OBJECTIVES The objective of the study was to conduct a follow-up investigation of 10 asymptomatic patients at diagnosis among the 98 confirmed coronavirus disease 2019 (COVID-19) cases reported in Busan between February 21, 2020 and March 13, 2020 to determine whether asymptomatic infection and transmission during asymptomatic period are possible. METHODS The study analyzed 10 asymptomatic, confirmed COVID-19 cases to determine whether asymptomatic infection is possible. We conducted in-depth interviews with patients and guardians; interviews with primary physicians; review of medical records and drug utilization review (DUR) reports; and base station-based location tracking. RESULTS Among the 98, confirmed COVID-19 cases reported in Busan, the study analyzed 10 (10.2%) asymptomatic patients at diagnosis. The results confirmed that two (2.0%) patients reported to be asymptomatic during the initial epidemiological investigation, but turned symptomatic before diagnosis as per the in-depth interview results. Four cases (4.0%) of early detection led to confirmed diagnosis during the incubation period and presentation of symptoms after diagnosis. In addition, the remaining four patients (4.0%), having no subjective symptoms nor specific findings on chest radiography and computed tomography, remained asymptomatic until the isolation order was lifted. With regard to whether transmission during the asymptomatic period is possible, it was found that one out of 23 household contacts of the confirmed patients was identified as an additional confirmed case after coming in close contact with an index patient during the presymptomatic period. CONCLUSIONS Among the 98 confirmed cases, asymptomatic infection was confirmed in four cases (4.0%). In addition, there was one additional confirmed case in which the patient was a family member who came in close contact with an index patient during the incubation period, thereby confirming that transmission during the asymptomatic period is possible. The possibility of transmission during the asymptomatic period has been confirmed; therefore, it is necessary to review the measures for expanding contact tracing that is currently being applied starting one day prior to the onset of symptoms.
【저자키워드】 COVID-19, SARS-CoV-2, asymptomatic infection, asymptomatic transmission, 【초록키워드】 coronavirus disease, Diagnosis, Contact tracing, Transmission, Symptom, Computed tomography, Asymptomatic, symptomatic, Patient, Incubation period, Isolation, presymptomatic, epidemiological, Follow-up, household contact, asymptomatic patient, Chest radiography, close contact, medical record, confirmed cases, measure, confirmed COVID-19 case, initial, analyzed, reported, the patient, addition, remained, conducted, applied, determine, onset of symptoms, 10 asymptomatic patient, lifted, 【제목키워드】 Diagnosis, Asymptomatic COVID-19,