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Clinical and Microbiological Features of Asymptomatic SARS-CoV-2 Infection and Mild COVID-19 in Seven Crewmembers of a Cruise Ship.
Intern Med. 2020 Dec 15; 59(24):3135-3140.IM

Abstract

Objective To describe the clinical features and clinical course of individuals diagnosed with asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or mild coronavirus disease (COVID)-19. Patients The study participants consisted of 7 crewmembers of the passenger cruise-liner, Diamond Princess, who were admitted to our hospital after becoming infected with SARS-CoV-2 aboard the ship. Methods The data on patient background and biochemical test results were obtained from the patients' medical records. All patients had a chest X-ray, and a throat swab and sputum samples were sent for culture on admission. Results The median age of the 7 patients, of whom 4 were male and 3 were female, was 39 years (range: 23-47 years). On admission, none of them had fever, but 4 (57%) had a cough. None of them showed any signs of organ damage on laboratory testing. Chest X-ray showed pneumonia in one individual, which resolved spontaneously, while the other 6 had normal chest X-ray findings. Culture of throat swabs and sputum samples revealed that 4 patients (57%) had bacterial upper respiratory infections (Haemophilus influenzae, Klebsiella pneumoniae, and Staphylococcus aureus). The period from a positive polymerase chain reaction (PCR) test to negative conversion ranged from 5 to 13 days, with a median of 8 days. Conclusion Healthy young adults without risk factors who acquire SARS-CoV-2 infection may have an asymptomatic infection or may experience mild COVID-19. In addition to obesity, an older age, underlying illness, and being overweight can lead to a risk of exacerbation; thus, hospital management for such individuals may be desirable. Culturing respiratory samples may be useful for diagnosing secondary bacterial pneumonia.

Authors+Show Affiliations

Department of Infection Control and Prevention, Kitasato University Hospital, Japan. Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Japan.Department of Infection Control and Prevention, Kitasato University Hospital, Japan. Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Japan.Department of Infection Control and Prevention, Kitasato University Hospital, Japan.Department of Cardiovascular Medicine, Kitasato University School of Medicine, Japan.Department of Rehabilitation, Kitasato University School of Allied Health Sciences, Japan.Department of Rehabilitation, Kitasato University School of Allied Health Sciences, Japan.Department of Cardiovascular Medicine, Kitasato University School of Medicine, Japan.Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Japan.Department of Infection Control and Prevention, Kitasato University Hospital, Japan. Department of Infection Control and Infectious Diseases, Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33132333

Citation

Hoshiyama, Takayuki, et al. "Clinical and Microbiological Features of Asymptomatic SARS-CoV-2 Infection and Mild COVID-19 in Seven Crewmembers of a Cruise Ship." Internal Medicine (Tokyo, Japan), vol. 59, no. 24, 2020, pp. 3135-3140.
Hoshiyama T, Wada T, Nihonyanagi S, et al. Clinical and Microbiological Features of Asymptomatic SARS-CoV-2 Infection and Mild COVID-19 in Seven Crewmembers of a Cruise Ship. Intern Med. 2020;59(24):3135-3140.
Hoshiyama, T., Wada, T., Nihonyanagi, S., Kameda, R., Yamaoka-Tojo, M., Fukuda, M., Ako, J., Yamaoka, K., & Takayama, Y. (2020). Clinical and Microbiological Features of Asymptomatic SARS-CoV-2 Infection and Mild COVID-19 in Seven Crewmembers of a Cruise Ship. Internal Medicine (Tokyo, Japan), 59(24), 3135-3140. https://doi.org/10.2169/internalmedicine.5601-20
Hoshiyama T, et al. Clinical and Microbiological Features of Asymptomatic SARS-CoV-2 Infection and Mild COVID-19 in Seven Crewmembers of a Cruise Ship. Intern Med. 2020 Dec 15;59(24):3135-3140. PubMed PMID: 33132333.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical and Microbiological Features of Asymptomatic SARS-CoV-2 Infection and Mild COVID-19 in Seven Crewmembers of a Cruise Ship. AU - Hoshiyama,Takayuki, AU - Wada,Tatsuhiko, AU - Nihonyanagi,Shin, AU - Kameda,Ryo, AU - Yamaoka-Tojo,Minako, AU - Fukuda,Michinari, AU - Ako,Jyunya, AU - Yamaoka,Kunihiro, AU - Takayama,Yoko, Y1 - 2020/11/02/ PY - 2020/11/3/pubmed PY - 2020/12/29/medline PY - 2020/11/2/entrez KW - COVID-19 KW - SARS-CoV-2 KW - coronavirus disease 2019 KW - secondary bacterial infection KW - severe acute respiratory syndrome coronavirus 2 KW - sputum culture SP - 3135 EP - 3140 JF - Internal medicine (Tokyo, Japan) JO - Intern Med VL - 59 IS - 24 N2 - Objective To describe the clinical features and clinical course of individuals diagnosed with asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or mild coronavirus disease (COVID)-19. Patients The study participants consisted of 7 crewmembers of the passenger cruise-liner, Diamond Princess, who were admitted to our hospital after becoming infected with SARS-CoV-2 aboard the ship. Methods The data on patient background and biochemical test results were obtained from the patients' medical records. All patients had a chest X-ray, and a throat swab and sputum samples were sent for culture on admission. Results The median age of the 7 patients, of whom 4 were male and 3 were female, was 39 years (range: 23-47 years). On admission, none of them had fever, but 4 (57%) had a cough. None of them showed any signs of organ damage on laboratory testing. Chest X-ray showed pneumonia in one individual, which resolved spontaneously, while the other 6 had normal chest X-ray findings. Culture of throat swabs and sputum samples revealed that 4 patients (57%) had bacterial upper respiratory infections (Haemophilus influenzae, Klebsiella pneumoniae, and Staphylococcus aureus). The period from a positive polymerase chain reaction (PCR) test to negative conversion ranged from 5 to 13 days, with a median of 8 days. Conclusion Healthy young adults without risk factors who acquire SARS-CoV-2 infection may have an asymptomatic infection or may experience mild COVID-19. In addition to obesity, an older age, underlying illness, and being overweight can lead to a risk of exacerbation; thus, hospital management for such individuals may be desirable. Culturing respiratory samples may be useful for diagnosing secondary bacterial pneumonia. SN - 1349-7235 UR - https://www.unboundmedicine.com/medline/citation/33132333/Clinical_and_Microbiological_Features_of_Asymptomatic_SARS_CoV_2_Infection_and_Mild_COVID_19_in_Seven_Crewmembers_of_a_Cruise_Ship_ L2 - https://dx.doi.org/10.2169/internalmedicine.5601-20 DB - PRIME DP - Unbound Medicine ER -