Viral Transmission and Clinical Features in Asymptomatic Carriers of SARS-CoV-2 in Wuhan, China

Tan, Fen; Wang, Kaige; Liu, Jiasheng; Liú, Dan; Luo, Jin-Yan; Zhou, Rui

doi:10.3389/fmed.2020.00547

Cited by 10 publications

(9 citation statements)

References 26 publications

(29 reference statements)

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“…While asymptomatic testing following exposure has increased in recent months, the current testing strategy in the U.S. still predominantly targets symptomatic patients despite estimates that asymptomatic patients represent 40–45% of infected individuals 10 , 72 . Transmission during the incubation period has been reported, and the viral load of symptomatic and asymptomatic patients is similar 73 – 76 . The relationship between SARS-CoV-2 viral shedding and risk of transmission is unclear, and the percentage of transmission attributable to asymptomatic or pre-symptomatic infection of SARS-CoV-2 is unknown 77 .…”

Section: Discussionmentioning

confidence: 95%

Host methylation predicts SARS-CoV-2 infection and clinical outcome

et al. 2021

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Background Since the onset of the SARS-CoV-2 pandemic, most clinical testing has focused on RT-PCR1. Host epigenome manipulation post coronavirus infection2–4 suggests that DNA methylation signatures may differentiate patients with SARS-CoV-2 infection from uninfected individuals, and help predict COVID-19 disease severity, even at initial presentation. Methods We customized Illumina’s Infinium MethylationEPIC array to enhance immune response detection and profiled peripheral blood samples from 164 COVID-19 patients with longitudinal measurements of disease severity and 296 patient controls. Results Epigenome-wide association analysis revealed 13,033 genome-wide significant methylation sites for case-vs-control status. Genes and pathways involved in interferon signaling and viral response were significantly enriched among differentially methylated sites. We observe highly significant associations at genes previously reported in genetic association studies (e.g.IRF7, OAS1). Using machine learning techniques, models built using sparse regression yielded highly predictive findings: cross-validated best fit AUC was 93.6% for case-vs-control status, and 79.1%, 80.8%, and 84.4% for hospitalization, ICU admission, and progression to death, respectively. Conclusions In summary, the strong COVID-19-specific epigenetic signature in peripheral blood driven by key immune-related pathways related to infection status, disease severity, and clinical deterioration provides insights useful for diagnosis and prognosis of patients with viral infections.

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Section: Discussionmentioning

confidence: 95%

Host methylation predicts SARS-CoV-2 infection and clinical outcome

et al. 2021

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“…This result was also verified in Zhejiang, China, where, among 36 children with confirmed COVID-19, 28% were asymptomatic carriers ( 13 ). Tan et al ( 14 ) identified that asymptomatic carriers were relatively young (mean age, 34.5 years old). Current evidence suggests that the asymptomatic carriers with SARS-CoV-2 vary by age, however, to the best of our knowledge, no studies have identified differences in sex between asymptomatic carriers.…”

Section: Demographic Characteristicsmentioning

confidence: 99%

“…The study by Liu et al ( 9 ) showed that the secondary attack rate of 131 asymptomatic carriers was 2.6% (24/914), while the secondary attack rate of 16 confirmed cases was 9.7% (23/236), further demonstrating that the transmission risk of asymptomatic carriers was decreased compared with that of the confirmed cases. In China, a study including 12 asymptomatic carriers in Wuhan also identified that only one carrier has transmitted the virus to a close contact ( 14 ). Chen et al ( 39 ) tracked 9 asymptomatic carriers and identified that none of them had transmitted SARS-CoV-2 to others, so they speculated that the absence of symptoms such as sneezing and coughing may interfere with virus shedding and decrease the risk of infection.…”

