was discharged 25 days after treatment, and his TR-PCR test was still positive on the 15th day. We found that there may be virus carriers in asymptomatic population with epidemiological contact history. After 14 days of isolation, asymptomatic infection may still carry the virus, which means the risk of transmission and present a new challenge to home isolation.</p></abstract><kwd-group id="kwd0005"><title>Keywords</title><kwd>Novel coronavirus (SARS-CoV-2)</kwd><kwd>Asymptomatic infection</kwd><kwd>home isolation</kwd></kwd-group></article-meta></front><body><p id="par0020">The outbreak and spread of novel coronavirus (SARS-CoV-2) that began in Wuhan, China, has attracted worldwide attention (<xref rid="bib0005" ref-type="bibr">Li et al., 2020</xref>, <xref rid="bib0010" ref-type="bibr">Marc Lipsitch et al., 2020</xref>, <xref rid="bib0015" ref-type="bibr">Zou et al., 2020</xref>). As of 24:00 on February 24, 2020, a total of 77658 confirmed cases have been reported in China, and 641742 cases of close contacts were tracked, including 87902 cases under medical observation. Most close contacts are still subject to home isolation, especially in Wuhan, the center of the epidemic. Isolation at home is mainly suitable for people who are healthy in the past, have no history of basic diseases and have no symptoms or mild symptoms at present (<xref rid="bib0020" ref-type="bibr">WHO, 2020</xref>). Considering the incubation period of SARS-CoV-2, it is recommended to home isolation for 14 days. Are those who do not experience symptoms during 14 days of isolation period necessarily safe? Of the 78 laboratory-confirmed patients collected from multiple centers, We found two asymptomatic infections.</p><p id="par0025">Case1: On January 22, 2020, a 36-year-old radiology technician performed chest CT scan on a patient who returned from Wuhan. A day later, the patient was diagnosed with Covid-19. All the health workers who had in contact with the patient were tested for real time reverse-transcription-polymerase-chain-reaction(RT-PCR), and the 36-years-old radiology technician was positive. He was immediately isolated on February 7. He stated that he had no symptoms, and his chest CT was negative on admission. Laboratory evaluation showed a myoglobin level of 86.7 ng/ml(reference range,0-70), an alanine aminotransferase level of 55U/L(reference range,0-50), a uric acid level of 459 umol/L(reference range,150-428). During the period of isolation, he had twice chest radiographs, both of which were negative. Kaletra (Lopinavir/Ritonavir) was given for antiviral treatment. On February 14 and 16, the results of RT-PCR test were negative and he was discharged. None of his close contacts were infected.</p><p id="par0030">Case 2: On January 26, 2020, a 45-year-old women for 4-days fever and cough was diagnosed with Covid-19 by a local public hospital. She claimed that she had dinner with a business partner from Wuhan 10 days ago. The local centre for Disease Control(CDC) performed RT-PCR test on her close contacts, and the results showed that her 19-year-old son was positive. Her son stated that he had no symptoms and he was immediately isolated on January 27. Laboratory tests including blood routine test, erythrocyte sedimentation rate(ESR), C-reactive protein and three items of myocardial enzyme spectrum were all negative. During the isolation, he had twice chest X-rays, both of which were negative. Kaletra (Lopinavir/Ritonavir) and ribavirin were given for antiviral treatment. On February 11, the 15 st day of isolation, he had his third RT-PCR test and the result was still positive. On February 15, the 19 st day of isolation, he carried out the fourth RT-PCR test and turned weak positive. On February 21, the 25 st day of isolation, his RT-PCR test turned negative for the second time and he was discharged (<xref rid="fig0005" ref-type="fig">Fig. 1</xref>). There were no symptoms during the treatment (<xref rid="fig0010" ref-type="fig">Fig. 2</xref>).<fig id="fig0005"><label>Fig. 1</label><caption><p>Timeline of RT-PCR test.</p></caption><alt-text id="at0005">Fig. 1</alt-text><graphic xlink:href="gr1_lrg"></graphic></fig><fig id="fig0010"><label>Fig. 2</label><caption><p>Viral load detected in throat swabs</p><p>Figure B shows cycle threshold (Ct) values of ORF1ab on reverse-transcriptase–polymerase-chain-reaction (RT-PCR) assay that were detected in throat swabs obtained from the two patients. Ct values of 29.96, 26.64, 23.32, and 20 corresponding to 1 × 10<sup>4</sup>, 1 × 10<sup>5</sup>, 1 × 10<sup>6</sup>, and 1.0 × 10<sup>7</sup> copies per milliliter. Negative samples are denoted with Ct value of more than 40.