The assessment of transmission efficiency and latent infection period in asymptomatic carriers of SARS-CoV-2 infection

Highlights

• 10.9% of asymptomatic SARS-CoV-2 carriers subsequently developed symptoms to become confirmed cases.

• The transmission efficiency of asymptomatic SARS-CoV-2 carriers was assessed.

• The attack rate for asymptomatic carriers was lower than that for confirmed cases.

• Close contact screening should be extended to include the incubation period.

Abstract

Few studies have focused on the transmission efficiency of asymptomatic carriers of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Our follow-up study was performed on 147 asymptomatic carriers in Anhui Province. Of these, 50.0% were male, 50.3% were older than 40 years, 43.8% were farmers, and 68.7% were from the north of Anhui Province. 16 of the 147 asymptomatic carriers developed symptoms in the following 14 days of isolated observation, and were subsequently diagnosed as confirmed cases. The possible latent infection period was found to range from 1–5 days before onset, with a median time of 2 days. The second attack rate for the 16 confirmed cases who had transferred from being asymptomatic carriers was 9.7% (23/236 close contacts), while for the 131 asymptomatic carriers the rate was 2.6% (24/914 close contacts), showing a significant difference in second attack rate between the two groups (p＜0.001). Our study indicated that COVID-19 cases are contagious during the incubation period, and that close contact screening should be extended to include the incubation period. Our results also showed that the transmission efficiency for asymptomatic carriers was lower than that for confirmed case.