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Research article
The Prevalence and Clinical Significance of Presymptomatic COVID-19 Patients: How We Can be One Step Ahead in Mitigating a Deadly Pandemic
Petrick Periyasamy
Pusat Perubatan Universiti Kebangsaan Malaysia
Corresponding Author
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Presymptomatic COVID-19 patients have been identified as a major stumbling block in efforts to break the chain of transmission. Studies on temporal dynamics of its shedding suggests it peaks 1-2 days prior to any symptom onset. Therefore, a large proportion of patients are actively spreading the disease unknowingly whilst undetected. However, lengthy lockdowns and isolation leads to a host of socioeconomic issues and are impractical. Conversely, there exists no study describing this group and their clinical significance despite their key role in disease transmission. As a result, we devised a study to look at the prevalence of presymptomatic patients with COVID-19 and subsequently, identify early indicators of infection through demographic information, biochemical and radiological abnormalities which would allow early diagnosis and isolation. In addition, we will look into the clinical significance of this group and their outcome; if it differs from asymptomatic or symptomatic patients. Our analysis shows a higher proportion of presymptomatic patients with atypical symptoms like chest pain while symptomatic patients commonly present with respiratory symptoms like cough and shortness of breath. Besides that, there were more females presenting as presymptomatic patients and receiving treatment compared to males and this was found to be statistically significant. Otherwise, we were not able to identify other statistically significant markers suggesting a patient is presymptomatic. As we have little means of identifying these silent spreaders, it highlights further the importance of general measures implemented to stop COVID-19 transmission like social distancing, face mask, and widespread testing.
Keywords
Coronavirus disease 2019, COVID-19, SARS-CoV-2, presymptomatic
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CURRENT STATUS: Under Review
Version (no preprint)
Posted 04 Jan, 2021
Review #1 received
Received 04 Jan, 2021
Reviewers invited
Invitations sent on 27 Dec, 2020
Reviewer #1 agreed
On 27 Dec, 2020
Editor assigned
On 26 Dec, 2020
Submission checks complete
On 26 Dec, 2020
Editor invited
On 26 Dec, 2020
This version was not preprinted
Version 1
Posted 18 Sep, 2020
No community comments so far
Review #2 received
Received 26 Nov, 2020
Editorial decision: Major revision
On 26 Nov, 2020
Reviewer #2 agreed
On 09 Nov, 2020
Review #1 received
Received 30 Sep, 2020
Reviewer #1 agreed
On 29 Sep, 2020
Editor assigned
On 18 Sep, 2020
Reviewers invited
Invitations sent on 18 Sep, 2020
Submission checks complete
On 16 Sep, 2020
Editor invited
On 15 Sep, 2020
First submitted
On 15 Aug, 2020
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Subject Areas
Infectious Diseases
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This preprint is under consideration at BMC Infectious Diseases. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
The Prevalence and Clinical Significance of Presymptomatic COVID-19 Patients: How We Can be One Step Ahead in Mitigating a Deadly Pandemic
Petrick Periyasamy
Pusat Perubatan Universiti Kebangsaan Malaysia
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version (no preprint)
Posted 04 Jan, 2021
Review #1 received
Received 04 Jan, 2021
Reviewers invited
Invitations sent on 27 Dec, 2020
Reviewer #1 agreed
On 27 Dec, 2020
Editor assigned
On 26 Dec, 2020
Submission checks complete
On 26 Dec, 2020
Editor invited
On 26 Dec, 2020
This version was not preprinted
Version 1
Posted 18 Sep, 2020
No community comments so far
Review #2 received
Received 26 Nov, 2020
Editorial decision: Major revision
On 26 Nov, 2020
Reviewer #2 agreed
On 09 Nov, 2020
Review #1 received
Received 30 Sep, 2020
Reviewer #1 agreed
On 29 Sep, 2020
Editor assigned
On 18 Sep, 2020
Reviewers invited
Invitations sent on 18 Sep, 2020
Submission checks complete
On 16 Sep, 2020
Editor invited
On 15 Sep, 2020
First submitted
On 15 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Presymptomatic COVID-19 patients have been identified as a major stumbling block in efforts to break the chain of transmission. Studies on temporal dynamics of its shedding suggests it peaks 1-2 days prior to any symptom onset. Therefore, a large proportion of patients are actively spreading the disease unknowingly whilst undetected. However, lengthy lockdowns and isolation leads to a host of socioeconomic issues and are impractical. Conversely, there exists no study describing this group and their clinical significance despite their key role in disease transmission. As a result, we devised a study to look at the prevalence of presymptomatic patients with COVID-19 and subsequently, identify early indicators of infection through demographic information, biochemical and radiological abnormalities which would allow early diagnosis and isolation. In addition, we will look into the clinical significance of this group and their outcome; if it differs from asymptomatic or symptomatic patients. Our analysis shows a higher proportion of presymptomatic patients with atypical symptoms like chest pain while symptomatic patients commonly present with respiratory symptoms like cough and shortness of breath. Besides that, there were more females presenting as presymptomatic patients and receiving treatment compared to males and this was found to be statistically significant. Otherwise, we were not able to identify other statistically significant markers suggesting a patient is presymptomatic. As we have little means of identifying these silent spreaders, it highlights further the importance of general measures implemented to stop COVID-19 transmission like social distancing, face mask, and widespread testing.
Figure 1
Figure 2