Department of Infectious Diseases, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China.
Department of Infectious Diseases, The People's Hospital of Suzhou New District, Suzhou, Jiangsu, China.
J Infect Dis. 2020 Jun 11;221(12):1940-1947. doi: 10.1093/infdis/jiaa205.
We retrospectively analyzed 26 persistently asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) carriers.
Epidemiological and clinical characteristics from the 26 asymptomatic patients with positive results for SARS-CoV-2 ribonucleic acid testing were obtained.
Twenty-two patients (84.6%) correlated with clustering occurrence. The median period from contact to diagnosis and the last positive nucleic acid test was 19 (8-24 days) and 21.5 days (10-36 days), respectively. The median period from diagnosis to negative nucleic acid test was significantly different between patients with normal or atypical chest computed tomography (CT) findings (n = 16, 61.5%; 7.5 days [2-20 days]) and patients with typical ground-glass or patchy opacities on CT (n = 10, 38.5%; 12.5 days [8-22 days]; P < .01). Seven patients (70.0%) with initial positive nucleic acid test results had a negative result simultaneously with improved CT findings. Obvious improvement in CT findings was observed in 3 patients (30.0%) despite positive nucleic acid test results.
In asymptomatic patients, changes in biochemical and inflammatory variables are small and changes on chest CT can occur. It is worth noting that the long existence of SARS-CoV-2 in some asymptomatic patients and false-negative results need to be considered in SARS-CoV-2 nucleic acid test.
我们回顾性分析了 26 例持续无症状的严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)携带者。
获取了 26 例 SARS-CoV-2 核糖核酸检测结果阳性的无症状患者的流行病学和临床特征。
22 例(84.6%)与聚集性发病相关。从接触到诊断和最后一次阳性核酸检测的中位时间分别为 19(8-24 天)和 21.5 天(10-36 天)。诊断后至核酸检测转为阴性的中位时间在胸部计算机断层扫描(CT)表现正常或不典型(n=16,61.5%;7.5 天[2-20 天])和 CT 表现为典型磨玻璃或斑片状混浊(n=10,38.5%;12.5 天[8-22 天])的患者之间存在显著差异(P<.01)。7 例(70.0%)初始核酸检测阳性结果的患者同时出现 CT 表现改善和阴性结果。3 例(30.0%)患者尽管核酸检测结果仍为阳性,但 CT 表现明显改善。
在无症状患者中,生化和炎症变量的变化较小,胸部 CT 可能会发生变化。值得注意的是,一些无症状患者中 SARS-CoV-2 存在时间较长,以及 SARS-CoV-2 核酸检测可能出现假阴性结果,需要加以考虑。