Asymptomatic SARS-CoV-2 infections: What do we need to know?

Tan, Caixia; Xiao, Yuanyuan; Meng, Xianyu; Huang, Xun; Li, Chunhui; Wu, Anhua

doi:10.1017/ice.2020.201

Cited by 6 publications

(7 citation statements)

References 14 publications

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“…If there are abnormal findings on the CXR or the patient presented with a fever before the visit, COVID-19 infection should be strongly suspected; hence, performing RT-PCR tests is strongly encouraged. However, asymptomatic infections in patients with COVID-19 have been confirmed in the literature and this study [ 9 10 ]. Therefore, COVID-19 testing in all patients with OHCA is recommended, if possible, because COVID-19 screening with test results or symptoms may not be feasible when COVID-19 is not the main cause of cardiac arrest ( Fig.…”

Section: Discussionsupporting

confidence: 76%

Confirmation of COVID-19 in Out-of-Hospital Cardiac Arrest Patients and Postmortem Management in the Emergency Department during the COVID-19 Outbreak

et al. 2020

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Background: There is currently a lack of evidence-based postresuscitation or postmortem guidelines for patients with out-of-hospital cardiac arrest (OHCA) in the setting of an emerging infectious disease. This study aimed to develop and validate a multimodal screening tool that aids in predicting the disease confirmation in emergency situations and patients with OHCA during a coronavirus disease 2019 (COVID-19) outbreak. Materials and Methods: We conducted a retrospective, multicenter observational study of adult patients with OHCA in Daegu, Korea. To identify the potential predictors that could be used in screening tools in the emergency department, we applied logistic regression to data collected from March 1 to March 14. The prediction performance of the screening variables was then assessed and validated on the data of patients with OHCA who were treated between February 19 and March 31, 2020. General patient characteristics and hematological findings of the COVID-19-negative and COVID-19-positive groups were compared. We also evaluated confirmation test criteria as predictors for COVID-19 positivity in patients with OHCA. Results: Advanced age, body temperature, and abnormal chest X-ray (CXR) revealed significant predictive ability in the derivation cohort. Of the 184 adult patients with OHCA identified in the validation cohort, 80 patients were included in the analysis. Notably, 9 patients were positive and 71 were negative on the COVID-19 reverse transcription polymerase chain reaction test. Five patients (55.6%) in the COVID-19-positive group had a fever before OHCA, and 12 (16.9%) of the COVID-19-negative group had a fever before OHCA (P = 0.018). Eight patients (88.9%) in the COVID-19-positive group had a CXR indicating pneumonic infiltration. Of the criteria for predicting COVID-19, fever or an abnormal CXR had a sensitivity of 100% (95% confidence interval [CI]: 65.4 -100) and a specificity of 22.5% (95% CI: 13.5 -34.0). Conclusion:The screening tools that combined fever or abnormal CXR had a good

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Section: Discussionsupporting

confidence: 76%

Confirmation of COVID-19 in Out-of-Hospital Cardiac Arrest Patients and Postmortem Management in the Emergency Department during the COVID-19 Outbreak

et al. 2020

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“…Therefore, a clinical definition of COVID-19 is not reliable and laboratory confirmation of SARS-CoV-2 is currently advised for confirmation [4]. As asymptomatic patients tested positive for SARS-CoV-2, the lack of test capacity resulted in a lack of knowledge of the underlying true infection risk [5,6]. Since then, test capacities have been upscaled, but there is still an urgent need for reliable and cost-effective high-throughput testing methods, specifically as regulations are currently easing and loci of rapid spread need to be detected as early as possible, to avoid uncontrolled viral spread.…”

Section: Introductionmentioning

confidence: 99%

Detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) by Mass Spectrometry

Wandernoth

Kriegsmann

Groh-Mohanu

et al. 2020

Viruses

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Background: Amplification of viral ribonucleic acid (RNA) by real-time reverse transcriptase polymerase chain reaction (rRT-PCR) is the gold standard to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since the initial outbreak, strategies to detect and isolate patients have been important to avoid uncontrolled viral spread. Although testing capacities have been upscaled, there is still a need for reliable high throughput test systems, specifically those that require alternative consumables. Therefore, we tested and compared two different methods for the detection of viral PCR products: rRT-PCR and mass spectrometry (MS). Methods: Viral RNA was isolated and amplified from oro- or nasopharyngeal swabs. A total of 22 samples that tested positive and 22 samples that tested negative for SARS-CoV-2 by rRT-PCR were analyzed by MS. Results of the rRT-PCR and the MS protocol were compared. Results: Results of rRT-PCR and the MS test system were in concordance in all samples. Time-to-results was faster for rRT-PCR. Hands-on-time was comparable in both assays. Conclusions: MS is a fast, reliable and cost-effective alternative for the detection of SARS-CoV-2 from oral and nasopharyngeal swabs.

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“…So far, no detection methods could be able to accurately determine contagious period of COVID-19. The initial RT-PCR falsenegative rates were even up to 29% [26], which may be ascribed to the viral infection "window period", position of the sample collection and the experience of the operator and so on. Combination SARS-CoV-2 RNA test of different specimens with multiple detective methods such as a IgM-IgG combined antibody test or the next generation sequencing(NGS)may help to identify more asymptomatic carriers.…”

Section: Nucleic Acid Test Resultsmentioning

confidence: 99%

Asymptomatic cases of coronavirus disease 2019 (COVID-19)：A review of literature on clinical characteristics and implications for epidemic control

Kang¹,

Ma²,

Lu³

et al. 2020

Preprint

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Asymptomatic SARS-CoV-2 infections: What do we need to know?

Abstract: , the number of confirmed cases of pandemic coronavirus disease 2019 (COVID-19) has reached 1,991,512, with 130,885 associated deaths. 1 Although the numbers of confirmed cases and deaths continue to increase steeply through

Cited by 6 publications

References 14 publications

Confirmation of COVID-19 in Out-of-Hospital Cardiac Arrest Patients and Postmortem Management in the Emergency Department during the COVID-19 Outbreak

Confirmation of COVID-19 in Out-of-Hospital Cardiac Arrest Patients and Postmortem Management in the Emergency Department during the COVID-19 Outbreak

Detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) by Mass Spectrometry

Asymptomatic cases of coronavirus disease 2019 (COVID-19)：A review of literature on clinical characteristics and implications for epidemic control

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