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Estimation of Undetected Asymptomatic COVID-19 Cases in South Korea Using a Probabilistic Model.

ABSTRACT: Increasing evidence shows that many infections of COVID-19 are asymptomatic, becoming a global challenge, since asymptomatic infections have the same infectivity as symptomatic infections. We developed a probabilistic model for estimating the proportion of undetected asymptomatic COVID-19 patients in the country. We considered two scenarios: one is conservative and the other is nonconservative. By combining the above two scenarios, we gave an interval estimation of 0.0001-0.0027 and in terms of the population, 5200-139,900 is the number of undetected asymptomatic cases in South Korea as of 2 February 2021. In addition, we provide estimates for total cases of COVID-19 in South Korea. Combination of undetected asymptomatic cases and undetected symptomatic cases to the number of confirmed cases (78,844 cases on 2 February 2021) shows that 0.17-0.42% (89,244-218,744) of the population have COVID-19. In conclusion, to control and understand the true ongoing reality of the pandemic, it is of outermost importance to focus on the ratio of undetected asymptomatic cases in the total population.

SUBMITTER: Lee C

PROVIDER: S-EPMC8124955 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:ObjectivesThe objective of the study was to conduct a follow-up investigation of 10 asymptomatic patients at diagnosis among the 98 confirmed coronavirus disease 2019 (COVID-19) cases reported in Busan between February 21, 2020 and March 13, 2020 to determine whether asymptomatic infection and transmission during asymptomatic period are possible.MethodsThe study analyzed 10 asymptomatic, confirmed COVID-19 cases to determine whether asymptomatic infection is possible. We conducted in-depth interviews with patients and guardians; interviews with primary physicians; review of medical records and drug utilization review (DUR) reports; and base station-based location tracking.ResultsAmong the 98, confirmed COVID-19 cases reported in Busan, the study analyzed 10 (10.2%) asymptomatic patients at diagnosis. The results confirmed that two (2.0%) patients reported to be asymptomatic during the initial epidemiological investigation, but turned symptomatic before diagnosis as per the in-depth interview results. Four cases (4.0%) of early detection led to confirmed diagnosis during the incubation period and presentation of symptoms after diagnosis. In addition, the remaining four patients (4.0%), having no subjective symptoms nor specific findings on chest radiography and computed tomography, remained asymptomatic until the isolation order was lifted. With regard to whether transmission during the asymptomatic period is possible, it was found that one out of 23 household contacts of the confirmed patients was identified as an additional confirmed case after coming in close contact with an index patient during the presymptomatic period.ConclusionsAmong the 98 confirmed cases, asymptomatic infection was confirmed in four cases (4.0%). In addition, there was one additional confirmed case in which the patient was a family member who came in close contact with an index patient during the incubation period, thereby confirming that transmission during the asymptomatic period is possible. The possibility of transmission during the asymptomatic period has been confirmed; therefore, it is necessary to review the measures for expanding contact tracing that is currently being applied starting one day prior to the onset of symptoms.

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Estimation of Undetected Asymptomatic COVID-19 Cases in South Korea Using a Probabilistic Model.

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