Section: Infectivity and Transmission Risk Of Asymptomatic Carriermentioning

confidence: 99%

“…However, the study from Hu et al ( 10 ) showed that the median spread interval was 9.5 days (up to 21 days), and the actual infection period may be longer as the exact date of the first infection is uncertain for some carriers. Tan et al ( 14 ) demonstrated that the median duration of virus shedding was 11.5 ( 9-14 ) days among 12 carriers in Wuhan, 2 of which were found to have positive RNA results lasting up to 2 months ( 14 ). Long et al ( 41 ) also reported a median duration of viral shedding of 19 ( 15-26 ) days in 37 asymptomatic carriers.…”

Section: Transmission Period Of Asymptomatic Carriersmentioning

confidence: 99%

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Clinical characteristics and infectivity of asymptomatic carriers of SARS‑CoV‑2 (Review)

Zhang

Zhou

et al. 2020

Exp Ther Med

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Since December 2019, the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global pandemic. At present, confirmed patients are the main source of infection, while a number of studies have indicated that asymptomatic carriers also have the ability to spread the virus. As of September 29, 2020, as the first country to report coronavirus disease 2019 (COVID-19), China has 375 asymptomatic infections according to the National Health Commission of China. Asymptomatic carriers have become the current focus of global epidemic prevention and control efforts. The present review article provides a brief introduction on the clinical characteristics and infectivity of asymptomatic carriers, and makes suggestions for the identification of asymptomatic carriers. Contents

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“…The proportion of Ig G + in patients with asymptomatic infection at the screening point was 72% (95% CI: 46–92%, I 2 = 94.2%, k = 8, n = 268; Figure 4 ) ( 17 , 25 , 26 , 40 , 51 , 56 , 58 , 60 ).…”

Section: Resultsmentioning

confidence: 99%

Epidemiological, Radiographical, and Laboratorial Characteristics of Chinese Asymptomatic Cases With COVID-19: A Systematic Review and Meta-Analysis

Yan

Ding

Guo

2022

Front. Public Health

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The comprehensive understanding of the characteristics of asymptomatic cases are helpful for the identification and management of patients with asymptomatic COVID-19 infection. Four electronic databases were searched from December 1, 2019 to February 8, 2022 for relevant articles. Data synthesis, subgroup analysis, and sensitivity analysis were performed on the included studies. I2 and Q tests were applied to evaluate heterogeneity across studies. The risk of publication bias was assessed and visualized using a funnel plot. A total of 45 studies consisting of 2,655 patients with no symptoms at the screening point were included. Pooled results showed that in China, 65% of initial no-symptoms COVID-19 patients did not present any COVID-19-related symptom during follow-up or by end of disease course (asymptomatic infections). High proportions of initial no-symptoms COVID-19 patients (76%) and patients with asymptomatic infection (55%) had abnormal CT features at the screening point. High proportion of patients with asymptomatic infection had been detected Ig G+ (72%) and/or Ig M+ (57%) at the screening point. The chest CT scan and SARS-CoV-2-specific antibody testing could serve as effective supplementary methods to identify asymptomatic cases in the early stage of SARS-CoV-2 infection. However, the chest CT scan and the SARS-CoV-2-specific IgM and IgG testing should not replace reverse transcription–polymerase chain reaction (RT-PCR) for screening in asymptomatic patients. The combination of repeated RT-PCR, chest CT scans, and the SARS-CoV-2-specific IgM and IgG testing should be performed for those highly suspected SARS-CoV-2 infections.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier: CRD 42021261130.

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Viral Transmission and Clinical Features in Asymptomatic Carriers of SARS-CoV-2 in Wuhan, China

Cited by 10 publications

References 26 publications

Host methylation predicts SARS-CoV-2 infection and clinical outcome

Host methylation predicts SARS-CoV-2 infection and clinical outcome

Clinical characteristics and infectivity of asymptomatic carriers of SARS‑CoV‑2 (Review)

Epidemiological, Radiographical, and Laboratorial Characteristics of Chinese Asymptomatic Cases With COVID-19: A Systematic Review and Meta-Analysis

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