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2.
Virol Sin ; 35(6): 785-792, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-1217481

ABSTRACT

Healthcare workers (HCWs) are at high risk of occupational exposure to the new pandemic human coronavirus, SARS-CoV-2, and are a source of nosocomial transmission in airborne infectious isolation rooms (AIIRs). Here, we performed comprehensive environmental contamination surveillance to evaluate the risk of viral transmission in AIIRs with 115 rooms in three buildings at the Shanghai Public Health Clinical Center, Shanghai, during the treatment of 334 patients infected with SARS-CoV-2. The results showed that the risk of airborne transmission of SARS-CoV-2 in AIIRs was low (1.62%, 25/1544) due to the directional airflow and strong environmental hygiene procedures. However, we detected viral RNA on the surface of foot-operated openers and bathroom sinks in AIIRs (viral load: 55.00-3154.50 copies/mL). This might be a source of contamination to connecting corridors and object surfaces through the footwear and gloves used by HCWs. The risk of infection was eliminated by the use of disposable footwear covers and the application of more effective environmental and personal hygiene measures. With the help of effective infection control procedures, none of 290 HCWs was infected when working in the AIIRs at this hospital. This study has provided information pertinent for infection control in AIIRs during the treatment of COVID-19 patients.


Subject(s)
COVID-19/transmission , Environmental Monitoring/methods , Hospitals, Isolation , SARS-CoV-2/isolation & purification , Air Microbiology , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/virology , China/epidemiology , Cross Infection/transmission , Environmental Microbiology , Health Personnel , Humans , Infection Control/instrumentation , Infection Control/methods , Pandemics/prevention & control , RNA, Viral/isolation & purification , Risk Factors , Viral Load
3.
Minerva Obstet Gynecol ; 73(2): 261-267, 2021 04.
Article in English | MEDLINE | ID: covidwho-1184117

ABSTRACT

BACKGROUND: Since COVID-19 was declared a pandemic, governments have taken actions to limit the transmission of the virus such as lockdown measures and reorganization of the local Health System. Quarantine measures have influenced pregnant women's daily lives. The aim of this study was to understand the impact of the changes imposed by COVID-19 emergency on the well-being of pregnant women and how the transformation of Schiavonia Hospital into a dedicated COVID hospital affected their pregnancy experience. METHODS: A cross-sectional survey was conducted. Pregnant women who gave birth in Schiavonia Hospital during the period May-September 2020 have been included. The assessment examined clinical characteristics, attitudes in relation to the pandemic and how it affected birth plans, perception of information received, and attitudes regards giving birth in a COVID hospital. RESULTS: One hundred four women responded to the survey, with an enrolment rate of 58%. About the influence of COVID-19 pandemic, 51% of respondents reported changing some aspect of their lifestyle. The identification of Schiavonia Hospital as COVID hospital did not modify the trust in the facility and in the obstetrics ward for the 90% of women, in fact for the 85.6% it was the planned Birth Center since the beginning of pregnancy. The communication was complete and exhaustive for 82.7% of the respondents. CONCLUSIONS: Despite the COVID hospital transformation, the women who came to give birth at Schiavonia Birth Center rated the healthcare assistance received at high level, evidencing high affection for the structure and the healthcare workers.


Subject(s)
Attitude to Health , COVID-19/epidemiology , Delivery Rooms/organization & administration , Delivery, Obstetric , Pregnant Women/psychology , Adult , Cross-Sectional Studies , Female , Health Facility Closure , Hospitals, Isolation/organization & administration , Humans , Italy/epidemiology , Life Style , Pandemics , Parity , Pregnancy , Prenatal Care/statistics & numerical data , Surveys and Questionnaires/statistics & numerical data , Women, Working/statistics & numerical data , Young Adult
6.
J Med Syst ; 45(4): 42, 2021 Feb 19.
Article in English | MEDLINE | ID: covidwho-1092039

ABSTRACT

In confronting the sudden epidemic of COVID-19, China and other countries have been under great deal of pressure to block virus transmission and reduce death cases. Fangcang shelter hospital, which is converted from large-scale public venue, is proposed and proven to be an effective way for administering medical care and social isolation. This paper presents the practice in information technology support for a Fangcang shelter hospital in Wuhan, China. The experiences include the deployment strategy of IT infrastructure, the redesign of function modules in the hospital information system (HIS), equipment maintenance and medical staff training. The deployment strategy and HIS modules have ensured smoothness and efficiency of clinical work. The team established a quick response mechanism and adhered to the principle of nosocomial infection control. Deployment of network and modification of HIS was finished in the 48 hours before patient admittance. A repair hotline and remote support for equipment and software were available whenever medical workers met with any questions. No engineer ever entered the contaminated areas and no one was infected by the coronavirus during the hospital operation. Up to now, Fangcang shelter hospital is adopted by many regions around the world facing the collapse of their medical systems. This valuable experience in informatization construction and service in Wuhan may help participators involving in Fangcang shelter hospital get better information technology support, and find more practical interventions to fight the epidemic.


Subject(s)
COVID-19/therapy , Emergency Shelter/organization & administration , Hospitals, Special/organization & administration , Mobile Health Units/organization & administration , Patient Isolation/statistics & numerical data , COVID-19/epidemiology , China , Emergencies , Facility Design and Construction , Hospitals, Isolation , Humans , Information Technology , Risk Factors
7.
Ann Ital Chir ; 91: 563-567, 2020.
Article in English | MEDLINE | ID: covidwho-1068445

ABSTRACT

2019-nCoV currently named SARS-CoV-2 is a highly pathogenic Coronavirus identified in Wuhan China in December 2019. Turkey declared the first case relatively late compared to Asian and European countries on March 11, as the first SARS-CoV-2 infection in Turkey. In this study, we aimed to determine patients' outcomes in 50 surgeries done in the incubation period of SARS-CoV-2 in our hospital. METHODS: We retrospectively analyzed the clinical data of 50 patients who underwent surgeries during the incubation period of CoVid-19 at Istinye University Gaziosmanpasa Medical Park Hospital in Istanbul, from March 2 to April 11, 2020. RESULTS: The age of 50 patients range was 21 to 73, and the median age was 43.32 (64%) patients were women. The median length of hospital stay is 2.6 days (1-21). Operations at various difficulty levels were also performed on patients with co-morbidities. No complication or mortality was observed except for 1 patient, and the ICU requirement of that patient was also due to high energy trauma. CONCLUSION: Although contrary claims have been made in various studies; it is the primary duty of us surgeons to operate CoVid-19 positive/suspicious patients safely and without any contamination, and on the other hand, to continue their operations without victimizing negative patients. In this pilot study, we would like to emphasize with necessary and adequate measures these can be achieved. KEY WORDS: CoVid-19, SARS-CoV-2, Surgery.


Subject(s)
COVID-19 Testing , COVID-19/diagnosis , Emergencies/epidemiology , Hospitals, Isolation/statistics & numerical data , Hospitals, University/statistics & numerical data , Infectious Disease Incubation Period , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Pandemics , SARS-CoV-2 , Surgical Procedures, Operative/statistics & numerical data , Adult , Aged , COVID-19/diagnostic imaging , COVID-19/epidemiology , Comorbidity , Elective Surgical Procedures/mortality , Elective Surgical Procedures/statistics & numerical data , Equipment Contamination/prevention & control , Female , Hospital Mortality , Humans , Infection Control/methods , Male , Middle Aged , Patient Isolation , Pilot Projects , Retrospective Studies , Surgical Procedures, Operative/mortality , Tomography, X-Ray Computed , Turkey/epidemiology , Young Adult
10.
Eur Rev Med Pharmacol Sci ; 25(1): 498-502, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1052576

