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The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application.

ABSTRACT: Background:A novel human coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified in China in December 2019. There is limited support for many of its key epidemiologic features, including the incubation period for clinical disease (coronavirus disease 2019 [COVID-19]), which has important implications for surveillance and control activities. Objective:To estimate the length of the incubation period of COVID-19 and describe its public health implications. Design:Pooled analysis of confirmed COVID-19 cases reported between 4 January 2020 and 24 February 2020. Setting:News reports and press releases from 50 provinces, regions, and countries outside Wuhan, Hubei province, China. Participants:Persons with confirmed SARS-CoV-2 infection outside Hubei province, China. Measurements:Patient demographic characteristics and dates and times of possible exposure, symptom onset, fever onset, and hospitalization. Results:There were 181 confirmed cases with identifiable exposure and symptom onset windows to estimate the incubation period of COVID-19. The median incubation period was estimated to be 5.1 days (95% CI, 4.5 to 5.8 days), and 97.5% of those who develop symptoms will do so within 11.5 days (CI, 8.2 to 15.6 days) of infection. These estimates imply that, under conservative assumptions, 101 out of every 10 000 cases (99th percentile, 482) will develop symptoms after 14 days of active monitoring or quarantine. Limitation:Publicly reported cases may overrepresent severe cases, the incubation period for which may differ from that of mild cases. Conclusion:This work provides additional evidence for a median incubation period for COVID-19 of approximately 5 days, similar to SARS. Our results support current proposals for the length of quarantine or active monitoring of persons potentially exposed to SARS-CoV-2, although longer monitoring periods might be justified in extreme cases. Primary Funding Source:U.S. Centers for Disease Control and Prevention, National Institute of Allergy and Infectious Diseases, National Institute of General Medical Sciences, and Alexander von Humboldt Foundation.

SUBMITTER: Lauer SA

PROVIDER: S-EPMC7081172 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application.

Lauer Stephen A SA Grantz Kyra H KH Bi Qifang Q Jones Forrest K FK Zheng Qulu Q Meredith Hannah R HR Azman Andrew S AS Reich Nicholas G NG Lessler Justin J

Annals of internal medicine 20200310 9

<h4>Background</h4>A novel human coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified in China in December 2019. There is limited support for many of its key epidemiologic features, including the incubation period for clinical disease (coronavirus disease 2019 [COVID-19]), which has important implications for surveillance and control activities.<h4>Objective</h4>To estimate the length of the incubation period of COVID-19 and describe its public health implica ...[more]

PMID: 32150748

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Project description:BackgroundCoronavirus disease 2019 (COVID-19) has currently become a major global public health problem. The prevalence of COVID-19 has increased rapidly worldwide. Because there is no effective COVID-19 vaccine available yet, it is increasingly important to understand the average incubation period of severe acute respiratory syndrome novel coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, to design appropriate preventive and control strategies.ObjectiveThis systematic review and meta-analysis was designed to estimate the pooled average incubation period of SARS-CoV-2, the virus that causes COVID-19.MethodsWe conducted a systematic electronic web-based search of online databases, including PubMed, Google Scholar, Embase, and the World Health Organization Hinari portal. We included peer-reviewed research studies written in the English language on the incubation period of SARS-CoV-2 using pre-defined quality and inclusion criteria. STATA version 15 statistical software was used to analyze the data. Joanna Briggs Institute critical appraisal quality assessment tool for observational studies was utilized to evaluate the included studies. We extracted relevant data and presented in a tabular form. The I 2 test was used to assess heterogeneity across studies. Funnel plot asymmetry and Egger tests were used to check for publication bias. The final effect size was determined by applying a random-effects model.ResultsOur search identified 206 studies, amongst which 18 studies, representing 22,595 participants were included in the final analysis. The pooled average incubation period of SARS-CoV-2 was 5.7 days (95% CI, 5.1-6.4). Subgroup analyses by geographic location showed that the pooled average incubation period of SARS-CoV-2 was 6.1 days (95% CI, 5.34-6.94) in China and 4.54 (95% CI, 3.9-5.2) in other countries (Singapore, South Korea, and globally).ConclusionsThe pooled average incubation period of SARS-CoV-2 was about 6 days. The longest incubation period was observed in China. Global health initiatives as well as local health planners should consider this average incubation period when designing optimal prevention and control strategies for SARS-CoV-2. (Curr Ther Res Clin Exp. 2020; 81:XXX-XXX).

Project description:In late December 2019, patients of atypical pneumonia due to an unidentified microbial agent were reported in Wuhan, Hubei Province, China. Subsequently, a novel coronavirus was identified as the causative pathogen which was named SARS-CoV-2. As of 12 February 2020, more than 44 000 cases of SARS-CoV-2 infection have been confirmed in China and continue to expand. Provinces, municipalities and autonomous regions of China have launched first-level response to major public health emergencies one after another from 23 January 2020, which means restricting movement of people among provinces, municipalities and autonomous regions. The aim of this study was to explore the correlation between the migration scale index and the number of confirmed coronavirus disease 2019 (COVID-19) cases and to depict the effect of restricting population movement. In this study, Excel 2010 was used to demonstrate the temporal distribution at the day level and SPSS 23.0 was used to analyse the correlation between the migration scale index and the number of confirmed COVID-19 cases. We found that since 23 January 2020, Wuhan migration scale index has dropped significantly and since 26 January 2020, Hubei province migration scale index has dropped significantly. New confirmed COVID-19 cases per day in China except for Wuhan gradually increased since 24 January 2020, and showed a downward trend from 6 February 2020. New confirmed COVID-19 cases per day in China except for Hubei province gradually increased since 24 January 2020, and maintained at a high level from 24 January 2020 to 4 February 2020, then showed a downward trend. Wuhan migration scale index from 9 January to 22 January, 10 January to 23 January and 11 January to 24 January was correlated with the number of new confirmed COVID-19 cases per day in China except for Wuhan from 22 January to 4 February. Hubei province migration scale index from 10 January to 23 January and 11 January to 24 January was correlated with the number of new confirmed COVID-19 cases per day in China except for Hubei province from 22 January to 4 February. Our findings suggested that people who left Wuhan from 9 January to 22 January, and those who left Hubei province from 10 January to 24 January, led to the outbreak in the rest of China. The 'Wuhan lockdown' and the launching of the first-level response to this major public health emergency may have had a good effect on controlling the COVID-19 epidemic. Although new COVID-19 cases continued to be confirmed in China outside Wuhan and Hubei provinces, in our opinion, these are second-generation cases.

Dataset Information

The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application.

Publications

The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application.

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