Comparison of the clinical and epidemiological characteristics between asymptomatic and symptomatic patients with COVID-19
Keywords:
COVID-19, asymptomatic, symptomatic, coronavirus, COVID-19.Abstract
Introduction: COVID-19 presents asymptomatic and symptomatic clinical forms, both with similar frequency, but with clinical and epidemiological differences.Objective: To compare the clinical and epidemiological characteristics between asymptomatic and symptomatic patients of COVID-19.
Methods: Comparative study of 91 COVID-19 positive patients, from March to July 2020. According to the clinical forms, two groups were created (asymptomatic and symptomatic). They were compared regarding age, sex, epidemiological and clinical antecedents, clinical manifestations and comorbidities.
Results: Asymptomatic patients were younger (mean 37,2), but similar in gender. The source of infection, contact with a confirmed case (83,3 %) and the municipalities Holguín and Gibara prevailed. The basic reproductive number was similar. Being elderly (63,0 %) and a carrier of arterial hypertension (44,4 %) predominated in symptomatic cases, most of the asymptomatic did not have comorbidities (56,8 %). Fever, dry cough and extrapulmonary digestive and neurological manifestations prevailed as symptoms. Significant differences were found in age (p = 0,02) and risk factors: older adult (p = 0,00) and arterial hypertension (p = 0,00).
Conclusions: There was similarity between the groups compared, except for age and risk factors: elderly and arterial hypertension.
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References
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2. Wang Y, Wang Y, Chen Y, Qin Q. Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID-19) implicate special control measures. J Med Virol. 2020 [acceso: 05/07/2020];92(6):568-76. Disponible en: https://www.doi.org/10.1002/jmv.25748
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5. Pérez Abreu M, Gómez Tejeda J, Dieguez Guach R. Características clínico-epidemiológicas de la COVID-19. Rev haban cienc méd. 2020 [acceso: 15/07/2020]; 19(2):e_3254. Disponible en: https://www.revhabanera.sld.cu/index.php/rhab/article/view/3254/2505
6. Chen Y, Liu Q, Guo D. Emerging coronaviruses: genome structure, replication, and pathogenesis. J Med Virol. 2020 [acceso: 10/07/2020];92(4):418-23. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31967327/
7. Pérez Fernández A, Suárez Hernández R, Rodríguez González E, Sarda Rojas J. Predictores de la aparición de síntomas en pacientes cardiópatas con la COVID- 19 asintomáticos al ingreso. Rev Cuban Cardiol. 2020 [acceso: 10/07/2020];26(2):e999. Disponible en: https://www.revcardiologia.sld.cu/index.php/revcardiologia/article/view/9998
8. Sánchez Hernández E, Cordona Gordo O, Ferrer Castro J, Pérez Fouces A, Despaigne Bicet F. Variabilidad de los resultados de la PCR evolutiva en pacientes con la COVID- 19. MEDISAN. 2020 [acceso: 20/07/2020];24(4):566. Disponible en: https://www.medisan.sld.cu/index.php/san/article/view/3146
9. World Medical Association. World Medical declaration of Helsinki: ethical principles for medical research involving human subjects. J Am Med Assoc. 2013[acceso: 20/07/2020]; 310(29):2191-4. Disponible en: https://pubmed.ncbi.nlm.nih.gov/24141714/
10. Wu Z, McGoogan JM. Characteristics of an important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: Summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020 [acceso: 5/07/2020];323(13):1239-42. Disponible en: https://jamanetwork.com/journals/jama/fullarticle/2762130
