Asymptomatic Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in a Rehabilitation Facility: Evolution of the Presence of Nasopharyngeal SARS-CoV-2 and Serological Antibody Responses

J Infect Dis. 2021 Feb 3;223(2):192-196. doi: 10.1093/infdis/jiaa610.


At the start of the UK coronavirus disease 2019 epidemic, this rare point prevalence study revealed that one-third of patients (15 of 45) in a London inpatient rehabilitation unit were found to be infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) but asymptomatic. We report on 8 patients in detail, including their clinical stability, the evolution of their nasopharyngeal viral reverse-transcription polymerase chain reaction (RT-PCR) burden, and their antibody levels over time, revealing the infection dynamics by RT-PCR and serology during the acute phase. Notably, a novel serological test for antibodies against the receptor binding domain of SARS-CoV-2 showed that 100% of our asymptomatic cohort remained seropositive 3-6 weeks after diagnosis.

Keywords: COVID-19; Imperial Hybrid DABA; SARS-CoV-2; SARS-CoV-2 receptor binding domain (RBD); anti-NP; anti-RBD; antibodies to nucleoprotein; asymptomatic.

MeSH terms

  • Antibodies, Viral / blood
  • Antibody Formation
  • Asymptomatic Infections / epidemiology
  • COVID-19 / diagnosis*
  • COVID-19 / epidemiology
  • COVID-19 / immunology*
  • COVID-19 / virology
  • Cohort Studies
  • Female
  • Humans
  • London / epidemiology
  • Male
  • Middle Aged
  • Nasopharynx / virology*
  • Rehabilitation Centers / statistics & numerical data*
  • SARS-CoV-2 / immunology
  • SARS-CoV-2 / isolation & purification*
  • Serologic Tests


  • Antibodies, Viral