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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
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
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