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Du X, Gao Y, Kang K, Chong Y, Zhang ML, Yang W, Wang CS, Meng XL, Fei DS, Dai QQ, Zhao MY. COVID-19 patient with an incubation period of 27 d: A case report. World J Clin Cases 2021; 9:5955-5962. [PMID: 34368314 PMCID: PMC8316961 DOI: 10.12998/wjcc.v9.i21.5955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 02/16/2021] [Accepted: 05/15/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND As a highly contagious disease, coronavirus disease 2019 (COVID-19) is wreaking havoc around the world due to continuous spread among close contacts mainly via droplets, aerosols, contaminated hands or surfaces. Therefore, centralized isolation of close contacts and suspected patients is an important measure to prevent the transmission of COVID-19. At present, the quarantine duration in most countries is 14 d due to the fact that the incubation period of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is usually identified as 1-14 d with median estimate of 4-7.5 d. Since COVID-19 patients in the incubation period are also contagious, cases with an incubation period of more than 14 d need to be evaluated. CASE SUMMARY A 70-year-old male patient was admitted to the Department of Respiratory Medicine of The First Affiliated Hospital of Harbin Medical University on April 5 due to a cough with sputum and shortness of breath. On April 10, the patient was transferred to the Fever Clinic for further treatment due to close contact to one confirmed COVID-19 patient in the same room. During the period from April 10 to May 6, nucleic acid and antibodies to SARS-CoV-2 were tested 7 and 4 times, respectively, all of which were negative. On May 7, the patient developed fever with a maximum temperature of 39℃, and his respiratory difficulties had deteriorated. The results of nucleic acid and antibody detection of SARS-CoV-2 were positive. On May 8, the nucleic acid and antibody detection of SARS-CoV-2 by Heilongjiang Provincial Center for Disease Control were also positive, and the patient was diagnosed with COVID-19 and reported to the Chinese Center for Disease Control and Prevention. CONCLUSION This case highlights the importance of the SARS-CoV-2 incubation period. Further epidemiological investigations and clinical observations are urgently needed to identify the optimal incubation period of SARS-CoV-2 and formulate rational and evidence-based quarantine policies for COVID-19 accordingly.
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Affiliation(s)
- Xue Du
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Yang Gao
- Department of Critical Care Medicine, The Sixth Affiliated Hospital of Harbin Medical University, Harbin 150028, Heilongjiang Province, China
- Institute of Critical Care Medicine, The Sino Russian Medical Research Center of Harbin Medical University, Harbin 150081, Heilongjiang Province, China
| | - Kai Kang
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Yang Chong
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Mei-Ling Zhang
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Wei Yang
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Chang-Song Wang
- Institute of Critical Care Medicine, The Sino Russian Medical Research Center of Harbin Medical University, Harbin 150081, Heilongjiang Province, China
- Department of Critical Care Medicine, The Harbin Medical University Cancer Hospital, Harbin 150081, Heilongjiang Province, China
| | - Xiang-Lin Meng
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Dong-Sheng Fei
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Qing-Qing Dai
- Department of Critical Care Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, Heilongjiang Province, China
| | - Ming-Yan Zhao
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
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Li ZY, Zhang Y, Peng LQ, Gao RR, Jing JR, Wang JL, Ren BZ, Xu JG, Wang T. Demand for longer quarantine period among common and uncommon COVID-19 infections: a scoping review. Infect Dis Poverty 2021; 10:56. [PMID: 33902695 PMCID: PMC8072089 DOI: 10.1186/s40249-021-00847-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 04/20/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND As one of the non-pharmacological interventions to control the transmission of COVID-19, determining the quarantine duration is mainly based on the accurate estimates of the incubation period. However, patients with coarse information of the exposure date, as well as infections other than the symptomatic, were not taken into account in previously published studies. Thus, by using the statistical method dealing with the interval-censored