2) đź“ŚAsymptomatic infection may be associated with subclinical lung abnormalities, as detected by computed tomography.
đź“ŚBecause of the high risk for silent spread by asymptomatic persons, it is imperative that testing programs include those without symptoms! #covid19
đź“ŚBecause of the high risk for silent spread by asymptomatic persons, it is imperative that testing programs include those without symptoms! #covid19
3) To supplement conventional diagnostic testing, which is constrained by capacity, cost, and its one-off nature, innovative tactics for public health surveillance, such as crowdsourcing digital wearable data and monitoring sewage sludge (eg @BiobotAnalytics), might be helpful.
4) The difficulty of distinguishing asymptomatic persons from merely presymptomatic is a stumbling block. To be clear, the asymptomatic individual is infected but will never develop symptoms. In contrast, presymptomatic is similarly infected but eventually will develop symptoms.
5) simple solution to this conundrum is longitudinal testing—that is, repeated observations of the individual over time. Unfortunately, only 5 studies include longitudinal data.
6) “The finding that 54% of the 76 asymptomatic persons on the Diamond Princess who were examined by computed tomography appeared to have significant subclinical abnormalities in their lungs is disturbing.”
7) “If confirmed, this finding suggests that absence of symptoms might not necessarily mean the absence of harm. The subclinical nature of the finding raises the possibility that SARS-CoV-2 infection causes subtle deficits in lung function that might not be immediately apparent.”
8) “Does relatively high proportion (60.5%) of asymptomatic cases on USS T Roosevelt—mostly aged 20s & 30s—suggest that asymptomatic is more likely in younger persons? Maybe but asymptomatic (47.8%) on French Charles de Gaulle aircraft carrier seems only marginally higher.”
9) Asymptomatic patients (from Wuhan) “were younger (median [interquartile range] age, 37 [26-45] years vs 56 [34-63] years; P < .001), and had a higher proportion of women (22 [66.7%] women vs 14 [31.%] [sic] women; P = .002).”
10) “The 96% rate of asymptomatic infection among thousands of inmates in 4 state prison systems is remarkable. Without any longitudinal data, we cannot estimate presymptomatic cases. Why, then, might the asymptomatic infection rate in this setting be so anomalously high?”
11) “One plausible factor could be cross-immunity imparted by the betacoronaviruses HCoV-OC43 and HCoV-HKU1, which has been proposed as a mitigating factor in #SARSCoV2.” ➡️ the authors are implying that cross immunity to 2 other milder sister coronaviruses could give immunity!⚠️
12) “According to CDC, HCoV-HKU1 was active from late Nov 2019 to mid-Feb 2020. In a locked-down congregate setting like a prison, possible that contagious respiratory viruses could spread rapidly—would be interesting to do a serosurvey for antibodies to these betacoronaviruses.”
13) “In a perfect world, perhaps using simple, accurate, inexpensive technology that is still on the drawing board, we would test each person every day for SARS-CoV-2. Until that is possible, innovative surveillance tactics might provide useful data for public health officials.”
14) “Self-monitoring with internet-connected thermometers and smart watches that monitor heart rate, then crowdsourcing the resulting data, has been shown to accurately predict the incidence of influenza-like illness.”
15) “Similarly, monitoring sewage sludge provided “SARS-CoV-2 RNA concentrations [that] were a seven-day leading indicator ahead of compiled COVID-19 testing data and led local hospital admissions data by three days”. @BiobotAnalytics @NewshaGhaeli
16) FULL TEXT: “Prevalence of Asymptomatic SARS-CoV-2 Infection: A Narrative Review” @AnnalsofIM acpjournals.org/doi/10.7326/M2…
