Descriptive, Retrospective Study of the Clinical Characteristics of Asymptomatic COVID-19 Patients

ABSTRACT Since the outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, China, it has rapidly spread around the world. Persons with asymptomatic disease exhibit viral shedding, resulting in transmission, which presents disease control challenges. However, the clinical characteristics of these a...

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Autores principales:	Huan Han, Zaichao Xu, Xiaoming Cheng, Youquan Zhong, Li Yuan, Fubing Wang, Yan Li, Fang Liu, Yingan Jiang, Chengliang Zhu, Yuchen Xia
Formato:	article
Lenguaje:	EN
Publicado:	American Society for Microbiology 2020
Materias:	COVID-19 asymptomatic antibody immune response liver function Microbiology QR1-502
Acceso en línea:	https://doaj.org/article/de77aada3d934107b662ad1ae7ea5301
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spelling	oai:doaj.org-article:de77aada3d934107b662ad1ae7ea53012021-11-15T15:30:58ZDescriptive, Retrospective Study of the Clinical Characteristics of Asymptomatic COVID-19 Patients10.1128/mSphere.00922-202379-5042https://doaj.org/article/de77aada3d934107b662ad1ae7ea53012020-10-01T00:00:00Zhttps://journals.asm.org/doi/10.1128/mSphere.00922-20https://doaj.org/toc/2379-5042ABSTRACT Since the outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, China, it has rapidly spread around the world. Persons with asymptomatic disease exhibit viral shedding, resulting in transmission, which presents disease control challenges. However, the clinical characteristics of these asymptomatic individuals remain elusive. We collected samples of 25 asymptomatic and 27 symptomatic COVID-19 patients. Viral titers of throat swabs were determined by quantitative reverse transcription-PCR (qRT-PCR). COVID-19 IgG and IgM were examined. Complete blood counts were determined, and serum biochemistry panels were performed. Cytokines, including gamma interferon (IFN-γ), tumor necrosis factor alpha (TNF-α), interleukin 2 (IL-2), IL-4, IL-6, and IL-10 were evaluated. T cell, B cell, and NK cell counts were measured using flow cytometry. Although similar viral loads were detected, asymptomatic patients had significantly faster virus turnover than symptomatic patients. Additionally, asymptomatic patients had higher counts of lymphocytes, T cells, B cells, and NK cells. While liver damage was observed in symptomatic patients, as indicated by elevated liver enzymes and decreased liver-synthesized proteins in the blood, asymptomatic patients showed normal liver measurements. Lactate dehydrogenase, a COVID-19 risk factor, was significantly lower in asymptomatic patients. These results suggest that asymptomatic COVID-19 patients had normal clinical indicators and faster viral clearance than symptomatic patients. Lymphocytes may play a role in their asymptomatic phenotype. Since asymptomatic patients may be a greater risk of virus transmission than symptomatic patients, public health interventions and a broader range of testing may be necessary for the control of COVID-19. IMPORTANCE Asymptomatic transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a potential problem for pandemic control through public health strategies. Our results demonstrate that asymptomatic COVID-19 patients have better outcomes than symptomatic patients. This may have been due to more active cellular immune responses and normal liver function. Since asymptomatic patients have no clinical symptoms which can easily prevent timely diagnosis and treatment, they may cause a greater risk of virus transmission than symptomatic patients, which poses a major challenge to infection control. Evidence suggests that nonpharmaceutical public health interventions, like social distancing and face mask ordinances, play important roles in the control of COVID-19. Looking forward, it may be necessary to proceed cautiously while reopening businesses in areas of epidemicity to prevent potential waves of COVID-19 in the future.Huan HanZaichao XuXiaoming ChengYouquan ZhongLi YuanFubing WangYan LiFang LiuYingan JiangChengliang ZhuYuchen XiaAmerican Society for MicrobiologyarticleCOVID-19asymptomaticantibodyimmune responseliver functionMicrobiologyQR1-502ENmSphere, Vol 5, Iss 5 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	COVID-19 asymptomatic antibody immune response liver function Microbiology QR1-502