ABSTRACT

OBJECTIVE: The study aimed to explore the effects of psychological intervention on alleviating anxiety in patients in novel coronavirus (2019-nCoV) isolation wards. PATIENTS AND METHODS: Between January 24th, 2020 and March 5th, 2020, 103 patients were studied. Among these, 32 were patients in the isolation ward of the Infectious Disease Department in Baoding Second Hospital with suspected 2019-nCoV, and 71 patients diagnosed with 2019-nCoV were in the Tangshan Infectious Disease Hospital. Of the 103 patients included, 97 cases were observed in isolation. Using a self-control study design, each patient's anxiety was scored on a self-rating anxiety scale before receiving the psychological intervention (on the 7th day of isolation) and after receiving the intervention (on the 14th day of isolation). The severity of anxiety was evaluated based on the anxiety score before receiving the intervention. The anxiety scores before and after receiving the intervention were then compared using the paired t-test, and p<0.05 was considered statistically significant. RESULTS: After receiving the psychological intervention once or twice a week, the anxiety of the patients improved significantly after one week. CONCLUSIONS: The anxiety of patients with 2019-nCoV in isolation wards can be alleviated through psychological intervention. By alleviating patient anxiety, this intervention also helps patients maintain their psychological wellbeing, which promotes rehabilitation and helps with the control of 2019-nCoV.


Subject(s)
Anxiety/prevention & control , COVID-19/psychology , Hospitals, Isolation , Psychosocial Intervention/methods , Quality of Life/psychology , Adaptation, Psychological , Adolescent , Adult , Aged , Aged, 80 and over , Anxiety/psychology , China , Diagnostic Self Evaluation , Female , Humans , Male , Middle Aged , Psychiatric Status Rating Scales , SARS-CoV-2 , Surveys and Questionnaires , Young Adult
12.
Int J Med Sci ; 18(3): 646-651, 2021.
Article in English | MEDLINE | ID: covidwho-1027827

ABSTRACT

Objectives: A significant proportion of discharged COVID-19 patients still have some symptoms. Traditional Chinese medicine (TCM) has played an important role in the treatment of COVID-19, but whether it is helpful for discharged patients is still unknown. The aim of this study was to retrospectively analyze the impacts of TCM treatment on the convalescents of COVID-19. Methods: A total of 372 COVID-19 convalescents from February 21 to May 3 in Shenzhen, China were retrospectively analyzed, 291 of them accepted clinically examined at least once and 191 convalescents accepted TCM. Results: After retrospective analysis of the clinical data of convalescents accepted TCM treatment or not, we found that the white blood cell count, as well as serum interleukin-6 and procalcitonin decreased in TCM group. Serum γ-glutamyl transpeptidase was significantly decreased, while prealbumin and albumin increased in TCM group. Red blood cell, hemoglobin, and platelet count increased in TCM group. The mechanisms of TCM treatment might be the overall regulations, including balanced immune response, improved hematopoiesis and coagulation systems, enhanced functions of liver and heart, increased nutrient intake and lipid metabolism. Conclusions: This study suggested that TCM treatment would be beneficial for discharged COVID-19 patients. However, long-term medical observation and further study with randomized trial should be done to confirm this result. Besides, the potential molecular mechanisms of TCM treatment should be further revealed.


Subject(s)
COVID-19/rehabilitation , Convalescence , Drugs, Chinese Herbal/administration & dosage , COVID-19/blood , COVID-19/diagnosis , Hospitals, Isolation/statistics & numerical data , Humans , Retrospective Studies , SARS-CoV-2/isolation & purification , Treatment Outcome
14.
Am J Trop Med Hyg ; 104(1): 85-90, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-934570

