Systematic screening on admission for SARS-CoV-2 to detect asymptomatic infections

Rahel N Stadler; Laura Maurer; Lisandra Aguilar-Bultet; Fabian Franzeck; Chantal Ruchti; Richard Kühl; Andreas F Widmer; Ruth Schindler; Roland Bingisser; Katharina M Rentsch; Hans Pargger; Raoul Sutter; Luzius Steiner; Christoph Meier; Werner Kübler; Hans H Hirsch; Adrian Egli; Manuel Battegay; Stefano Bassetti; Sarah Tschudin-Sutter

doi:10.1186/s13756-021-00912-z

Systematic screening on admission for SARS-CoV-2 to detect asymptomatic infections

Antimicrob Resist Infect Control. 2021 Feb 27;10(1):44. doi: 10.1186/s13756-021-00912-z.

Authors

Rahel N Stadler¹, Laura Maurer¹, Lisandra Aguilar-Bultet¹, Fabian Franzeck¹, Chantal Ruchti¹, Richard Kühl¹, Andreas F Widmer¹, Ruth Schindler¹, Roland Bingisser², Katharina M Rentsch³, Hans Pargger⁴, Raoul Sutter⁴, Luzius Steiner⁵, Christoph Meier⁶, Werner Kübler⁶, Hans H Hirsch^{1

7

8}, Adrian Egli⁹, Manuel Battegay¹, Stefano Bassetti¹⁰, Sarah Tschudin-Sutter^{11

12}

Affiliations

¹ Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland.
² Emergency Department, University Hospital Basel, University of Basel, Basel, Switzerland.
³ Laboratory Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
⁴ Intensive Care Unit, University Hospital Basel, University of Basel, Basel, Switzerland.
⁵ Anesthesiology, University Hospital Basel, University of Basel, Basel, Switzerland.
⁶ University Hospital Basel, University of Basel, Basel, Switzerland.
⁷ Clinical Virology, Laboratory Medicine, University Hospital Basel, Basel, Switzerland.
⁸ Transplantation and Clinical Virology, Department Biomedicine, University of Basel, Basel, Switzerland.
⁹ Clinical Microbiology, University Hospital Basel, University of Basel, Basel, Switzerland.
¹⁰ Internal Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
¹¹ Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland. sarah.tschudin@usb.ch.
¹² Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland. sarah.tschudin@usb.ch.

Abstract

The proportion of asymptomatic carriers of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains elusive and the potential benefit of systematic screening during the SARS-CoV-2-pandemic is controversial. We investigated the proportion of asymptomatic inpatients who were identified by systematic screening for SARS-CoV-2 upon hospital admission. Our analysis revealed that systematic screening of asymptomatic inpatients detects a low total number of SARS-CoV-2 infections (0.1%), questioning the cost-benefit ratio of this intervention. Even when the population-wide prevalence was low, the proportion of asymptomatic carriers remained stable, supporting the need for universal infection prevention and control strategies to avoid onward transmission by undetected SARS-CoV-2-carriers during the pandemic.

Keywords: Asymptomatic carriers; COVID-19; SARS-CoV-2; Screening.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Asymptomatic Infections / epidemiology*
COVID-19 / diagnosis*
COVID-19 / epidemiology
COVID-19 / transmission
COVID-19 Testing / economics
COVID-19 Testing / methods
Cost-Benefit Analysis
Female
Humans
Male
Mass Screening / economics
Mass Screening / methods
Middle Aged
SARS-CoV-2 / isolation & purification*
Switzerland / epidemiology