key: cord-0761299-sg3srt8r
authors: Ling, Zhoukun; Xu, Xi; Gan, Qingxin; Zhang, Lieguang; Luo, Liangping; Tang, Xiaoping; Liu, Jinxin
title: Asymptomatic SARS-CoV-2 infected patients with persistent negative CT findings
date: 2020-03-12
journal: Eur J Radiol
DOI: 10.1016/j.ejrad.2020.108956
sha: 17fbe8328258b7e0df15b3f363a980b1ccdabd12
doc_id: 761299
cord_uid: sg3srt8r

nan

A recent outbreak of coronavirus disease 2019 in Wuhan, China has become a public health emergency of international concern [1] . As of February 20, 2020, the coronavirus named as severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 has infected more than 75,000 individuals, and caused over 2000 fatal cases.

A previous research reported a familial cluster of COVID-19 pneumonia [2] . In this family, a 10-year-old child had no clinical symptoms, but showed ground glass lung opacification on CT, subsequently, the patient presented positive for the SARS-CoV-2 nucleic acid by real time polymerase chain reaction (RT-PCR). Therefore, these findings indicated the clinical symptoms were not essential components of SARS-CoV-2 infection.

We observed 295 patients with laboratory-identified SARS-CoV-2 infection by RT-PCR between January 23, 2020 and February 18, 2020 in Guangzhou Eighth People's Hospital. The majority patients had a history of exposure in Wuhan or to infected patients. 49 (17 %) patients presented negative chest CT images at initial presentation; fifteen of 49 patients who had a repeat CT scan that became positive (after 3-6 days) for COVID-19 pneumonia. Thirty-four of 49 patients showed persistent negative CT images (after 3-14 days), and thirty of 34 patients showed few clinical symptoms, 4 patients showed no clinical symptoms. Moreover, two of 4 patients subsequently presented two consecutive negative nucleic acid detection at least 24 h apart and finally recovered (Fig. 1) .

In our observation, we found that four patients with SARS-CoV-2 infection, showed no clinical symptoms or abnormal chest CT images. Lirong Zou et al. [3] reported that the asymptomatic and symptomatic patients showed resemble viral load. The viral RNA can be detected in the respiratory secretions of asymptomatic patients for no less than 5 days. Thus, they suspect that the asymptomatic or few symptomatic patients still have transmission potential.

It is worth noting that, the clinical symptoms and radiological abnormalities are not the essential components of SARS-CoV-2 infection. Therefore, the detection and isolation of infected cases require more careful strategies and screening practices. If some people have a history of exposure to infected areas or contact with patients, regardless of radiological manifestations or clinical symptoms, medical observation and home isolation or SARS-CoV-2 nucleic acid tests are quite important to rule out infection. Medical observation and home isolation for suspected individuals play important roles in timely detecting and containing this emerging communicable disease. 

The written informed consent for this retrospective study was waived.

Not applicable.

Not applicable.

The authors declare that they have no conflicts of interest.

A novel coronavirus from patients with pneumonia in China

A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster

SARS-CoV-2 viral load in upper respiratory specimens of infected patients