High rate prevalence of asymptomatic SARS-CoV-2 infection: Comparative epidemiology with other pandemic flu and impact on COVID 19 control measures

Authors

  • Papiya Bigoniya DSKM College of Pharmacy, Faculty of Pharmacy, RKDF University, Gandhi Nagar, Bhopal-462024, Madhya Pradesh,India

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus responsible for CODIV 19 pandemic, an international public health emergency. Conventional routes of transmission of SARS-CoV-2 are respiratory droplets and direct surface based contact, similar to SARS-CoV, Middle East respiratory syndrome-related coronavirus (MERS-CoV), and highly pathogenic influenza. Some clinical features of infectivity and viral susceptibility of SARS-CoV-2 are similar to SARS-CoV-1, MERS-CoV, suggesting a difference in the viral tropism despite the phylogenetic homogeneity. The incubation period of SARS-CoV-2 is in line with other coronaviruses, but with lower case fatality rate, although the presence of comorbidities can make it highly lethal. The major concern with SARS-CoV-2 is its ability to spread silently by the asymptomatic and presymptomatic carriers. About 70-80% positive cases of COVID 19 is coming out to be asymptomatic, presymptomatic, or very mild symptomatic which dangerously higher compared to SARS-CoV-1, MERS-CoV, H1N1, and seasonal influenza. Asymptomatic and presymptomatic carriers based silent spreading of SARS-CoV-2 has become a major concern due to short serial interval, and soaring level of virus shedding from the upper respiratory tract. Asymptomatic transmission is making containment measures difficult to implement, now early detection and isolation of asymptomatic and presymptomatic persons can be an effective strategy to control spread. High transmutability and silent infection rate SARS-CoV-2 will hopefully help in the fast development of community herd immunity, assuming to have 12 to 14 months active spread period compared to 18-24 for previous pandemic flu. Mass screening by rapid antibody tests, especially in congregate living conditions, mandatory use face masks, social-distancing, and strict execution of sanitization practices even after the relaxation of lockdown, can effectively help to control the COVID 19 infection rate.

Keywords:

Asymptomatic carriers, Coronavirus, severe acute respiratory syndrome, Silent spreaders

DOI

https://doi.org/10.25004/IJPSDR.2020.120415

References

World Health Organization. Current WHO phase of pandemic alert for pandemic (H1N1) 2009. Available from: https://www.who.int/csr/disease/swineflu/phase/en/. [Last accessed on 2020 April 24].

Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: Implications for virus origins and receptor binding. Lancet 2020;395:565-74.

Wu C, Liu Y, Yang Y, Zhang P, Zhong W, Wang Y, et al. Analysis of therapeutic targets for SARS-CoV-2 and discovery of potential drugs by computational methods. Acta Pharmaceutica Sinica B 2020; Available from: https://doi.org/10.1016/j.apsb.2020.02.008. [Last accessed on 2020 April 22]

Lei H, Li Y, Xiao S, Lin CH, Norris SL, Wei D, et al. Routes of transmission of influenza A H1N1, SARS CoV, and norovirus in air cabin: comparative analyses. Indoor Air 2018;28:394-403.

van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, et al. Correspondence: Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med 2020;382(16):1564-7.

Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020;382:1708-20.

Gudbjartsson DF, Helgason A, Jonsson H, Magnusson OT, Melsted P, Norddahl GL, et al. Spread of SARS-CoV-2 in the Icelandic population. N Engl J Med 2020; Available from: https://doi.org/10.1056/NEJMoa2006100.

Onder G, Rezza G, Brusaferro S. Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy. J Am Med Assoc 2020; Available from: https://doi.org/10.1001/jama.2020.4683.

Linton NM, Kobayashi T, Yang Y, Hayashi K, Akhmetzhanov AR, Jung SM, et al. Incubation period and other epidemiological characteristics of 2019 novel coronavirus infections with right truncation: A statistical analysis of publicly available case data. J Clin Med 2020;9(2). Available from: https://doi.org/10.3390/jcm9020538.

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506.