ABSTRACT

Globally, India has reported the third highest number of COVID-19 cases. Chennai, the capital of Tamil Nadu state, witnessed a huge surge in COVID-19 cases, resulting in the establishment of isolation facilities named COVID Care Center (CCC). In our study, we describe the demographic, epidemiological, and clinical characteristics; clinical progression; and outcome of 1,263 asymptomatic/mildly symptomatic COVID-19 patients isolated in one such CCC between May 4, 2020 and June 4, 2020. Around 10.5% of the patients progressed to moderate/severe illness, requiring referral for tertiary care, and three died. Nearly half (49.5%) of the patients were symptomatic at the time of admission, 2.2% of the patients developed symptoms post-testing, and 48.5% patients remained asymptomatic during the entire course of illness. Most common presenting symptoms were fever (69.9%) and cough (29.6%), followed by generalized body pain, breathlessness, and loss of smell and taste. On multivariate analysis, we identified that symptomatic patients with comorbidities and higher neutrophil-lymphocyte ratio (NLR) were more likely to progress to severe illness warranting referral for tertiary care. COVID Care Center ensured case isolation and monitoring of asymptomatic/mildly symptomatic patients, thereby providing hospital beds for sick patients. COVID Care Center isolation facilities are safe alternatives for medical institutions to isolate and monitor COVID-19 patients. Older symptomatic patients with comorbidities and a high NLR admitted in an isolation facility must be frequently monitored for prompt identification of clinical progression and referral to higher center for advanced medical care.


Subject(s)
COVID-19/epidemiology , COVID-19/pathology , Hospitals, Isolation , SARS-CoV-2 , Adolescent , Adult , Child , Child, Preschool , Female , Humans , India/epidemiology , Infant , Male , Middle Aged , Young Adult
15.
Eur Rev Med Pharmacol Sci ; 24(20): 10867-10873, 2020 10.
Article in English | MEDLINE | ID: covidwho-914962

ABSTRACT

OBJECTIVE: To summarize the experience of three Chinese cities (Wuhan, Shanghai and Haikou) and provide a reference for global efforts to combat COVID-19 spread among children. MATERIALS AND METHODS: Through collecting the measures and outcomes of preventing and controlling COVID-19 in China's three hospitals, we compared the effect of different strategies. RESULTS: From January to March 2020, the number of suspected and confirmed COVID-19 cases in Wuhan increased exponentially, and Wuhan Children's Hospital as a whole was transformed into a designated quarantine and treatment facility, which is the "Wuhan Model". Shanghai has more children's hospitals with better capabilities to tackle public health emergency. Besides, it is far away from Wuhan and had a small caseload. Children's Hospital of Fudan University, a facility in Shanghai to treat pediatric infectious diseases, is famous for its well-equipped building for infectious disease treatment and professional medical team, and therefore no major transformation was required. That is the "Shanghai Model". Haikou is located on an island. Amid the outbreak, large numbers of tourists and travelers from Hubei had already arrived in Haikou. Hainan Women and Children's Medical Center, as the only pediatric care hospital in Hainan Province, did not have a separate building for infectious disease treatment. After a citywide survey of the medical resources and facilities available, a temporarily idle hospital 3 kilometers away from Hainan Women and Children's Medical Center was requisitioned as the quarantine and treatment facility for pediatric cases. That is the "Hainan Model". The three models enabled the treatment of all suspected and confirmed cases and no fatality was reported. CONCLUSIONS: The COVID-19 coping strategies for children should be designed according to the existing conditions of the local children's hospitals and the risk levels of the epidemic.


