Clinical and immunological assessment of asymptomatic SARS-CoV-2 infections
Open accessAbstract
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 policy 1. 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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Asymptomatic SARS-CoV-2 infections have lower cytokine levels than symptomatic infections.
“Asymptomatic SARS-CoV-2 infections have been shown to exhibit lower levels of cytokines”
From COVID-19 and the human innate immune system (2021) · cites this paper as Long et al., 2020
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- Authors
- Long, Q.-X., Tang, X.-J., Shi, Q.-L., Li, Q., Deng, H.-J., Yuan, J., Hu, J.-L., Xu, W., Zhang, Y., Lv, F.-J., Su, K., Zhang, F., Gong, J., Wu, B., Liu, X.-M., Li, J.-J., Qiu, J.-F., Chen, J., & Huang, A.-L.
- Affiliations
- Chongqing Medical University (CN)
- The Affiliated Yongchuan Hospital of Chongqing Medical University (CN)
- Yueqing People's Hospital (CN)
- Second Affiliated Hospital of Chongqing Medical University (CN)
- Corresponding author
- Chen, Juan
- ORCID
- Venue
- Nature Medicine
- Published
- 2020-06-18
- Volume
- 26
- Issue
- 8
- Pages
- 1200-1204
- ISSN
- 1078-8956 (ISSN-L)
- 1546-170X
- OpenAlex
- W3036931136
- Cited by
- 2,686
- References
- 1
- Citations by year
- 2026: 20 · 2025: 50 · 2024: 102 · 2023: 207 · 2022: 481 · 2021: 1109 · 2020: 711 · 2013: 1 · 2012: 1
- FWCI
- 82.34
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Nature Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Natural Science Foundation of China (81871656, 8181101099)
- Topics
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
- Keywords
- asymptomatic SARS-CoV-2 infection, COVID-19 pandemic, viral shedding duration, neutralizing antibodies, seroconversion, seronegativity, cytokines, immune response, convalescence, serological survey
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Adolescent, Adult, Aged, Child, China, Female, Hospitalization, Humans, Immunoglobulin G, Immunity, Innate, Male, Middle Aged, Pneumonia, Viral, Cytokines, Coronavirus Infections, Young Adult, Asymptomatic Infections, Pandemics
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