Department of Clinical Sciences and Community Health, University of Milan, Milano, Italy.
VisMederi Research, Milan, Italy.
BMJ Open. 2021 Mar 24;11(3):e046800. doi: 10.1136/bmjopen-2020-046800.
In Italy, the pandemic of COVID-19 resulted in congestion of hospitals and laboratories and probably determined an underestimation of the number of infected subjects, as the molecular diagnosis of SARS-CoV-2 infection was mainly performed on hospitalised patients. Therefore, limited data are available about the number of asymptomatic/paucisymptomatic subjects in the general population across time. To understand SARS-CoV-2 infection in the general population, we have developed a cross-sectional study (the 'UNIversity against CORoNavirus study') to investigate infection trends in asymptomatic/paucisymptomatic subjects in Milan (Italy), between March and June 2020.
The study population included 2023 subjects asymptomatic at the enrolment.
A nasal mid-turbinate swab for the detection of SARS-CoV-2 RNA and blood specimen for testing serum antibodies (immunoglobulin M (IgM) and IgG) were collected.
Subjects showing positivity for the SARS-CoV-2 RNA and/or for anti-SARS-CoV-2 Ig is 237 (11.7%). Only 1.2% (n=25) of the total population had a positive nasal swab for SARS-CoV-2 and the large majority (21/25) of them were observed in March. A total of 226 subjects (11%) had IgM (n=19; 0.9%), IgG (n=155; 7.7%) or both (n=52; 2.6%) against SARS-CoV-2. Subjects with a present or past SARS-CoV-2 infection did not differ from other subjects as regards the number of cohabiting family members, travels, fever and upper and lower respiratory infection episodes.
Results from the present study support the hypothesis that the actual spread of the virus in Lombardy was underestimated in the official records. However, as it is not known how long Ig persist, numbers should be taken cautiously.
在意大利,COVID-19 大流行导致医院和实验室拥堵,可能导致感染人数被低估,因为 SARS-CoV-2 感染的分子诊断主要在住院患者中进行。因此,关于整个流行期间一般人群中无症状/轻症感染者的数量,数据有限。为了了解一般人群中的 SARS-CoV-2 感染情况,我们开展了一项横断面研究(“UNIversity against CORoNavirus 研究”),以调查米兰(意大利)无症状/轻症感染者的感染趋势。
研究人群包括 2023 名在入组时无症状的受试者。
采集鼻中道拭子以检测 SARS-CoV-2 RNA,并采集血液标本以检测血清抗体(免疫球蛋白 M(IgM)和 IgG)。
SARS-CoV-2 RNA 和/或抗 SARS-CoV-2 Ig 阳性的受试者为 237 例(11.7%)。仅有 1.2%(n=25)的总人群鼻拭子对 SARS-CoV-2 呈阳性,其中绝大多数(21/25)在 3 月观察到。共有 226 例(11%)受试者存在针对 SARS-CoV-2 的 IgM(n=19;0.9%)、IgG(n=155;7.7%)或两者(n=52;2.6%)。有或曾有 SARS-CoV-2 感染的受试者在共同居住的家庭成员人数、旅行、发热以及上、下呼吸道感染发作等方面与其他受试者无差异。
本研究结果支持以下假设,即病毒在伦巴第的实际传播在官方记录中被低估。然而,由于尚不清楚 Ig 持续存在的时间,因此应谨慎解读数字。