Varia M, Wilson S, Sarwal S, McGeer A, Gournis E, Galanis E, et al. Investigation of a nosocomial outbreak of severe acute respiratory syndrome (SARS) in Toronto, Canada. Can Med Assoc J 2003;169(4):285-92.

Virlogeux V, Fang VJ, Park M, Wu JT, Cowling BJ. Comparison of incubation period distribution of human infections with MERS-CoV in South Korea and Saudi Arabia. Sci Rep 2016;6. Available from: https://doi.org/10.1038/srep35839.

Lessler J, Reich NG, Brookmeyer R, Perl TM, Nelson KE, CummingsDAT. Incubation periods of acute respiratory viral infections: A systematic review. Lancet Infect Dis 2009;9(5):291-300.

World Health Organization. Middle East respiratory syndrome coronavirus (MERS-CoV). 2019. Available from: https://www.who.int/news-room/fact-sheets/detail/middle-east-respiratory-syndrome-coronavirus-(mers-cov). [Last accessed on 2020 April 28].

Chan-Yeung M, Xu, RH. SARS: Epidemiology. Respirology (Carlton, Vic.). 2003;8 Suppl:S9-14.

Wu ZQ, Zhang Y, Zhao N, Yu Z, Pan H, Chan TC, et al. Comparative epidemiology of human fatal infections with novel, high (H5N6 and H5N1) and low (H7N9 and H9N2) pathogenicity avian influenza A viruses. Int J Environ Res Public Health 2017;14(3):263. Available from: https://doi.org/10.3390/ijerph14030263.

World Health Organization. Coronavirus disease (COVID-2019) situation reports. 2019. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/. [Last accessed on 2020 April 22].

Chen N, Zhou M, Dong X, Jieming Q, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020;395:507-13.

Chan JF, Yuan S, Kok KH, Kai-Wang K, Chu H, Yang J, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet 2020;395:514-23.

Rothe C, Schunk M, Sothmann P, Bretzel G, Froeschl G, Wallrauch C, et al. Transmission of 2019-nCoV infection from an asymptomatic contact in Germany. N Engl J Med 2020;382:970-71.

Lauer SA, Grantz KH, Bi Q, Jones FK, Zheng Q, Meredith HR, et al. The incubation period of coronavirus disease 2019 (COVID-19) from publicly reported confirmed cases: Estimation and application. Ann Intern Med 2020. Available from: https://doi.org/10.7326/M20-050.

World Health Organization. COVID-19 - virtual press conference - 01 April 2020. Available from: https://www.who.int/docs/default-source/coronaviruse/transcripts/who-audio-emergencies-coronavirus-press-conference-full-01apr2020-final.pdf?sfvrsn=573dc140_2.

Centers for Disease Control and prevention. Asymptomatic and presymptomatic SARS-CoV-2 infections in residents of a long-term care skilled nursing facility - King County, Washington, March 2020. Morbidity and Mortality Weekly Report. 2020;69(13):377-81.

Centers for Disease Control and prevention. Presymptomatic transmission of SARS-CoV-2 - Singapore, January 23–March 16. Morbidity and Mortality Weekly Report. 2020;69(14):411-5.

Chen WJ, Chen SL, Chien LJ, Chen CC, King CC, Harn MR, et al. Silent transmission of the dengue virus in southern Taiwan. Am J Trop Med Hyg 1996;55(1):12-6.

Furuya-Kanamori L, Cox M, Milinovich GJ, Magalhaes RJ, Mackay IM, Yakob L. Heterogeneous and dynamic prevalence of asymptomatic influenza virus infections. Emerg Infect Dis 2016;22(6):1052-6.

European Centre for Disease Prevention and Control. An agency of the European Union. The sleeping giant: the danger of neglecting latent tuberculosis infection. 2018. Available from: https://www.ecdc.europa.eu/en/news-events/sleeping-giant-danger-neglecting-latent-tuberculosis-infection.

Wang Y, Liu Y, Liu L, Wang X, Luo N, Ling L. Clinical outcome of 55 asymptomatic cases at the time of hospital admission infected with SARS-coronavirus-2 in Shenzhen, China. J Infect Dis 2020;jiaa119. Available from: https://doi.org/10.1093/infdis/jiaa119.