11. Gao Z, Yinghui X, Chao S, Xu W, Ye G, Shi Q, et al. A systematic review of asymptomatic infections with COVID-19. Journal of Microbiology, Immunology and Infection. 2020 [acceso: 05/07/2020]; [en prensa]. Disponible en: https://doi.org/10.1016/j.jmii.2020.05.001
12. Wu Z, McGoogan J. Asymptomatic a pre-Symptomatic COVID-19 in China. Infect Dis Poverty. 2020 [acceso: 10/07/2020]; 9(72):[aprox. 2 p.].Disponible en: https://idpjournal.biomedcentral.com/articles/10.1186/s40249-020-00679-2
13. Mizumoto K, Kogaya K, Zarebski A, Chowell G. Estimating the asymptomatic proportion of coronavirus diseases 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020. Euro surveill. 2020 [acceso: 10/07/2020];25 (10):[aprox. 5 p.]. Disponible en: https://www.doi.org/10.2807/1560-7917
14. Albalate M, Arribas P, Torres E, Cintra M, Alcázar R, Puerta M, et al. Alta prevalencia de la COVID-19 asintomáticos en hemodiálisis. Aprendiendo día a día el primer mes de la pandemia de COVID-19. Nefrología. 2020 [acceso: 10/07/2020]; 40(3):279-86. Disponible en: https://www.sciencedirect.com/science/article/pii/s2013251420300754
15. Pollan M, Pérez Gómez B, Pastor Barriuso R, Oteo J, Hernán M, Pérez Olmeda M, et al. Prevalence of SARS-CoV-2 in Spain (ENE-COVID): a nationwide, population-based seroepidemilogical study. The Lancet. 2020 [acceso: 10/07/2020]; 396(10250):535-44. Disponible en: https://www.thelancet.com/journal/lancet/onlinefirst
16. Ferrer Castro J, Sánchez Hernández E, Poulout Mendoza A, del Río Caballero G, Figueredo Sánchez D. Caracterización clínica y epidemiológica de pacientes confirmados con la COVID-19 en la provincia de Santiago de Cuba. MEDISAN. 2020 [acceso: 16/07/2020]; 24(3): [aprox. 10 p]: Disponible en: https://medisan.sld.cu/index.php/san/article/view/3145
17. Aguilar Hernández I, Wong Corrales L, Perera Milian L, Hernández Pérez R. Caracterización de los casos confirmados de la COVID-19 en Mayabeque. Medimay. 2020 [acceso: 5/07/2020]; 27(2):230-6. Disponible en: https://medimay.sld.cu/index.php/rcmh/article/view/1660
18. Urquiza Yero Y, Pérez Ojeda M, Cortés González A, Escalona Pérez I, Cabrales León M. Características clínico epidemiológicas de los pacientes de Las Tunas positivos al RT-PCR para la COVID-19. Revista Electrónica Dr. Zoilo E. Marinello Vidaurreta. 2020 [acceso: 10/07/2020]; 45(4): [aprox. 9 p.]. Disponible en: https://revzoilomarinello.sld.cu/index.php/zmv/article/view/2361
19. Hu Z, SongC, Xu C, Jin G, Chen Y, Xu X, et al. Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, China. Sci China Life Sci. 2020 [acceso: 20/07/2020]; 63(5):706-11. Disponible en: https://doi.org/10.1007/s11427-020-1661-4
20. Rongrong Y, Xien G, Yong X. Comparison of Clinical Characteristics of Patients with Asymptomatic Vs Symptomatic Coronavirus Disease 2019 in Wuhan, China. JAMA Network Open. 2020 [acceso: 5/07/2020]; 3(5):e2010182. Disponible en: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2766237
21. Cummings M, Baldwin M, Abrams D, Jacobson S, Meyer B, Balough E, et al. Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study. Lancet. 2020 [acceso: 10/07/2020]; 395(10239):1763-70. Disponible en: https://www.doi.org/10.1016/S0140-6736(20)31189-2
22. Acosta G, Escobar G, Bernaola G, Alfaro J, Taype W, Marcos C, et al. Caracterización de pacientes con COVID-19 grave atendidos en un hospital de referencia nacional del Perú. Rev Perú Med Exp Salud Pública. 2020 [acceso: 25/07/2020]; 37(2):253-8. Disponible en: https://www.scielo.org.pe/scielo.php?pid=S1726-46342020000200253&script=sci_arttext
23. Wenham C, Smith J, Morgan R. COVID-19: the gendered impacts of the outbreak. The lancet. 2020 [acceso: 7/07/2020]; 395(10227):846-8. Disponible en: https://www.doi.org/10.1016/s0140-6736(20)30526-2
