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Tytuł:
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Virus shedding dynamics in asymptomatic and mildly symptomatic patients infected with SARS-CoV-2.
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Autorzy:
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Li W; Chongqing University Central Hospital, China.
Su YY; State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, Fujian, China.
Zhi SS; Chongqing University Central Hospital, China.
Huang J; Chongqing University Central Hospital, China.
Zhuang CL; State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, Fujian, China.
Bai WZ; Chongqing University Central Hospital, China.
Wan Y; Division of Infectious Diseases, Chongqing Public Health Medical Center, China.
Meng XR; Yuzhong District Center for Disease Control and Prevention of Chongqing, Chongqing, China.
Zhang L; Division of Infectious Diseases, Chongqing Public Health Medical Center, China.
Zhou YB; Yuzhong District Center for Disease Control and Prevention of Chongqing, Chongqing, China.
Luo YY; Yuzhong District Center for Disease Control and Prevention of Chongqing, Chongqing, China.
Ge SX; State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, Fujian, China. Electronic address: .
Chen YK; Division of Infectious Diseases, Chongqing Public Health Medical Center, China. Electronic address: .
Ma Y; Chongqing University Central Hospital, China. Electronic address: .
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Źródło:
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Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases [Clin Microbiol Infect] 2020 Nov; Vol. 26 (11), pp. 1556.e1-1556.e6. Date of Electronic Publication: 2020 Jul 09.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: 2015- : London : Elsevier
Original Publication: Paris : Decker Europe, c1995-
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MeSH Terms:
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Asymptomatic Infections*
Virus Shedding*
Betacoronavirus/*physiology
Coronavirus Infections/*virology
Pneumonia, Viral/*virology
Adult ; Antibodies, Viral/blood ; Betacoronavirus/isolation & purification ; COVID-19 ; COVID-19 Testing ; COVID-19 Vaccines ; China/epidemiology ; Clinical Laboratory Techniques ; Convalescence ; Coronavirus Infections/diagnosis ; Coronavirus Infections/transmission ; Female ; Hospitalization ; Humans ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/transmission ; RNA, Viral/genetics ; SARS-CoV-2
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References:
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Emerg Infect Dis. 2019 Apr;25(4):753-766. (PMID: 30882305)
N Engl J Med. 2020 Apr 30;382(18):1708-1720. (PMID: 32109013)
Lancet. 2020 Mar 28;395(10229):1054-1062. (PMID: 32171076)
Clin Infect Dis. 2016 Feb 15;62(4):477-483. (PMID: 26565003)
Sci China Life Sci. 2020 May;63(5):706-711. (PMID: 32146694)
N Engl J Med. 2020 Mar 19;382(12):1177-1179. (PMID: 32074444)
JAMA. 2020 Apr 21;323(15):1502-1503. (PMID: 32105304)
Clin Infect Dis. 2020 Nov 19;71(16):2027-2034. (PMID: 32221519)
JAMA. 2020 Apr 7;323(13):1239-1242. (PMID: 32091533)
Zhonghua Liu Xing Bing Xue Za Zhi. 2020 Feb 10;41(2):145-151. (PMID: 32064853)
JAMA. 2020 Apr 21;323(15):1488-1494. (PMID: 32125362)
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Contributed Indexing:
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Keywords: Antibodies; Asymptomatic infections; Convalescence; SARS-CoV-2; Virus shedding
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Substance Nomenclature:
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0 (Antibodies, Viral)
0 (COVID-19 Vaccines)
0 (Covid-19 aAPC vaccine)
0 (RNA, Viral)
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Entry Date(s):
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Date Created: 20200713 Date Completed: 20201120 Latest Revision: 20220716
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Update Code:
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20240105
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PubMed Central ID:
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PMC7346822
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DOI:
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10.1016/j.cmi.2020.07.008
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PMID:
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32653662
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Objectives: Asymptomatic patients, together with those with mild symptoms of coronavirus disease 2019 (COVID-19), may play an important role in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. However, the dynamics of virus shedding during the various phases of the clinical course of COVID-19 remains unclear at this stage.
Methods: A total of 18 patients found to be positive for SARS-CoV-2 infection by real-time reverse transcription PCR (RT-PCR) assay and admitted to Chongqing University Central Hospital between 29 January and 5 February 2020 were enrolled into this study. Medical data, pulmonary computed tomographic (CT) scan images and RT-PCR results were periodically collected during the patients' hospital stay. All participants were actively followed up for 2 weeks after discharge.
Results: A total of nine (50%) asymptomatic patients and nine (50%) patients with mild symptoms of COVID-19 were identified at admission. Six patients (66.7%) who were asymptomatic at admission developed subjective symptoms during hospitalization and were recategorized as being presymptomatic. The median duration of virus shedding was 11.5, 28 and 31 days for presymptomatic, asymptomatic and mildly symptomatic patients, separately. Seven patients (38.9%) continued to shed virus after hospital discharge. During the convalescent phase, detectable antibodies to SARS-CoV-2 and RNA were simultaneously observed in five patients (27.8%).
Conclusions: Long-term virus shedding was documented in patients with mild symptoms and in asymptomatic patients. Specific antibody production to SARS-CoV-2 may not guarantee virus clearance after discharge. These observations should be considered when making decisions regarding clinical and public health, and when considering strategies for the prevention and control of SARS-CoV-2 infection.
(Copyright © 2020 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)
