Presymptomatic SARS-CoV-2 Infections and Transmission in a Skilled Nursing Facility

Bottom Line:

Positive SARS-CoV-2 (the virus causing COVID-19) screens were observed in more than half of residents who did not have symptoms at the time of testing. Infection-control strategies for residents with symptoms were not sufficient to prevent viral transmission.

Reference:

Arons, M.M. et al. Presymptomatic SARS-CoV-2 Infections and Transmission in a Skilled Nursing Facility. The New England Journal of Medicine (2020). DOI: 10.1056/NEJMoa2008457

Date Published:

28 May 2020

Synopsis:

Two surveys were conducted one week apart from one another to assess transmission and evaluate the current symptom-based screening in nursing facility residents. In addition, nasopharyngeal and oropharyngeal testing was done to determine whether these residents carry the virus. Twenty-three days after the first positive result, 57 out of 89 patients tested positive for COVID-19, 56% of whom did not have any symptoms at the time of testing. As of April 3, 11 of the 57 patients had been hospitalized and 15 had died. Of the 34 patients who received sequencing of the virus gene, the majority belong to two clusters with minimal difference in genes. All in all, the results indicate that COVID-19 was transmitted rapidly in the nursing facility, with many patients carrying and transmitting the virus without any symptoms.

Summary by: Sheida Naderi-Azad