Subject(s)
Coronavirus Infections/prevention & control , Hospitals, Isolation/organization & administration , Hospitals, Pediatric/organization & administration , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Adaptation, Psychological , Adolescent , COVID-19 , Child , Child, Preschool , China/epidemiology , Female , Humans , Infant , Male
16.
J Med Internet Res ; 22(10): e19878, 2020 10 14.
Article in English | MEDLINE | ID: covidwho-862647

ABSTRACT

BACKGROUND: As the COVID-19 epidemic increases in severity, the burden of quarantine stations outside emergency departments (EDs) at hospitals is increasing daily. To address the high screening workload at quarantine stations, all staff members with medical licenses are required to work shifts in these stations. Therefore, it is necessary to simplify the workflow and decision-making process for physicians and surgeons from all subspecialties. OBJECTIVE: The aim of this paper is to demonstrate how the National Cheng Kung University Hospital artificial intelligence (AI) trilogy of diversion to a smart quarantine station, AI-assisted image interpretation, and a built-in clinical decision-making algorithm improves medical care and reduces quarantine processing times. METHODS: This observational study on the emerging COVID-19 pandemic included 643 patients. An "AI trilogy" of diversion to a smart quarantine station, AI-assisted image interpretation, and a built-in clinical decision-making algorithm on a tablet computer was applied to shorten the quarantine survey process and reduce processing time during the COVID-19 pandemic. RESULTS: The use of the AI trilogy facilitated the processing of suspected cases of COVID-19 with or without symptoms; also, travel, occupation, contact, and clustering histories were obtained with the tablet computer device. A separate AI-mode function that could quickly recognize pulmonary infiltrates on chest x-rays was merged into the smart clinical assisting system (SCAS), and this model was subsequently trained with COVID-19 pneumonia cases from the GitHub open source data set. The detection rates for posteroanterior and anteroposterior chest x-rays were 55/59 (93%) and 5/11 (45%), respectively. The SCAS algorithm was continuously adjusted based on updates to the Taiwan Centers for Disease Control public safety guidelines for faster clinical decision making. Our ex vivo study demonstrated the efficiency of disinfecting the tablet computer surface by wiping it twice with 75% alcohol sanitizer. To further analyze the impact of the AI application in the quarantine station, we subdivided the station group into groups with or without AI. Compared with the conventional ED (n=281), the survey time at the quarantine station (n=1520) was significantly shortened; the median survey time at the ED was 153 minutes (95% CI 108.5-205.0), vs 35 minutes at the quarantine station (95% CI 24-56; P<.001). Furthermore, the use of the AI application in the quarantine station reduced the survey time in the quarantine station; the median survey time without AI was 101 minutes (95% CI 40-153), vs 34 minutes (95% CI 24-53) with AI in the quarantine station (P<.001). CONCLUSIONS: The AI trilogy improved our medical care workflow by shortening the quarantine survey process and reducing the processing time, which is especially important during an emerging infectious disease epidemic.


Subject(s)
Artificial Intelligence , Betacoronavirus , Quarantine , Adult , COVID-19 , Coronavirus Infections , Female , Hospitals, Isolation , Humans , Middle Aged , Pandemics , Pneumonia, Viral , Quarantine/methods , SARS-CoV-2 , Surveys and Questionnaires , Taiwan/epidemiology
17.
Int J Gynaecol Obstet ; 151(3): 341-346, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-813312

ABSTRACT

OBJECTIVE: To determine the impact of roster reorganization on ensuring uninterrupted services while providing necessary relief to healthcare workers (HCW) in the obstetrics department of a tertiary care center amid the COVID-19 outbreak. METHODS: The COVID-19 rostering response began in April 2020 and evolved in two phases: (1) development of new areas for screening and managing suspected/positive cases of COVID-19; and (2) team segregation according to area of work. The impact of these changes on HCWs and patients was assessed 3 months later. RESULTS: Developing separate areas helped to minimize the risk of exposure of patients and HCWs to those with COVID-19. Residents and consultants worked intensively in clinical areas for 1 week followed by 1-2 weeks of non-clinical or standby assignments, providing adequate opportunity for isolation. Frequent re-evaluation of the roster was nevertheless required as the pandemic progressed. Segregating teams vertically significantly reduced the number of contacts identified on contact tracing and quarantine leaves, while maintaining patient satisfaction with no increase in adverse events. Residents found the roster to be "smart" and "pandemic-appropriate." CONCLUSION: The "COVID emergency roster" helped ensure quality care with minimum risk of exposure and sufficient breaks for physical and psychological recovery of HCWs.


