What is known about asymptomatic and presymptomatic infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)?

Updated: Jun 16, 2020
  • Author: Medscape Drugs & Diseases; more...
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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been documented in patients who never develop symptoms (asymptomatic) and in those who are not yet symptomatic (presymptomatic). [1] Because routine testing is not performed in asymptomatic persons, the prevalence of asymptomatic infection and detection of presymptomatic infection remains unclear.

In one study, as many as 13% of pediatric SARS-CoV-2 infections confirmed by reverse transcription polymerase chain reaction (RT-PCR) were asymptomatic. [1] In a separate study of skilled nursing facility residents infected with SARS-CoV-2 from a healthcare worker, half were asymptomatic or presymptomatic at the time of contact tracing evaluation and testing.

Chest imaging anomalies may be present before symptomatic onset. [1] Some data suggest a tendency for detection of presymptomatic infection in younger individuals as well as a lesser likelihood of being associated with viral pneumonia.

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