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THREAD:
1/ Given my interactions with @ASlavitt and @jeremyfaust yesterday, I decided to make a compiled list of data on asymptomatic transmission. This is not complete, but the most striking data I have seen on #COVID19 and #SARSCoV2 worldwide. https://twitter.com/ASlavitt/status/1249914030267019264
1/ Given my interactions with @ASlavitt and @jeremyfaust yesterday, I decided to make a compiled list of data on asymptomatic transmission. This is not complete, but the most striking data I have seen on #COVID19 and #SARSCoV2 worldwide. https://twitter.com/ASlavitt/status/1249914030267019264
2/ A nice summary published in @TIME yesterday:
Covert coronavirus infections could be seeding new outbreaks
https://www.nature.com/articles/d41586-020-00822-x
Covert coronavirus infections could be seeding new outbreaks
https://www.nature.com/articles/d41586-020-00822-x
3/ USA (NY) #usaCoronavirus #NewYork
Universal Screening for #SARSCoV2 in Women Admitted for Delivery @ColumbiaWomens @NB83
- 33 positive cases, 29 (87%) asymptomatic
- https://www.nejm.org/doi/full/10.1056/NEJMc2009316
Universal Screening for #SARSCoV2 in Women Admitted for Delivery @ColumbiaWomens @NB83
- 33 positive cases, 29 (87%) asymptomatic
- https://www.nejm.org/doi/full/10.1056/NEJMc2009316
4/ USA (MA) #usaCoronavirus
#SARSCoV2 titers in wastewater are higher than expected from clinically confirmed cases
- #viral titer in feces to be about 3000 times higher than that in sampled raw sewage
- https://www.medrxiv.org/content/10.1101/2020.04.05.20051540v1.full.pdf
#SARSCoV2 titers in wastewater are higher than expected from clinically confirmed cases
- #viral titer in feces to be about 3000 times higher than that in sampled raw sewage
- https://www.medrxiv.org/content/10.1101/2020.04.05.20051540v1.full.pdf
5/ #CHINA:
Covid-19: 4/5 of cases are #asymptomatic, #CHINA figures
- Found 43 000 cases of asymptomatic infection through contact tracing
- 166 new infections, 130 (78%) asymptomatic identified in the 24 hours to the afternoon of Wednesday 1 April
- https://bmj.com/content/369/bmj.m1375?=&utm_source=adestra&utm_medium=email&utm_campaign=usage&utm_content=daily&utm_term=text…
Covid-19: 4/5 of cases are #asymptomatic, #CHINA figures
- Found 43 000 cases of asymptomatic infection through contact tracing
- 166 new infections, 130 (78%) asymptomatic identified in the 24 hours to the afternoon of Wednesday 1 April
- https://bmj.com/content/369/bmj.m1375?=&utm_source=adestra&utm_medium=email&utm_campaign=usage&utm_content=daily&utm_term=text…
6/ #CHINA:
Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus ( #SARSCoV2 )
undocumented infections was 55% of documented infections https://science.sciencemag.org/content/early/2020/03/24/science.abb3221
Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus ( #SARSCoV2 )
undocumented infections was 55% of documented infections https://science.sciencemag.org/content/early/2020/03/24/science.abb3221
7/ #CHINA:
A familial cluster of pneumonia associated with the 2019 novel #coronavirus indicating person-to-person transmission: a study of a family cluster
- Reports of #asymptomatic infected children
- https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30154-9/fulltext
A familial cluster of pneumonia associated with the 2019 novel #coronavirus indicating person-to-person transmission: a study of a family cluster
- Reports of #asymptomatic infected children
- https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30154-9/fulltext
8/ #DIAMONDPRINCESS ( #JAPAN):
Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020
- 634 confirmed cases, 328 (51.7%) were reported to be asymptomatic.
- https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.10.2000180
Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020
- 634 confirmed cases, 328 (51.7%) were reported to be asymptomatic.
- https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.10.2000180
9/ #ICELAND:
- Iceland countrywide data
- 0.3%-0.8% of Iceland's population is infected with the respiratory illness, about 50% of those who test positive for the virus are #asymptomatic when they are tested
- https://covid.is/data
- https://www.marketwatch.com/story/iceland-finds-that-half-its-citizens-with-coronavirus-have-shown-no-symptoms-2020-04-10
- Iceland countrywide data
- 0.3%-0.8% of Iceland's population is infected with the respiratory illness, about 50% of those who test positive for the virus are #asymptomatic when they are tested
- https://covid.is/data
- https://www.marketwatch.com/story/iceland-finds-that-half-its-citizens-with-coronavirus-have-shown-no-symptoms-2020-04-10
10/ #JAPAN
Estimation of the asymptomatic ratio of novel coronavirus infections (COVID-19)
- Among the Japanese patients evacuated from Wuhan, the center of the coronavirus outbreak, 30.8% were asymptomatic.
- https://www.ijidonline.com/article/S1201-9712(20)30139-9/pdf
Estimation of the asymptomatic ratio of novel coronavirus infections (COVID-19)
- Among the Japanese patients evacuated from Wuhan, the center of the coronavirus outbreak, 30.8% were asymptomatic.
- https://www.ijidonline.com/article/S1201-9712(20)30139-9/pdf
11/ #SOUTHKOREA:
- “Korea currently has a significantly higher rate of asymptomatic cases than other countries, perhaps due to our extensive testing," said Jeong Eun-kyeong, director of KCDC, at a press briefing on 03/16/2020.