data, we assessed the quarantine duration for both common and uncommon infections. The latter type includes the presymptomatic, the asymptomatic and the recurrent test positive patients. METHODS As of 10 December 2020, information on cases have been collected from the English and Chinese databases, including Pubmed, Google scholar, CNKI (China National Knowledge Infrastructure) and Wanfang. Official websites and medias were also searched as data sources. All data were transformed into doubly interval-censored and the accelerated failure time model was applied. By estimating the incubation period and the time-to-event distribution of worldwide COVID-19 patients, we obtain the large percentiles for determining and suggesting the quarantine policies. For symptomatic and presymptomatic COVID-19 patients, the incubation time is the duration from exposure to symptom onset. For the asymptomatic, we substitute the date of first positive result of nucleic acid testing for that of symptom onset. Furthermore, the time from hospital discharge or getting negative test result to the positive recurrence has been calculated for recurrent positive patients. RESULTS A total of 1920 laboratory confirmed COVID-19 cases were included. Among all uncommon infections, 34.1% (n = 55) of them developed symptoms or were identified beyond fourteen days. Based on all collected cases, the 95th and 99th percentiles were estimated to be 16.2 days (95% CI 15.5-17.0) and 22.9 days (21.7‒24.3) respectively. Besides, we got similar estimates based on merely symptomatic and presymptomatic infections as 15.1 days (14.4‒15.7) and 21.1 days (20.0‒22.2). CONCLUSIONS There are a certain number of infected people who require longer quarantine duration. Our findings well support the current practice of the extended active monitoring. To further prevent possible transmissions induced and facilitated by such infectious outliers after the 14-days quarantine, properly prolonging the quarantine duration could be prudent for high-risk scenarios and in regions with insufficient test resources.
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Affiliation(s)
- Zhi-Yao Li
- Department of Health Statistics and Epidemiology, School of Public Health, Collaborative Innovation Center of Reverse Microbial Etiology, Shanxi Medical University, 56 Xinjiannanlu Street, Yingze District, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Yu Zhang
- Department of Health Statistics and Epidemiology, School of Public Health, Collaborative Innovation Center of Reverse Microbial Etiology, Shanxi Medical University, 56 Xinjiannanlu Street, Yingze District, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Liu-Qing Peng
- Department of Health Statistics and Epidemiology, School of Public Health, Collaborative Innovation Center of Reverse Microbial Etiology, Shanxi Medical University, 56 Xinjiannanlu Street, Yingze District, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Rong-Rong Gao
- Department of Health Statistics and Epidemiology, School of Public Health, Collaborative Innovation Center of Reverse Microbial Etiology, Shanxi Medical University, 56 Xinjiannanlu Street, Yingze District, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Jia-Rui Jing
- Department of Health Statistics and Epidemiology, School of Public Health, Collaborative Innovation Center of Reverse Microbial Etiology, Shanxi Medical University, 56 Xinjiannanlu Street, Yingze District, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Jia-Le Wang
- Department of Health Statistics and Epidemiology, School of Public Health, Collaborative Innovation Center of Reverse Microbial Etiology, Shanxi Medical University, 56 Xinjiannanlu Street, Yingze District, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Bin-Zhi Ren
- Shanxi Provincial Center for Disease Control and Prevention, Taiyuan, 030001, People's Republic of China
- Shanxi Provincial Key Laboratory of Major Infectious Disease Pandemic Response, Taiyuan, 030001, People's Republic of China
| | - Jian-Guo Xu
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, People's Republic of China
- Institute of Public Health, Nankai University, Tianjing, 300350, People's Republic of China
| | - Tong Wang
- Department of Health Statistics and Epidemiology, School of Public Health, Collaborative Innovation Center of Reverse Microbial Etiology, Shanxi Medical University, 56 Xinjiannanlu Street, Yingze District, Taiyuan, 030001, Shanxi, People's Republic of China.
- Shanxi Provincial Key Laboratory of Major Infectious Disease Pandemic Response, Taiyuan, 030001, People's Republic of China.
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