Background COVID-19 patients with long incubation period were reported in clinical practice and tracing of close contacts, but their epidemiological or clinical features remained vague. Methods We analyzed 11,425 COVID-19 cases reported between January–August, 2020 in China. The accelerated failure time model, Logistic and modified Poisson regression models were used to investigate the determinants of prolonged incubation period, as well as their association with clinical severity and transmissibility, respectively. Result Among local cases, 268 (10.2%) had a prolonged incubation period of > 14 days, which was more frequently seen among elderly patients, those residing in South China, with disease onset after Level I response measures administration, or being exposed in public places. Patients with prolonged incubation period had lower risk of severe illness (OR adjusted = 0.386, 95% CI: 0.203–0.677). A reduced transmissibility was observed for the primary patients with prolonged incubation period (50.4, 95% CI: 32.3–78.6%) than those with an incubation period of ≤14 days. Conclusions The study provides evidence supporting a prolonged incubation period that exceeded 2 weeks in over 10% for COVID-19. Longer monitoring periods than 14 days for quarantine or persons potentially exposed to SARS-CoV-2 should be justified in extreme cases, especially for those elderly. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12337-9.
【저자키워드】 COVID-19, Transmissibility, Clinical severity, Prolonged incubation period, 【초록키워드】 SARS-CoV-2, quarantine, Local, elderly patients, China, Patient, Incubation period, epidemiological, clinical feature, Clinical practice, association, Evidence, administration, COVID-19 patient, disease onset, determinant, supplementary material, COVID-19 case, lower risk, measure, South, Poisson regression model, extreme, Result, analyzed, reported, remained, reduced, adjusted, provide, were used, Level, accelerated, exceeded, 【제목키워드】 Epidemics, China, Incubation period, COVID-19 patient, implication, feature,