</p></caption><alt-text id="at0010">Fig. 2</alt-text><graphic xlink:href="gr2_lrg"></graphic></fig></p><p id="par0035">We discovered that after 14 days of isolation, there were still virus carriers in asymptomatic population, which means the risk of transmission (<xref rid="bib0025" ref-type="bibr">Bai et al., 2020</xref>, <xref rid="bib0030" ref-type="bibr">Hoehl et al., 2020</xref>). Due to the large number of close contacts and relatively limited medical resources, it is impossible for all contacts to go to the hospital for RT-PCR detection, which presents a new challenge for home isolation.</p><sec id="sec0005"><title>Author declarations</title><p id="par0040">All authors declare no conflicts of interest, no funding source. The work has been approved by the ethics committee of the hospital and the patients' families signed the informed consent.</p></sec><sec sec-type="COI-statement" id="sec0010"><title>Declaration of interests</title><p id="par0045">The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.</p></sec></body><back><ref-list id="bibl0005"><title>Reference</title><ref id="bib0005"><element-citation publication-type="journal" id="sbref0005"><person-group person-group-type="author"><name><surname>Li</surname><given-names>Q</given-names></name><name><surname>Guan</surname><given-names>X</given-names></name><name><surname>Wu</surname><given-names>P</given-names></name></person-group><article-title>Early transmission dynamics in Wuhan, China, of novel coronavirus–infected pneumonia</article-title><source>N Engl J Med.</source><year>2020</year><comment>oa2001316</comment></element-citation></ref><ref id="bib0010"><element-citation publication-type="journal" id="sbref0010"><person-group person-group-type="author"><name><surname>Marc Lipsitch</surname><given-names>D.</given-names></name><name><surname>David</surname><given-names>L.</given-names></name><name><surname>Swerdlow</surname></name><name><surname>Lyn Finelli</surname><given-names>M.D.</given-names></name></person-group><article-title>Dr.P.H. Defini ng the Epidemiology of Covid-19-Studies Needed</article-title><source>N Engl J Med</source><year>2020</year><comment>DOI: 10. 1056/NEJMp2002125</comment></element-citation></ref><ref id="bib0015"><element-citation publication-type="journal" id="sbref0015"><person-group person-group-type="author"><name><surname>Zou</surname><given-names>Lirong</given-names></name><name><surname>Feng Ruan</surname><given-names>M.Med</given-names></name><name><surname>Mingxing Huang</surname><given-names>Ph.D</given-names></name></person-group><article-title>SAR S-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients</article-title><source>N Engl J Med</source><year>2020</year></element-citation></ref><ref id="bib0020"><element-citation publication-type="book" id="sbref0020"><person-group person-group-type="author"><name><surname>WHO</surname></name></person-group><chapter-title>Coronavirus disease (COVID-19) advice for the public</chapter-title><year>2020</year><comment>Available at:https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public</comment></element-citation></ref><ref id="bib0025"><element-citation publication-type="journal" id="sbref0025"><person-group person-group-type="author"><name><surname>Bai</surname><given-names>Yan</given-names></name><name><surname>Yao</surname><given-names>Lingsheng</given-names></name><name><surname>Wei</surname><given-names>Tao</given-names></name></person-group><article-title>Presumed asymptomati c carrier transmission of Covid-19</article-title><source>JAMA</source><year>2020</year><comment>Published online February 21,202 0. DOI</comment></element-citation></ref><ref id="bib0030"><element-citation publication-type="journal" id="sbref0030"><person-group person-group-type="author"><name><surname>Hoehl</surname><given-names>Sebastian</given-names></name><name><surname>Rabenau</surname><given-names>Holger</given-names></name><name><surname>Berger</surname><given-names>Annemarie</given-names></name></person-group><article-title>Evidence of SARS-CoV-2 Infection in Returning Travelers from Wuhan, Chi na</article-title><source>N Engl J Me</source><year>2020</year><comment>DOI:10.1056/NEJMc2001899</comment></element-citation></ref></ref-list></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Sante/explor/SrasV1/Data/Pmc/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000889 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd -nk 000889 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Sante
|area= SrasV1
|flux= Pmc
|étape= Corpus
|type= RBID
|clé= PMC:7128755
|texte= The enlightenment from two cases of asymptomatic infection with SARS-CoV-2: is it safe after 14 days of isolation?
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/RBID.i -Sk "pubmed:32251796" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd \
| NlmPubMed2Wicri -a SrasV1
| This area was generated with Dilib version V0.6.33. |  |