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Case Reports
. 2021 Jul 3;18(1):138.
doi: 10.1186/s12985-021-01609-w.

Transmission frequency of COVID-19 through pre-symptomatic and asymptomatic patients in AJK: a report of 201 cases

Majid Mahmood  1 , Noor-Ul-Ain Ilyas  2 , Muhammad Faraz Khan  3 , Muhammad Naseem Hasrat  4 , Nicholas Richwagen  5
Affiliations
Case Reports

Transmission frequency of COVID-19 through pre-symptomatic and asymptomatic patients in AJK: a report of 201 cases

Majid Mahmood et al. Virol J. .

Abstract

Background: The COVID-19 pandemic is a catastrophic global phenomenon, affecting human life in a way unseen since the 1918 influenza pandemic. Effective management of this threat requires halting transmission, a strategy requiring accurate knowledge of SARS-CoV-2 transmission patterns.

Methods: This was a retrospective contact study aiming to estimate the transmission rate of COVID-19 by tracing contacts in symptomatic, pre-symptomatic, and asymptomatic patients. History of patients' contacts during 24 h before appearance of symptoms or infection confirmation was traced for disease transmission.

Results: Overall, a total of 201 COVID-19 patients had contact with 7168 people in 24 h with an average of 35.66 contacts per patient, ranging from a minimum of 4 to maximum of 87 contacts (meetings). Out of 7168 persons met, infection was detected in 64 (0.89%). For the 155 symptomatic patients, a total of 5611 contacted persons were traced before appearance of symptoms (pre-symptomatic) in last 24 h with an average of 36.20 meetings per patient. The infection was transmitted in 63 (1.12%) people with 5548 (98.88%) remaining uninfected. Out of the 63 transmissions, 62 (98.4%) were traced within 6 h before symptom onset, while only 1 was identified in the 6-12 h timeframe before symptoms. A total of 1557 persons were traced having meeting/contacts with asymptomatic cases in last 24 h before infection confirmation. Out of these 1557 persons, only 1 was found to be infected and the infection rate was calculated to be 0.06%. Statistically, the transmission rate by pre-symptomatic patients was found to be significantly higher than the transmission rate by asymptomatic individuals (P < 0.05).

Conclusion: In the studied population, the risk of pre-symptomatic and asymptomatic transmission of COVID-19 was low, with transmission risks of 1.12% and 0.06% respectively. Pre-symptomatic infection becomes very rare in contacts made longer than 6 h before onset of symptoms. The infection transmission is traced as long as about 9 h before the appearance of clear symptoms in the patients, but the incidence rate was as low as about 0.02% of the total contacts in that period.

Keywords: AJK; Asymptomatic; COVID-19; COVID-19 patients; COVID-19 transmission; Pakistan; Pre-symptomatic.

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Conflict of interest statement

No competing interests exists among authors.

Figures

Fig. 1
Fig. 1
The flow chart of study methodology with inclusion and exclusion of study participants
See this image and copyright information in PMC

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