Asymptomatic infection by SARS-CoV-2 in healthcare workers: A study in a large teaching hospital in Wuhan, China

Int J Infect Dis. 2020 Oct:99:219-225. doi: 10.1016/j.ijid.2020.07.082. Epub 2020 Aug 3.

Abstract

Objectives: To investigate the proportion and characteristics of asymptomatic infection among healthcare workers (HCWs).

Methods: This study retrospectively investigated 1407 HCWs who were screened for COVID-19 by chest computed tomography (CT) scans and nasopharyngeal swabs for SARS-CoV-2 nucleic acid. Demographics, CT features, nasopharyngeal swabs, baseline symptoms, and laboratory data were collected.

Results: Of 1407 HCWs, 235 had symptoms and 1172 were asymptomatic close contacts, of which, 107 were symptomatic cases and 84 were close contacts who had abnormal CT findings. Of 152 symptomatic individuals and 908 close contacts tested for SARS-CoV-2 nucleic acid, 122 symptomatic cases and 38 close contacts had positive reverse-transcriptase real-time polymerase chain (RT-PCR) test results. The rate of confirmed asymptomatic infections was 4.2% (38/908). Both symptomatic and asymptomatic infected cases had high titrations of specific IgG or had ≥four-fold increase in IgG during convalescence compared with the acute phase. Combining the RT-PCR tests and serological findings, the rate of asymptomatic infections was 9.7% (88/908). In terms of the duration of viral shedding, there was no significant difference between symptomatic mild/moderate participants and asymptomatic infections.

Conclusions: The findings demonstrated that a high rate of asymptomatic SARS-CoV-2 carriers existed among healthcare worker close contacts during the outbreak of COVID-19.

Keywords: Asymptomatic; COVID-19; Epidemiology; Healthcare worker; Pneumonia; SARS-CoV-2.

MeSH terms

  • Adult
  • Asymptomatic Infections / epidemiology*
  • Betacoronavirus*
  • COVID-19
  • Carrier State
  • China / epidemiology
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / pathology*
  • Female
  • Health Personnel*
  • Hospitals, Teaching*
  • Humans
  • Male
  • Pandemics
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / pathology*
  • Retrospective Studies
  • SARS-CoV-2
  • Virus Shedding
  • Young Adult