Subject(s)
COVID-19/prevention & control , Hospitals, Isolation/organization & administration , Personnel Staffing and Scheduling/organization & administration , Adult , COVID-19/diagnosis , COVID-19/therapy , Female , Gynecology/methods , Humans , India , Male , Obstetrics/methods , Pandemics , Pregnancy , SARS-CoV-2 , Tertiary Care Centers/organization & administration , Young Adult
18.
Clin Microbiol Infect ; 26(12): 1658-1662, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-753742

ABSTRACT

OBJECTIVES: Environmental surfaces have been suggested as likely contributors in the transmission of COVID-19. This study assessed the infectivity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) contaminating surfaces and objects in two hospital isolation units and a quarantine hotel. METHODS: SARS-CoV-2 virus stability and infectivity on non-porous surfaces was tested under controlled laboratory conditions. Surface and air sampling were conducted at two COVID-19 isolation units and in a quarantine hotel. Viral RNA was detected by RT-PCR and infectivity was assessed by VERO E6 CPE test. RESULTS: In laboratory-controlled conditions, SARS-CoV-2 gradually lost its infectivity completely by day 4 at ambient temperature, and the decay rate of viral viability on surfaces directly correlated with increase in temperature. Viral RNA was detected in 29/55 surface samples (52.7%) and 16/42 surface samples (38%) from the surroundings of symptomatic COVID-19 patients in isolation units of two hospitals and in a quarantine hotel for asymptomatic and very mild COVID-19 patients. None of the surface and air samples from the three sites (0/97) were found to contain infectious titres of SARS-Cov-2 on tissue culture assay. CONCLUSIONS: Despite prolonged viability of SARS-CoV-2 under laboratory-controlled conditions, uncultivable viral contamination of inanimate surfaces might suggest low feasibility for indirect fomite transmission.


Subject(s)
COVID-19/transmission , Fomites/virology , Hospitals, Isolation/statistics & numerical data , Housing/statistics & numerical data , Microbial Viability , SARS-CoV-2/isolation & purification , COVID-19/virology , Humans , RNA, Viral/isolation & purification , Surface Properties , Temperature
19.
Am J Infect Control ; 49(4): 447-451, 2021 04.
Article in English | MEDLINE | ID: covidwho-726383

ABSTRACT

BACKGROUND: Coronavirus disease 2019 has spread globally and been a public health emergency worldwide. It is important to reduce the risk of healthcare associated infections among the healthcare workers and patients. This study aimed to investigate the contamination of environment in isolation wards and sewage, and assess the quality of routine disinfection procedures in our hospital. METHODS: Routine disinfection procedures were performed 3-times a day in general isolation wards and 6-times a day in isolated ICU wards in our hospital. Environmental surface samples and sewage samples were collected for viral RNA detection. Severe acute respiratory syndrome coronavirus 2 RNA detection was performed with quantitative reverse transcription polymerase chain reaction. RESULTS: A total of 163 samples were collected from February 6 to April 4. Among 122 surface samples, 2 were positive for severe acute respiratory syndrome coronavirus 2 RNA detection. One was collected from the flush button of the toilet bowl, and the other was collected from a hand-basin. Although 10 of the sewage samples were positive for viral RNA detection, all positive samples were negative for viral culture. CONCLUSION: These results revealed the routine disinfection procedures in our hospital were effective in reducing the potential risk of healthcare associated infection. Two surface samples were positive for viral detection, suggesting that more attention should be paid when disinfecting places easy to be ignored.


