Asymptomatic COVID-19 Patients: Experience and Lessons from a Developing Country

Abstract

The world is facing a pandemic due to the SARS-Coronavirus 2, since late 2019. Many questions remain unanswered regarding the disease course. Key amongst its talking point is the case of asymptomatic patients. This potentially jeopardizes infection control strategy as asymptomatic cases are difficult to identify and hence difficult to isolate. Our study intends to define the clinical and radiological features of asymptomatic COVID-19 cases, the disease course as well as highlight the role of chest CT in its management. This is a monocentric study involving 114 asymptomatic adults admitted in our COVID-19 Unit. Clinical, radiological and laboratory findings were retrospectively analyzed. Chi-squared, Fisher exact test and the student test were used for statistical analysis. Asymptomatic patients represent 51.81% of patients. There was a slight male predominance with a mean age of 37.64 years. Patients with abnormal CT had a longer hospital stay than those with unremarkable CT and even more so were older. None of the patients presented severe or critical extension of parenchymal lesions. Only two patients (4.54%) with normal CT on admission presented with abnormalities on control CT. Cases with worsening CT were older with bilateral pulmonary involvement. All patients remained asymptomatic on treatment. Even when asymptomatic, COVID-19 patients present mild lung lesions. The positivity of the initial chest CT imaging is directly correlated to the disease course. Older patients with bilateral pulmonary lesions are more likely to worsen and should be closely monitored. Moreover, it is safe to manage asymptomatic patients with normal CT in a non-hospital setting.