PT  - JOURNAL ARTICLE
AU  - Sang Hyun Ra
AU  - Joon Seo Lim
AU  - Gwang-un Kim
AU  - Min Jae Kim
AU  - Jiwon Jung
AU  - Sung-Han Kim
TI  - Upper respiratory viral load in asymptomatic individuals and mildly symptomatic patients with SARS-CoV-2 infection
AID  - 10.1136/thoraxjnl-2020-215042
DP  - 2020 Aug 28
TA  - Thorax
PG  - thoraxjnl-2020-215042
4099  - http://thorax.bmj.com/content/early/2020/08/28/thoraxjnl-2020-215042.short
4100  - http://thorax.bmj.com/content/early/2020/08/28/thoraxjnl-2020-215042.full
AB  - Background Asymptomatic individuals with SARS-CoV-2 infection have viable viral loads and have been linked to several transmission cases. However, data on the viral loads in such individuals are lacking. We assessed the viral loads in asymptomatic individuals with SARS-CoV-2 infection in comparison with those in symptomatic patients with COVID-19.Methods Study participants were recruited from a community facility designated for the isolation of patients with mild COVID-19 in South Korea. The presence of symptoms was evaluated with a questionnaire-based survey. Viral loads in the upper respiratory tract were measured with real-time reverse transcription-PCR (RT-PCR) targeting the E, RdRp and N genes of SARS-CoV-2, with a cycle threshold (Ct) value of 40 for determining positivity.Results In 213 patients with SARS-CoV-2 infection, 41 (19%) had remained asymptomatic from potential exposure to laboratory confirmation and admission; of them, 39 (95%) underwent follow-up RT-PCR testing after a median 13 days. In 172 symptomatic patients, 144 (84%) underwent follow-up RT-PCR testing. Twenty-one (54%) asymptomatic individuals and 92 (64%) symptomatic patients tested positive for SARS-CoV-2 at follow-up. Asymptomatic individuals and symptomatic patients did not show any significant differences in the mean Ct values of the E (31.15 vs 31.43; p>0.99), RdRp (32.26 vs 32.93; p=0.92) and N (33.05 vs 33.28; p>0.99) genes.Conclusion Approximately one-fifth of the individuals without severe symptoms were asymptomatic, and their viral loads were comparable to those in symptomatic patients. A large proportion of mildly symptomatic patients with COVID-19 or asymptomatic individuals with SARS-CoV-2 showed persistent positive upper respiratory RT-PCR results at follow-up.