Wei WE, Li Z, Chiew CJ, Yong SE, Toh MP, Lee VJ. Presymptomatic transmission of SARS-CoV-2 - Singapore, January 23–March 16, 2020. MMWR Morb Mortal Wkly Rep 2020;69:411-5.

Kimball A, Hatfield KM, Arons M, James A, Taylor J, Spicer K, et al. Asymptomatic and presymptomatic SARS-CoV-2 infections in residents of a long-term care skilled nursing facility - King County, Washington, March 2020. MMWR Morb Mortal Wkly Rep 2020;69:377-81.

Inui S, Fujikawa A, Jitsu M, Kunishima N, Watanabe S, Suzuki Y, et al. Chest CT findings in cases from the cruise ship “Diamond Princess” with coronavirus disease 2019 (COVID-19). Radiolog Cardiothoracic Imag 2020;2(2). Available from: https://doi.org/10.1148/ryct.2020200110.

Hu Z, Song C, Xu C, Jin G, Chen Y, Xu X, et al. Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, China. Sci China Life Sci 2020;63. Available from: https://doi.org/10.1007/s11427-020-1661-4.

Ong SWX, Tan YK, Chia PY, Lee TH, Ng OT, Wong MSY, et al. Air, surface environmental, and personal protective equipment contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from a symptomatic patient. J Am Med Assoc 2020;323(16):1610-2.

World Health Organization. Novel coronavirus (2019-nCoV): situation report, 12 (Report). 1st February 2020. Available from: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200201-sitrep-12-ncov.pdf?sfvrsn=273c5d35_2.

Song YJ, Yang JS, Yoon HJ, Nam HS, Lee SY, Cheong HK, et al. Asymptomatic Middle East respiratory syndrome coronavirus infection using a serologic survey in Korea. Epidemiol Health 2018;40: e2018014. Available from: https://doi.org/10.4178/epih.e2018014.

Wilder-Smith A, Teleman MD, Heng BH, Earnest A, Ling AE, Leo YS. Asymptomatic SARS coronavirus infection among healthcare workers, Singapore. Emerg Infect Dis 2005;11(7):1142-5.

Wölfel R, Corman VM, Guggemos W, Seilmaier M, Zange S, Müller MA, et al. Virological assessment of hospitalized patients with COVID-2019. Nature 2020. Available from: https://doi.org/10.1038/s41586-020-2196-x.

Ip DKM, Lau LLH, Leung NHL, Fang VJ, Chan KH, Chu DKW, et al. Viral shedding and transmission potential of asymptomatic and paucisymptomatic influenza virus infections in the community. Clin Infect Dis 2017;64:736-42.

Arons MM, Hatfield KM, Reddy SC, Kimball A, James A, Jacobs JR, et al. Presymptomatic SARS-CoV-2 infections and transmission in a skilled nursing facility. N Engl J Med. 2020. Available from: https://doi.org/10.1056/NEJMoa2008457.

Centers for Disease Control and Prevention. Use of cloth face coverings to help slow the spread of COVID-19. 2020. Available from: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover.html.

Published

30-07-2020
Statistics
Abstract Display: 537
PDF Downloads: 487
Dimension Badge

How to Cite

“High Rate Prevalence of Asymptomatic SARS-CoV-2 Infection: Comparative Epidemiology With Other Pandemic Flu and Impact on COVID 19 Control Measures”. International Journal of Pharmaceutical Sciences and Drug Research, vol. 12, no. 4, July 2020, pp. 415-21, https://doi.org/10.25004/IJPSDR.2020.120415.

Issue

Section

Review Article

How to Cite

“High Rate Prevalence of Asymptomatic SARS-CoV-2 Infection: Comparative Epidemiology With Other Pandemic Flu and Impact on COVID 19 Control Measures”. International Journal of Pharmaceutical Sciences and Drug Research, vol. 12, no. 4, July 2020, pp. 415-21, https://doi.org/10.25004/IJPSDR.2020.120415.

Similar Articles

1-10 of 122

You may also start an advanced similarity search for this article.