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      Clinical and immunological assessment of asymptomatic SARS-CoV-2 infections.

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          Abstract

          The clinical features and immune responses of asymptomatic individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have not been well described. We studied 37 asymptomatic individuals in the Wanzhou District who were diagnosed with RT-PCR-confirmed SARS-CoV-2 infections but without any relevant clinical symptoms in the preceding 14 d and during hospitalization. Asymptomatic individuals were admitted to the government-designated Wanzhou People's Hospital for centralized isolation in accordance with policy1. The median duration of viral shedding in the asymptomatic group was 19 d (interquartile range (IQR), 15-26 d). The asymptomatic group had a significantly longer duration of viral shedding than the symptomatic group (log-rank P = 0.028). The virus-specific IgG levels in the asymptomatic group (median S/CO, 3.4; IQR, 1.6-10.7) were significantly lower (P = 0.005) relative to the symptomatic group (median S/CO, 20.5; IQR, 5.8-38.2) in the acute phase. Of asymptomatic individuals, 93.3% (28/30) and 81.1% (30/37) had reduction in IgG and neutralizing antibody levels, respectively, during the early convalescent phase, as compared to 96.8% (30/31) and 62.2% (23/37) of symptomatic patients. Forty percent of asymptomatic individuals became seronegative and 12.9% of the symptomatic group became negative for IgG in the early convalescent phase. In addition, asymptomatic individuals exhibited lower levels of 18 pro- and anti-inflammatory cytokines. These data suggest that asymptomatic individuals had a weaker immune response to SARS-CoV-2 infection. The reduction in IgG and neutralizing antibody levels in the early convalescent phase might have implications for immunity strategy and serological surveys.

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          Author and article information

          Journal
          Nat Med
          Nature medicine
          Springer Science and Business Media LLC
          1546-170X
          1078-8956
          August 2020
          : 26
          : 8
          Affiliations
          [1 ] Key Laboratory of Molecular Biology on Infectious Diseases, Ministry of Education, Chongqing Medical University, Chongqing, China.
          [2 ] School of Public Health and Management, Chongqing Medical University, Chongqing, China.
          [3 ] Chongqing Center for Disease Control and Prevention, Chongqing, China.
          [4 ] Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
          [5 ] Wanzhou People's Hospital, Chongqing, China.
          [6 ] Wanzhou District Center for Disease Control and Prevention, Chongqing, China.
          [7 ] The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
          [8 ] School of Public Health and Management, Chongqing Medical University, Chongqing, China. jfqiu@126.com.
          [9 ] Key Laboratory of Molecular Biology on Infectious Diseases, Ministry of Education, Chongqing Medical University, Chongqing, China. chenjuan2014@cqmu.edu.cn.
          [10 ] Key Laboratory of Molecular Biology on Infectious Diseases, Ministry of Education, Chongqing Medical University, Chongqing, China. ahuang@cqmu.edu.cn.
          Article
          10.1038/s41591-020-0965-6
          10.1038/s41591-020-0965-6
          32555424
          09e68052-8fc2-40fa-98db-3dd1f4e05664

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