A Prospective Cohort Study in Nonhospitalized Household Contacts With Severe Acute Respiratory Syndrome Coronavirus 2 Infection: Symptom Profiles and Symptom Change Over Time
Author:
Yousaf Anna R12, Duca Lindsey M12, Chu Victoria12, Reses Hannah E1, Fajans Mark1, Rabold Elizabeth M12, Laws Rebecca L1, Gharpure Radhika12, Matanock Almea1, Wadhwa Ashutosh13, Pomeroy Mary12, Njuguna Henry1, Fox Garrett1, Binder Alison M1, Christiansen Ann4, Freeman Brandi13, Gregory Christopher1, Tran Cuc H1, Owusu Daniel12, Ye Dongni1, Dietrich Elizabeth1, Pevzner Eric1, Conners Erin E1, Pray Ian125, Rispens Jared12, Vuong Jeni1, Christensen Kim6, Banks Michelle1, O’Hegarty Michelle1, Mills Lisa1, Lester Sandra1, Thornburg Natalie J1, Lewis Nathaniel126, Dawson Patrick12, Marcenac Perrine12, Salvatore Phillip12, Chancey Rebecca J1, Fields Victoria12, Buono Sean13, Yin Sherry1, Gerber Susan1, Kiphibane Tair7, Dasu Trivikram8, Bhattacharyya Sanjib8, Westergaard Ryan4, Dunn Angela3, Hall Aron J1, Fry Alicia M1, Tate Jacqueline E1, Kirking Hannah L1, Nabity Scott1
Affiliation:
1. COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA 2. Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA 3. Laboratory Leadership Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA 4. North Shore Health Department, Milwaukee, Wisconsin, USA 5. Wisconsin Department of Health, Milwaukee, Wisconsin, USA 6. Utah Department of Health, Salt Lake City, Utah, USA 7. Salt Lake County Health Department, Salt Lake City, Utah, USA 8. City of Milwaukee Health Department, Milwaukee, Wisconsin, USA
Abstract
Abstract
Background
Improved understanding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spectrum of disease is essential for clinical and public health interventions. There are limited data on mild or asymptomatic infections, but recognition of these individuals is key as they contribute to viral transmission. We describe the symptom profiles from individuals with mild or asymptomatic SARS-CoV-2 infection.
Methods
From 22 March to 22 April 2020 in Wisconsin and Utah, we enrolled and prospectively observed 198 household contacts exposed to SARS-CoV-2. We collected and tested nasopharyngeal specimens by real-time reverse-transcription polymerase chain reaction (rRT-PCR) 2 or more times during a 14-day period. Contacts completed daily symptom diaries. We characterized symptom profiles on the date of first positive rRT-PCR test and described progression of symptoms over time.
Results
We identified 47 contacts, median age 24 (3–75) years, with detectable SARS-CoV-2 by rRT-PCR. The most commonly reported symptoms on the day of first positive rRT-PCR test were upper respiratory (n = 32 [68%]) and neurologic (n = 30 [64%]); fever was not commonly reported (n = 9 [19%]). Eight (17%) individuals were asymptomatic at the date of first positive rRT-PCR collection; 2 (4%) had preceding symptoms that resolved and 6 (13%) subsequently developed symptoms. Children less frequently reported lower respiratory symptoms (21%, 60%, and 69% for <18, 18–49, and ≥50 years of age, respectively; P = .03).
Conclusions
Household contacts with laboratory-confirmed SARS-CoV-2 infection reported mild symptoms. When assessed at a single timepoint, several contacts appeared to have asymptomatic infection; however, over time all developed symptoms. These findings are important to inform infection control, contact tracing, and community mitigation strategies.
Publisher
Oxford University Press (OUP)
Subject
Infectious Diseases,Microbiology (medical)
Cited by
54 articles.
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