Journal Article

Epidemiological and viral features of a cohort of SARS-CoV-2 symptomatic and asymptomatic individuals in an area of the Colombian Caribbean

Arrieta, German, Garay, Evelyn, Guzman-Teran, Camilo, Contreras, Héctor, Martinez-Bravo, Caty, Lopez, Yesica, Mattar, Salim, Galeano, Ketty, Alvis-Guzman, Nelson, Camargo-Assis, Francisco, Tique, Vaneza, Ospina, Martha, Faccini-Martínez, Álvaro A., Rivero, Ricardo, Contreras, Verónica, Miranda, Jorge, Gonzalez-Tous, Marco, Garcia-Perez, Alejandra, Mercado-Reyes, Marcela

2020

Overview

Background Severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) is an emerging viral pandemic disease. In the last 6 months, SARS-CoV-2 has caused millions of reported cases and hundreds of thousands of deaths. As other world regions, South America has not contained the pandemic’s advance since it lacks the hospital and economic capacities. Public health implications of transmission, while the asymptomatic/presymptomatic infection is a critical concern at the current pandemic. Objective Describe the socio-demographic, clinical, and viral features of a cohort of SARS-CoV-2 infected individuals from the Colombian Caribbean. Methods Six hundred eighty-six clinical samples of suspected SARS-CoV-2 infection cases and contacts individuals from several hospital centers in the department of Córdoba, Colombia, were received at our laboratory between April 9th and May 16th, 2020. RNA was extracted using lysis buffers and spin columns. The samples were tested for SARS-CoV-2 by reverse transcription real-time polymerase chain reaction (RT-qPCR) using commercially available multiplex real-time PCR assay for simultaneous detection of 3 target genes of SARS-CoV-2 (Allplex™, 2019-nCoV assay, Korea). Viral copies quantification was done using a standard curve constructed from seriated dilutions of a SARS-CoV-2 positive control. Statics descriptive methods were used. Results Thirty-five nasopharyngeal samples were positive for SARS-CoV-2 infection; the average age was 43 (range, 1–95 years). Seventeen of 35 (49%) of the patients showed symptoms. Most of them had a cough, fever, and odynophagia; three of the patients reported having arthralgia. Only two patients required hospitalization. None of the patients had known co-morbidities. RT-qPCR results show that two of the symptomatic patients had significantly higher RNA copies than the rest. Eighteen of 35 (51%) individuals were asymptomatic, and the average age was 30 (range, 6–61 years). Four asymptomatic individuals showed a higher copy than some symptomatic patients; nonetheless, the average of RNA copies 8.26 × 10 10 was lower than the symptomatic. Conclusions This study shows that asymptomatic patients may develop infections with a high number of RNA copies. Since a considerable percentage of infections may be asymptomatic/presymptomatic, enhanced testing approaches may be needed to detect these persons. Due the occurrence of a large proportion of infections being a result from transmission originated in asymptomatic/presymptomatic individuals, public health interventions in Colombia should be based on two steps: a massive molecular screening, and viral load quantification. Finally, a remarkable issue in our study is the average age of symptomatic and asymptomatic groups (43 and 30 respectively) which may be important because of the economic impact that has been caused by the coronavirus pandemic and may be probably the cause of the reduced lethality observed in the country and the department at the time of this study.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adolescent / Adult / Age / Aged, 80 and over / Arthralgia / Asymptomatic / Asymptomatic infections / Biochemistry / Biomedical and Life Sciences / Biomedicine / Caribbean Region - epidemiology / Carrier State - epidemiology / Child / Child, Preschool / Colombia / Communicable disease control / Coronavirus infections / Coronaviruses / Cough / COVID-19 / COVID-19 - epidemiology / COVID-19 - etiology / COVID-19 - transmission / Development and progression / Disease transmission / Drug Resistance / Economic impact / Economics / Environment and public health / Epidemics / Epidemiology / Female / Females / Fever / Health aspects / Health promotion / Humans / Impact analysis / Infant / Infection / Infections / Infectious Diseases / Lethality / Lysis / Male / Medical Microbiology / Microbial Genetics and Genomics / Middle Aged / Mortality / Pandemics / Parasitology / Patients / Polymerase chain reaction / Pre symptomatic disease / Prospective Studies / Public health / Real time / Respiratory diseases / Reverse transcription / Ribonucleic acid / RNA / RNA polymerase / SARS-CoV-2 - genetics / Severe acute respiratory syndrome coronavirus 2 / Short Report / Signs and symptoms / Socioeconomic Factors / Target detection / Viral diseases / Viral Emerging and Re-emerging Infectious Diseases / Viral Load / Young Adult