- https://www.dw.com/en/up-to-30-of-coronavirus-cases-asymptomatic/a-52900988
- “Korea currently has a significantly higher rate of asymptomatic cases than other countries, perhaps due to our extensive testing," said Jeong Eun-kyeong, director of KCDC, at a press briefing on 03/16/2020.
- https://www.dw.com/en/up-to-30-of-coronavirus-cases-asymptomatic/a-52900988
12/ OTHER HELPFUL ARTICLES:
Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany
- https://www.nejm.org/doi/full/10.1056/NEJMc2001468
Coronavirus: Why it’s so deadly in Italy
- Demographics and why they are a warning to other countries
- https://medium.com/@andreasbackhausab/coronavirus-why-its-so-deadly-in-italy-c4200a15a7bf
Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany
- https://www.nejm.org/doi/full/10.1056/NEJMc2001468
Coronavirus: Why it’s so deadly in Italy
- Demographics and why they are a warning to other countries
- https://medium.com/@andreasbackhausab/coronavirus-why-its-so-deadly-in-italy-c4200a15a7bf
13/ Of additional concern is prolonged asymptomatic viral shedding:
A special case of COVID-19 with long duration of viral shedding for 49 days (CHINA) https://www.medrxiv.org/content/10.1101/2020.03.22.20040071v1
A special case of COVID-19 with long duration of viral shedding for 49 days (CHINA) https://www.medrxiv.org/content/10.1101/2020.03.22.20040071v1
14/ PROLONGED VIRAL SHEDDING
Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study (CHINA)
- Viral shedding of survivors can occur on average for 20 days, at max 37 days. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30566-3/fulltext
Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study (CHINA)
- Viral shedding of survivors can occur on average for 20 days, at max 37 days. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30566-3/fulltext
15/ I hope no one believes that I am an expert on #SARSCoV2 or believes that *I* think I am an expert on #COVID19
My role has been asking questions, synthesizing ideas, and hoping to catalyze discussion amongst colleagues.
More thinking, more questions…
@ScottGottliebMD
My role has been asking questions, synthesizing ideas, and hoping to catalyze discussion amongst colleagues.
More thinking, more questions…
@ScottGottliebMD
16/ If you are also curious or interested in my late night medical #COVID19 and #SARSCOV2 queries please check out my other 3 threads:
THREAD 1: Hypercoagulable State in COVID19 https://threadreaderapp.com/thread/1248512794749739008.html
THREAD 1: Hypercoagulable State in COVID19 https://threadreaderapp.com/thread/1248512794749739008.html
17/ THREAD 2: COVID19 as a Biphasic Disease of Hypercoagulable State and Endothelial Damage Followed by Immune Response
https://threadreaderapp.com/thread/1249236555962646528.html
THREAD 3: Eyes, ENT, Neuro, and #SARSCoV2 https://threadreaderapp.com/thread/1249790563991400450.html
https://threadreaderapp.com/thread/1249236555962646528.html
THREAD 3: Eyes, ENT, Neuro, and #SARSCoV2 https://threadreaderapp.com/thread/1249790563991400450.html
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#USA #usaCoronavirus
4800 sailors on aircraft carrier
>600 sailors (12.5%) tested positive for #SARSCoV2
~360 sailors (~60%) who tested positive have no symptoms https://www.reuters.com/article/us-health-coronavirus-usa-military-sympt-idUSKCN21Y2GB
4800 sailors on aircraft carrier
>600 sailors (12.5%) tested positive for #SARSCoV2
~360 sailors (~60%) who tested positive have no symptoms https://www.reuters.com/article/us-health-coronavirus-usa-military-sympt-idUSKCN21Y2GB
Yet another data point to add to the amassing pile of ASYMPTOMATIC TRANSMISSION:
#Boston #homeless shelter #USA #usaCoronavirus
397 people tested
146 people (36.7%) tested positive for #SARSCoV2
146 people (100%) who tested positive have no symptoms https://www.boston25news.com/news/cdc-reviewing-stunning-universal-testing-results-boston-homeless-shelter/Z253TFBO6RG4HCUAARBO4YWO64/
#Boston #homeless shelter #USA #usaCoronavirus
397 people tested
146 people (36.7%) tested positive for #SARSCoV2
146 people (100%) who tested positive have no symptoms https://www.boston25news.com/news/cdc-reviewing-stunning-universal-testing-results-boston-homeless-shelter/Z253TFBO6RG4HCUAARBO4YWO64/
#SantaClara County
- 3,330 individuals tested
- 50 tested positive (1.5%)
Seroprevalence of antibodies to #SARSCoV2 is 2.49%-4.16%, with uncertainty bounds ranging from 1.80%-5.70%.
#COVID19 cases likely 40-84 fold higher than currently reported
https://www.medrxiv.org/content/10.1101/2020.04.14.20062463v1.full.pdf
- 3,330 individuals tested
- 50 tested positive (1.5%)
Seroprevalence of antibodies to #SARSCoV2 is 2.49%-4.16%, with uncertainty bounds ranging from 1.80%-5.70%.
#COVID19 cases likely 40-84 fold higher than currently reported
https://www.medrxiv.org/content/10.1101/2020.04.14.20062463v1.full.pdf
