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Frequency of Symptoms and Asymptomatic SARS-CoV-2 Infection in New Orleans, Louisiana after 7 Weeks of a Stay-at-Home Order

37 Pages Posted: 1 Jul 2020

See all articles by Amy Feehan

Amy Feehan

Ochsner Clinic Foundation - Clinical Infectious Diseases Research

Daniel Fort

Center for Outcomes and Health Services Research, Ochsner Clinic Foundation

Julia Garcia-Diaz

University of Queensland, Ochsner Clinical School

Eboni G. Price-Haywood

University of Queensland, Ochsner Clinical School

Cruz Velasco

Center for Outcomes and Health Services Research, Ochsner Clinic Foundation

Eric Sapp

Public Democracy

Dawn Pevey

Ochsner Health

Leonardo Seoane

University of Queensland, Ochsner Clinical School

More...

Abstract

Background: Individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who do not report symptoms throughout the course of infection (asymptomatic) or those who are asymptomatic when they first contract the virus (presymptomatic) are a major public health concern. However, few prevalence studies to date have targeted the question of asymptomatic frequency within a community.

Methods: A stratified, random sample of subjects were sent to testing sites to complete a verbal consent, survey, nasopharyngeal swab, and blood draw. Swabs were tested for active viral shedding (PCR) and blood was tested for immunoglobulin G (IgG) specific to SARS-CoV-2.

Findings: Of the 2,640 subjects, 24 (0·9%) were PCR-positive alone, 30 (1·1%) were PCR-positive and IgG-positive, and 129 (4·9%) were IgG-positive alone. Subjects who reported anosmia were 17 times more likely to test positive. Thirty-eight percent of subjects never experienced symptoms despite developing antibodies to the virus, and 75% did not experience symptoms in the early stage of infection. Rates of reported asymptomatic infection and comorbidities statistically significantly increased with age.

Interpretation: This is the first randomized study that pairs PCR and IgG serology that addresses asymptomatic SARS-CoV-2 infection, showing a high frequency of asymptomatic disease. More research is needed to clarify differences between symptomatic and asymptomatic disease. Prevalence and outcomes studies of SARS-CoV-2 should include this group.

Funding Statement: This study was supported by ReNOLA, a charitable foundation, and Ochsner Health.

Declaration of Interests: The authors all report that ReNOLA, a 401(c3) charitable foundation, paid Public Democracy (Eric Sapp) to conduct recruitment, but was not involved in the study design, execution, analysis or this publication. All other fees were paid by Ochsner Health. The authors have no other conflicts of interest to report.

Ethics Approval Statement: This study was approved by the Ochsner Clinic Foundation Institutional Review Board #2020·163.

Keywords: SARS-CoV-2; COVID-19; asymptomatic infection; asymptomatic frequency; anosmia

Suggested Citation

Feehan, Amy and Fort, Daniel and Garcia-Diaz, Julia and Price-Haywood, Eboni G. and Velasco, Cruz and Sapp, Eric and Pevey, Dawn and Seoane, Leonardo, Frequency of Symptoms and Asymptomatic SARS-CoV-2 Infection in New Orleans, Louisiana after 7 Weeks of a Stay-at-Home Order (6/18/2020). Clin Microbiol Infect. 2021;S1198-743X(20)30789-8. doi:10.1016/j.cmi.2020.12.029, Available at SSRN: https://ssrn.com/abstract=3633166 or http://dx.doi.org/10.2139/ssrn.3633166

Amy Feehan (Contact Author)

Ochsner Clinic Foundation - Clinical Infectious Diseases Research ( email )

1514 Jefferson Highway
New Orleans, LA
United States

Daniel Fort

Center for Outcomes and Health Services Research, Ochsner Clinic Foundation

Julia Garcia-Diaz

University of Queensland, Ochsner Clinical School

Eboni G. Price-Haywood

University of Queensland, Ochsner Clinical School

Cruz Velasco

Center for Outcomes and Health Services Research, Ochsner Clinic Foundation

Eric Sapp

Public Democracy

Dawn Pevey

Ochsner Health

Leonardo Seoane

University of Queensland, Ochsner Clinical School

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