spellingShingle	COVID-19 asymptomatic antibody immune response liver function Microbiology QR1-502 Huan Han Zaichao Xu Xiaoming Cheng Youquan Zhong Li Yuan Fubing Wang Yan Li Fang Liu Yingan Jiang Chengliang Zhu Yuchen Xia Descriptive, Retrospective Study of the Clinical Characteristics of Asymptomatic COVID-19 Patients
description	ABSTRACT Since the outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, China, it has rapidly spread around the world. Persons with asymptomatic disease exhibit viral shedding, resulting in transmission, which presents disease control challenges. However, the clinical characteristics of these asymptomatic individuals remain elusive. We collected samples of 25 asymptomatic and 27 symptomatic COVID-19 patients. Viral titers of throat swabs were determined by quantitative reverse transcription-PCR (qRT-PCR). COVID-19 IgG and IgM were examined. Complete blood counts were determined, and serum biochemistry panels were performed. Cytokines, including gamma interferon (IFN-γ), tumor necrosis factor alpha (TNF-α), interleukin 2 (IL-2), IL-4, IL-6, and IL-10 were evaluated. T cell, B cell, and NK cell counts were measured using flow cytometry. Although similar viral loads were detected, asymptomatic patients had significantly faster virus turnover than symptomatic patients. Additionally, asymptomatic patients had higher counts of lymphocytes, T cells, B cells, and NK cells. While liver damage was observed in symptomatic patients, as indicated by elevated liver enzymes and decreased liver-synthesized proteins in the blood, asymptomatic patients showed normal liver measurements. Lactate dehydrogenase, a COVID-19 risk factor, was significantly lower in asymptomatic patients. These results suggest that asymptomatic COVID-19 patients had normal clinical indicators and faster viral clearance than symptomatic patients. Lymphocytes may play a role in their asymptomatic phenotype. Since asymptomatic patients may be a greater risk of virus transmission than symptomatic patients, public health interventions and a broader range of testing may be necessary for the control of COVID-19. IMPORTANCE Asymptomatic transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a potential problem for pandemic control through public health strategies. Our results demonstrate that asymptomatic COVID-19 patients have better outcomes than symptomatic patients. This may have been due to more active cellular immune responses and normal liver function. Since asymptomatic patients have no clinical symptoms which can easily prevent timely diagnosis and treatment, they may cause a greater risk of virus transmission than symptomatic patients, which poses a major challenge to infection control. Evidence suggests that nonpharmaceutical public health interventions, like social distancing and face mask ordinances, play important roles in the control of COVID-19. Looking forward, it may be necessary to proceed cautiously while reopening businesses in areas of epidemicity to prevent potential waves of COVID-19 in the future.
format	article
author	Huan Han Zaichao Xu Xiaoming Cheng Youquan Zhong Li Yuan Fubing Wang Yan Li Fang Liu Yingan Jiang Chengliang Zhu Yuchen Xia
author_facet	Huan Han Zaichao Xu Xiaoming Cheng Youquan Zhong Li Yuan Fubing Wang Yan Li Fang Liu Yingan Jiang Chengliang Zhu Yuchen Xia
author_sort	Huan Han
title	Descriptive, Retrospective Study of the Clinical Characteristics of Asymptomatic COVID-19 Patients
title_short	Descriptive, Retrospective Study of the Clinical Characteristics of Asymptomatic COVID-19 Patients
title_full	Descriptive, Retrospective Study of the Clinical Characteristics of Asymptomatic COVID-19 Patients
title_fullStr	Descriptive, Retrospective Study of the Clinical Characteristics of Asymptomatic COVID-19 Patients
title_full_unstemmed	Descriptive, Retrospective Study of the Clinical Characteristics of Asymptomatic COVID-19 Patients
title_sort	descriptive, retrospective study of the clinical characteristics of asymptomatic covid-19 patients
publisher	American Society for Microbiology
publishDate	2020
url	https://doaj.org/article/de77aada3d934107b662ad1ae7ea5301
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Descriptive, Retrospective Study of the Clinical Characteristics of Asymptomatic COVID-19 Patients

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