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Patterns of viral clearance in the natural course of asymptomatic COVID-19: Comparison with symptomatic non-severe COVID-19

Authors
 Jae-Sun Uhm  ;  Jin Young Ahn  ;  JongHoon Hyun  ;  Yujin Sohn  ;  Jung Ho Kim  ;  Su Jin Jeong  ;  Nam Su Ku  ;  Jun Yong Choi  ;  Yu-Kyung Park  ;  Ho-Sung Yi  ;  Sung Kyu Park  ;  Bong-Ok Kim  ;  Hyewon Kim  ;  Jinwoo Choi  ;  Seung-Mo Kang  ;  Yeong Ho Choi  ;  Hae Kyoung Yoon  ;  Sunkyung Jung  ;  Hyeong Nyeon Kim  ;  Joon-Sup Yeom  ;  Yoon Soo Park 
Citation
 INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES, Vol.99 : 279-285, 2020-10 
Journal Title
INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES
ISSN
 1201-9712 
Issue Date
2020-10
MeSH
Adult ; Asymptomatic Diseases ; Betacoronavirus / genetics* ; Cohort Studies ; Coronavirus Infections / diagnosis ; Coronavirus Infections / epidemiology* ; Coronavirus Infections / virology ; Disease Progression ; Female ; Humans ; Male ; Middle Aged ; Pandemics* ; Pneumonia, Viral / diagnosis ; Pneumonia, Viral / epidemiology* ; Pneumonia, Viral / virology ; Republic of Korea / epidemiology ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction ; Viral Load
Keywords
Asymptomatic ; COVID-19 ; Coronavirus disease 2019 ; Negative conversion ; SARS-CoV-2 ; Viral clearance
Abstract
Objectives: The aim of this study was to elucidate patterns of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) clearance in the natural course of asymptomatic coronavirus disease 2019 (COVID-19).

Methods: Consecutive patients with non-severe COVID-19 were included retrospectively. Asymptomatic patients with a normal body temperature and no evidence of pneumonia throughout the disease course were assigned to the asymptomatic group. The reverse transcription PCR (RT-PCR) assay was repeated every two to five days after the first follow-up RT-PCR assay. Negative conversion was defined as two consecutive negative RT-PCR assay results within a 24-h interval. Rebound of the cycle threshold (Ct) value was defined as negative from the single RT-PCR assay and positive from the following assay.

Results: Among a total of 396 patients identified (median age 42.5 years (interquartile range (IQR) 25.0-55.0 years), 35.6% male), 68 (17.2%) were assigned to the asymptomatic group and 328 (82.8%) to the symptomatic group. The time until negative conversion was significantly shorter in the asymptomatic group than in the symptomatic group: median 14.5 days (IQR 11.0-21.0 days) and 18.0 days (IQR 15.0-22.0 days), respectively (p = 0.001). Rebound of Ct values was observed in 78 patients (19.7%).

Conclusions: Time until negative conversion is shorter in asymptomatic COVID-19 than in symptomatic COVID-19. Rebound of Ct values is not uncommon.
Files in This Item:
T202004575.pdf Download
DOI
10.1016/j.ijid.2020.07.070
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ku, Nam Su(구남수) ORCID logo https://orcid.org/0000-0002-9717-4327
Kim, Jung Ho(김정호) ORCID logo https://orcid.org/0000-0002-5033-3482
Park, Yoon Soo(박윤수)
Sohn, Yujin(손유진)
Ahn, Jin Young(안진영) ORCID logo https://orcid.org/0000-0002-3740-2826
Uhm, Jae Sun(엄재선) ORCID logo https://orcid.org/0000-0002-1611-8172
Yeom, Joon Sup(염준섭) ORCID logo https://orcid.org/0000-0001-8940-7170
Jeong, Su Jin(정수진) ORCID logo https://orcid.org/0000-0003-4025-4542
Choi, Jun Yong(최준용) ORCID logo https://orcid.org/0000-0002-2775-3315
Hyun, Jong Hoon(현종훈) ORCID logo https://orcid.org/0000-0002-9621-0250
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/180305
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