24. Guzmán O, Lucchesi E, Trelles M, Pinedo R, Camere M, Daly A, et al. Características clínicas y epidemiológicas de 25 casos de COVID-19 atendidos en la Clínica Delgado de Lima. Rev Soc Peru Med Interna. 2020 [acceso: 29/06/2020]; 33(1):15-24.Disponible en: https://www.revistamedicinainterna.net/index.php/spmi/article/view/506
25. Chen Y, Wang A, Yi B, Ding K, Wang H, Wang J, et al. The epidemiological characteristics of infection in close contacts of COVID-19 in Ningbo city. Chin J Epidemiol. 2020 [acceso: 29/07/2020];41(5):667-71. Disponible en: https://www.researchgate.net/publication/341651933_Epidemiological_char-acteristics_of_infection_in_COVID-19_close_contacts_in_Nigbo_city
26. He D, Zhao Sh, Lin Q, Zhuang Z, Cao P, Wang M,Yang L. The relative transmissibility of asymptomatic COVID-19 infections among close contacts. International Journal of Infectious Diseases. 2020 [acceso: 5/08/2020]; 94:145-7. Disponible en: https://www.sciencedirect.com/science/article/pii/s1201971220302502
27. Ministerio de Salud Pública. Anuario Estadístico de Salud 2019. La Habana: Dirección de registros médicos y estadísticas de salud; 2020[acceso: 5/08/2020]. Disponible en: https://files.sld.cu/bvscuba.sld.cu/files/2020/05/Anuario-Electr%C3%B3nico-Espa%C3%B1ol-2019-ed-2020.pdf
28. Madjid M, Safavi-Naeini P, Solomon SD, Vardeny O. Potential effects of coronaviruses on the cardiovascular system: A review. JAMA Cardiology. 2020 [acceso: 15/07/2020];5(7):831-40. Disponible en: https://jamanetwork.com/journals/jamacardiology/fullarticle/2763846
29. Zheng Y, Ma Y, Zhang J. COVID-19 and the cardiovascular system. Nat Rev Cardiol. 2020 [acceso: 5/08/2020]; 17:259-60. Disponible en: https://www.nature.com/articles/s41569-020-0360-5?fbclid=IwAR3TjvxiEtYQqNkpsPuEuuef94Gp2m4a89Y2pw2FtOxsSPxGZ18Tml
30. Adultos mayores y COVID-19. Atlanta:Centro para el Control y Prevención de las Enfermedades;2000[actualizado: 27/07/2020; acceso: 13/08/2020]. [aprox. 5 p.]. Disponible en: https://español.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/older-adults.html
31. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet. 2020 [acceso: 13/07/2020];395(10223):507-13. Disponible en: https://www.thelancet.com/journals/lancet/article/PIIs0140-6736(20)30211-7/fulltext
32. Chen X, Hu W, Ling J, Mo P, Zhang Y, Jiang Q, et al. Hypertension and Diabetes Delay the Viral Clearance in COVID-19 Patients. medRxiv. 2020 [acceso: 24/04/2020]. Disponible en: https://www.medrxiv.org/content/10.1101/2020.03.22.20040774v1.full.pdf
33. García Céspedes ME, Bell Castillo J, Romero Calzado DE, Ferrales Biset N. La COVID-19 en personas hipertensas. MEDISAN. 2020 [acceso: 5/08/2020];24(3):501-14. Disponible en: https://scielo.sld.cu/scielo.php?script=sci_arttex&pid=s1029_3019202000030-0501&ing=es&nrm=iso&tlng=es
34. Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, Liu L, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020 [acceso: 5/07/2020];382(18):1708-20. Disponible en: https://www.nejm.org/doi/full/10.1056/nejmoa2002032
35. Góngora Gómez O, Gámez Leyva LR. Manifestaciones extrapulmonares de la infección por el nuevo Coronavirus SARS-CoV-2. Rev haban cienc méd. 2020 [acceso: 30/07/2020]; 19(Supl.): e3378. Disponible en: https://www.revhabanera.sld.cu/index.php/rhab/article/view/3378
Published
2021-04-19
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Ruiz Nápoles JB, Ruiz Nápoles K. Comparison of the clinical and epidemiological characteristics between asymptomatic and symptomatic patients with COVID-19. Rev Cubana Med Milit [Internet]. 2021 Apr. 19 [cited 2025 Jan. 28];50(2):e0210919. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/919
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