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Does incubation period of COVID-19 vary with age? A study of epidemiologically linked cases in Singapore.

ABSTRACT: This study estimates the incubation period of COVID-19 among locally transmitted cases, and its association with age to better inform public health measures in containing COVID-19. Epidemiological data of all PCR-confirmed COVID-19 cases from all restructured hospitals in Singapore were collected between 23 January 2020 and 2 April 2020. Activity mapping and detailed epidemiological investigation were conducted by trained personnel. Positive cases without clear exposure to another positive case were excluded from the analysis. One hundred and sixty-four cases (15.6% of patients) met the inclusion criteria during the defined period. The crude median incubation period was 5 days (range 1-12 days) and median age was 42 years (range 5-79 years). The median incubation period among those 70 years and older was significantly longer than those younger than 70 years (8 vis-à-vis 5 days, P = 0.040). Incubation period was negatively correlated with day of illness in both groups. These findings support current policies of 14-day quarantine periods for close contacts of confirmed cases and 28 days for monitoring infections in known clusters. An elderly person who may have a longer incubation period than a younger counterpart may benefit from earlier and proactive testing, especially after exposure to a positive case.

SUBMITTER: Tan WYT

PROVIDER: S-EPMC7484300 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Does incubation period of COVID-19 vary with age? A study of epidemiologically linked cases in Singapore.

Tan W Y T WYT Wong L Y LY Leo Y S YS Toh M P H S MPHS

Epidemiology and infection 20200902

This study estimates the incubation period of COVID-19 among locally transmitted cases, and its association with age to better inform public health measures in containing COVID-19. Epidemiological data of all PCR-confirmed COVID-19 cases from all restructured hospitals in Singapore were collected between 23 January 2020 and 2 April 2020. Activity mapping and detailed epidemiological investigation were conducted by trained personnel. Positive cases without clear exposure to another positive case ...[more]

PMID: 32873357

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Project description: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.

Dataset Information

Does incubation period of COVID-19 vary with age? A study of epidemiologically linked cases in Singapore.

Publications

Does incubation period of COVID-19 vary with age? A study of epidemiologically linked cases in Singapore.

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