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中国武汉以外地区无症状严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2)感染者的特征。

Characterization of an Asymptomatic Cohort of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infected Individuals Outside of Wuhan, China.

机构信息

Department of Respiratory Medicine, Daping Hospital, Army Medical University, Chongqing, China.

Department of Respiratory Medicine, Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.

出版信息

Clin Infect Dis. 2020 Nov 19;71(16):2132-2138. doi: 10.1093/cid/ciaa629.

Abstract

PURPOSE

We aimed to further clarify the epidemiological and clinical characteristics of asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections.

METHODS

We identified close contacts of confirmed coronavirus disease 2019 (COVID-19) cases in northeast Chongqing, China, who were confirmed by real-time reverse transcription polymerase chain reaction-positive (RT-PCR+). We stratified this cohort by normal vs abnormal findings on chest computed tomography (CT) and compared the strata regarding comorbidities, demographics, laboratory findings, viral transmission and other factors.

RESULTS

Between January 2020 and March 2020, we identified and hospitalized 279 RT-PCR+ contacts of COVID-19 patients. 63 (23%) remained asymptomatic until discharge; 29 had abnormal and 34 had normal chest CT findings. The mean cohort age was 39.3 years, and 87.3% had no comorbidities. Mean time to diagnosis after close contact with a COVID-19 index patient was 16.0 days, and it was 13.4 days and 18.7 days for those with abnormal and normal CT findings, respectively (P < .05). Nine patients (14.3%) transmitted the virus to others; 4 and 5 were in the abnormal and normal CT strata, respectively. The median length of time for nucleic acid to turn negative was 13 days compared with 10.4 days in those with normal chest CT scans (P < .05).

CONCLUSIONS

A portion of asymptomatic individuals were capable of transmitting the virus to others. Given the frequency and potential infectiousness of asymptomatic infections, testing of traced contacts is essential. Studies of the impact of treatment of asymptomatic RT-PCR+ individuals on disease progression and transmission should be undertaken.

摘要

目的

我们旨在进一步阐明无症状严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)感染的流行病学和临床特征。

方法

我们确定了中国重庆东北部确诊的 2019 年冠状病毒病(COVID-19)病例的密切接触者,这些接触者通过实时逆转录聚合酶链反应阳性(RT-PCR+)得到确认。我们根据胸部计算机断层扫描(CT)的正常与异常结果对该队列进行分层,并比较了各层的合并症、人口统计学、实验室结果、病毒传播和其他因素。

结果

2020 年 1 月至 2020 年 3 月,我们确定并住院治疗了 279 名 COVID-19 患者的 RT-PCR+接触者。63 人(23%)在出院前一直无症状;29 人胸部 CT 异常,34 人胸部 CT 正常。队列的平均年龄为 39.3 岁,87.3%无合并症。与 COVID-19 索引患者密切接触后诊断的平均时间为 16.0 天,异常和正常 CT 发现者分别为 13.4 天和 18.7 天(P<0.05)。9 名患者(14.3%)将病毒传播给他人;异常和正常 CT 分层中分别有 4 人和 5 人。核酸转阴的中位数时间为 13 天,而胸部 CT 扫描正常的患者为 10.4 天(P<0.05)。

结论

一部分无症状个体能够将病毒传播给他人。鉴于无症状感染的频率和潜在传染性,对追踪接触者进行检测至关重要。应开展关于治疗无症状 RT-PCR+个体对疾病进展和传播的影响的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6de3/7759730/c8b7e5e24991/ciaa629_fig1.jpg

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