Viral dynamics in asymptomatic patients with COVID-19. (July 2020)

• Record Type: Journal Article
• Authors: Zhou, Rui; Li, Furong; Chen, Fengjuan; Liu, Huamin; Zheng, Jiazhen; Lei, Chunliang; Wu, Xianbo
• Is Part Of: International journal of infectious diseases. Volume 96(2020)
• Page Start: 288
• Page End: 290
• Publication Date: 2020-07
• Subjects: COVID-19 -- Asymptomatic patients -- Viral load -- Viral shedding; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2020.05.030
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: The viral load and viral shedding patterns of asymptomatic patients with COVID-19 were described. The viral load of asymptomatic patients peaked during the early stage of hospitalization. The Ct values of asymptomatic patients (APs) were higher than asymptomatic patients in incubation period (APIs). APs still have a duration of viral shedding, suggesting the possibility of transmission during the asymptomatic period. Abstract: Data are limited on the viral load, viral shedding patterns, and potential infectivity of asymptomatic patients (APs) with coronavirus disease 2019 (COVID-19). This study included 31 adult patients who were virologically confirmed to have COVID-19 but were asymptomatic on admission. Among these 31 patients, 22 presented symptoms after admission and were defined as asymptomatic patients in the incubation period (APIs); the other nine patients remained asymptomatic during hospitalization and were defined as asymptomatic patients (APs). The median cycle threshold (Ct) value of APs (39.0, interquartile range (IQR) 37.5–39.5) was significantly higher than that of APIs (34.5, IQR 32.2–37.0), indicating a lower viral load in APs. However, the duration of viral shedding remained similar in the two groups (7 days, IQR 5–14 days vs. 8 days, IQR 5–16 days). The study findings demonstrated that although APs with COVID-19 have a lower viral load, they still have certain period of viral shedding, which suggests the possibility of transmission during their asymptomatic period. Further longitudinal surveillance of these asymptomatic cases via virus nucleic acid testing are warranted.