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Characteristics of viral specimens collected from asymptomatic and fatal cases of COVID-19.

ABSTRACT: We sought to determine the characteristics of viral specimens associated with fatal cases, asymptomatic cases and non-fatal symptomatic cases of COVID-19. This included the analysis of 1264 specimens found reactive for at least two SARS-CoV-2 specific loci from people screened for infection in Northern Nevada in March-May of 2020. Of these, 30 were specimens from fatal cases, while 23 were from positive, asymptomatic cases. We assessed the relative amounts of SARS-CoV-2 RNA from sample swabs by real-time PCR and use of the threshold crossing value (Ct). Moreover, we compared the amount of human RNase P found on the same swabs. A considerably higher viral load was found to be associated with swabs from cases involving fatality and the difference was found to be strongly statistically significant. Noting this difference, we sought to assess whether any genetic correlation could be found in association with virus from fatal cases using whole genome sequencing. While no common genetic elements were discerned, one branch of epidemiologically linked fatal cases did have two point mutations, which no other of 156 sequenced cases from northern Nevada had. The mutations caused amino acid changes in the 3'-5' exonuclease protein, and the product of the gene, orf8.

SUBMITTER: Gorzalski AJ

PROVIDER: S-EPMC7718074 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Characteristics of viral specimens collected from asymptomatic and fatal cases of COVID-19.

Gorzalski Andrew J AJ Hartley Paul P Laverdure Chris C Kerwin Heather H Tillett Richard R Verma Subhash S Rossetto Cyprian C Morzunov Sergey S Van Hooser Stephanie S Pandori Mark W MW

Journal of biomedical research 20200901 6

We sought to determine the characteristics of viral specimens associated with fatal cases, asymptomatic cases and non-fatal symptomatic cases of COVID-19. This included the analysis of 1264 specimens found reactive for at least two SARS-CoV-2 specific loci from people screened for infection in Northern Nevada in March-May of 2020. Of these, 30 were specimens from fatal cases, while 23 were from positive, asymptomatic cases. We assessed the relative amounts of SARS-CoV-2 RNA from sample swabs by ...[more]

PMID: 33243941

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Project description:As part of ongoing efforts to contain the coronavirus disease (COVID-19) pandemic, understanding the role of asymptomatic patients in the transmission system is essential for infection control. However, the optimal approach to risk assessment and management of asymptomatic cases remains unclear. This study proposed a Susceptible, Exposed, Infectious, No symptoms, Hospitalized and reported, Recovered, Death (SEINRHD) epidemic propagation model. The model was constructed based on epidemiological characteristics of COVID-19 in China and accounting for the heterogeneity of social contact networks. The early community outbreaks in Wuhan were reconstructed and fitted with the actual data. We used this model to assess epidemic control measures for asymptomatic cases in three dimensions. The impact of asymptomatic cases on epidemic propagation was examined based on the effective reproduction number, abnormally high transmission events, and type and structure of transmission. Management of asymptomatic cases can help flatten the infection curve. Tracing 75% of the asymptomatic cases corresponds to a 32.5% overall reduction in new cases (compared with tracing no asymptomatic cases). Regardless of population-wide measures, household transmission is higher than other types of transmission, accounting for an estimated 50% of all cases. The magnitude of tracing of asymptomatic cases is more important than the timing; when all symptomatic patients were traced, tested, and isolated in a timely manner, the overall epidemic was not sensitive to the time of implementing the measures to trace asymptomatic patients. Disease control and prevention within families should be emphasized during an epidemic. Note to Practitioners-This article addresses the urgent need to assess the risk of another COVID-19 outbreak caused by asymptomatic cases and to find the optimal, most practical approach to asymptomatic case management. Previous studies mostly focused on the clinical and statistical characteristics of asymptomatic cases; few have evaluated the impact of asymptomatic case measures using mathematical modeling at the community scale. This study proposed a Susceptible, Exposed, Infectious, No symptoms, Hospitalized and reported, Recovered, Death (SEINRHD) propagation model based on local community structures and social contact networks, according to the development characteristics and trend of COVID-19 in a Chinese community. The conclusion provides theoretical support for emergency work of relevant departments in different periods of an epidemic. In the early stages of the epidemic, timely detection and isolation of symptomatic patients should be a priority. Where there are surplus resources for epidemic prevention, the authorities should consider increasing the proportion of asymptomatic patients being traced. Epidemic prevention measures among family members should be a primary focus of attention. This combination of strategies can help reduce the rate of viral transmission and result in extinguishing the epidemic.

Dataset Information

Characteristics of viral specimens collected from asymptomatic and fatal cases of COVID-19.

Publications

Characteristics of viral specimens collected from asymptomatic and fatal cases of COVID-19.

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