Subject(s)
COVID-19/prevention & control , Disinfection/methods , Hospitals, Isolation/standards , SARS-CoV-2 , Disinfection/standards , Health Personnel , Humans , Occupational Exposure/prevention & control
20.
JAMA Intern Med ; 180(11): 1447-1452, 2020 Nov 01.
Article in English | MEDLINE | ID: covidwho-696078

ABSTRACT

IMPORTANCE: There is limited information about the clinical course and viral load in asymptomatic patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). OBJECTIVE: To quantitatively describe SARS-CoV-2 molecular viral shedding in asymptomatic and symptomatic patients. DESIGN, SETTING, AND PARTICIPANTS: A retrospective evaluation was conducted for a cohort of 303 symptomatic and asymptomatic patients with SARS-CoV-2 infection between March 6 and March 26, 2020. Participants were isolated in a community treatment center in Cheonan, Republic of Korea. MAIN OUTCOMES AND MEASURES: Epidemiologic, demographic, and laboratory data were collected and analyzed. Attending health care personnel carefully identified patients' symptoms during isolation. The decision to release an individual from isolation was based on the results of reverse transcription-polymerase chain reaction (RT-PCR) assay from upper respiratory tract specimens (nasopharynx and oropharynx swab) and lower respiratory tract specimens (sputum) for SARS-CoV-2. This testing was performed on days 8, 9, 15, and 16 of isolation. On days 10, 17, 18, and 19, RT-PCR assays from the upper or lower respiratory tract were performed at physician discretion. Cycle threshold (Ct) values in RT-PCR for SARS-CoV-2 detection were determined in both asymptomatic and symptomatic patients. RESULTS: Of the 303 patients with SARS-CoV-2 infection, the median (interquartile range) age was 25 (22-36) years, and 201 (66.3%) were women. Only 12 (3.9%) patients had comorbidities (10 had hypertension, 1 had cancer, and 1 had asthma). Among the 303 patients with SARS-CoV-2 infection, 193 (63.7%) were symptomatic at the time of isolation. Of the 110 (36.3%) asymptomatic patients, 21 (19.1%) developed symptoms during isolation. The median (interquartile range) interval of time from detection of SARS-CoV-2 to symptom onset in presymptomatic patients was 15 (13-20) days. The proportions of participants with a negative conversion at day 14 and day 21 from diagnosis were 33.7% and 75.2%, respectively, in asymptomatic patients and 29.6% and 69.9%, respectively, in symptomatic patients (including presymptomatic patients). The median (SE) time from diagnosis to the first negative conversion was 17 (1.07) days for asymptomatic patients and 19.5 (0.63) days for symptomatic (including presymptomatic) patients (P = .07). The Ct values for the envelope (env) gene from lower respiratory tract specimens showed that viral loads in asymptomatic patients from diagnosis to discharge tended to decrease more slowly in the time interaction trend than those in symptomatic (including presymptomatic) patients (ß = -0.065 [SE, 0.023]; P = .005). CONCLUSIONS AND RELEVANCE: In this cohort study of symptomatic and asymptomatic patients with SARS-CoV-2 infection who were isolated in a community treatment center in Cheonan, Republic of Korea, the Ct values in asymptomatic patients were similar to those in symptomatic patients. Isolation of asymptomatic patients may be necessary to control the spread of SARS-CoV-2.


Subject(s)
Asymptomatic Infections , Hospitals, Isolation , Patient Isolation/methods , SARS-CoV-2 , Viral Load/methods , Virus Shedding , Adult , Asymptomatic Infections/epidemiology , Asymptomatic Infections/therapy , COVID-19/diagnosis , COVID-19/physiopathology , COVID-19 Testing/methods , COVID-19 Testing/statistics & numerical data , Epidemiological Monitoring , Female , Hospitals, Isolation/methods , Hospitals, Isolation/statistics & numerical data , Humans , Male , Public Health/statistics & numerical data , Republic of Korea/epidemiology , Retrospective Studies , SARS-CoV-2/isolation & purification , SARS-CoV-2/physiology , Symptom Assessment/methods , Symptom Assessment/statistics & numerical data
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