COVID-19 ‘asymptomatic’ patients: an old wives’ tale

ABSTRACT

Introduction

A novel virus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was reported via nucleic acid identification in December, 2019. ‘Asymptomatic cases’ have arised as an obstacle for an accurate diagnosis, curtailing the elimination of the ongoing pandemic.

Areas covered

In this review, we analyze the definition of symptoms and the principles of diagnosing COVID-19. Also, we explore the major reasons for cases presenting a phenotype with mild symptoms. Host, viral and environmental aspects for a COVID-19 leading to mild symptoms are being highlighted. A final aspect regarding a rational asymptomatic COVID-19 is presumed.

Expert opinion

Diagnosing a pandemic via a sole test can be risky. Epidemiological administration should be more accurate and precise, not only for the societal pandemic levels and following policies, but for the same scientific community, that studies SARS-CoV-2 and its mutants. Several other issues should be answered before analyzing human genome for the asymptomatic scenario.

KEYWORDS:

• COVID-19
• asymptomatic
• cases
• patients
• carriers
• diagnosis
• infection

Article highlights

• Mass testing can lead to asymptomatic cases, being either false-positive cases or in pre-/post- symptomatic conditions.

• COVID-19 patient’s diagnosis requires both medical information, radiological and laboratory data.

• Symptoms of an individual are the integration of host, viral and environmental parameters

• It seems idealistic for a rational asymptomatic COVID-19 patient to exist in reality.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded