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COVID-19:无症状 SARS-COV-2 感染与传播的洞察。

COVID-19: Insight into the asymptomatic SARS-COV-2 infection and transmission.

机构信息

National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, P.R. China.

Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, P.R. China.

出版信息

Int J Biol Sci. 2020 Aug 27;16(15):2803-2811. doi: 10.7150/ijbs.48991. eCollection 2020.

Abstract

The existence of a substantial but unclear number of asymptomatic SARS-COV-2 patients worldwide has raised concerns among global public health authorities. In this review, according to the published literature, we provided the evidence that asymptomatic infections can result in person-to-person transmission. Four studies suggested that the virus can be transmitted by asymptomatic patients for at least two consecutive generations, indicating its strong infectivity. Asymptomatic infection tends to be, but is not only, identified among young people (<20 years old). The majority of asymptomatic patients appear to have a milder clinical course during hospitalization, but the severity of the symptoms of the secondary patients infected by SARS-COV-2 from asymptomatic patients varies with their physical constitution. The proportion of asymptomatic individuals among all confirmed cases widely differed (from 1.95% to 87.9%) according to the study setting and the populations studied. The increasing large-scale tests are expected to give more information about the true number of asymptomatic infections in the population. In China and other countries, various guidelines for management of asymptomatic cases have been issued. Importantly, early detection, early reporting, early isolation and early treatment of asymptomatic patients require the joint efforts of policy makers, clinicians, technicians, epidemiologists, virologists and patients.

摘要

无症状 SARS-CoV-2 患者在全球范围内大量存在,但其确切数量仍不明确,这引起了全球公共卫生当局的关注。在这篇综述中,我们根据已发表的文献提供了证据,表明无症状感染可导致人际传播。四项研究表明,该病毒可通过无症状患者至少连续两代传播,表明其具有很强的传染性。无症状感染往往存在,但不仅存在于年轻人(<20 岁)中。大多数无症状患者在住院期间的临床过程似乎较轻,但由无症状患者感染 SARS-CoV-2 的继发患者的症状严重程度因个体体质而异。根据研究环境和研究人群的不同,无症状个体在所有确诊病例中的比例差异很大(从 1.95%到 87.9%)。预计大规模检测的增加将提供更多关于人群中无症状感染真实数量的信息。在中国和其他国家,已经发布了针对无症状病例管理的各种指南。重要的是,对无症状患者的早期发现、早期报告、早期隔离和早期治疗需要政策制定者、临床医生、技术人员、流行病学家、病毒学家和患者的共同努力。

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