新型冠狀病毒（COVID-19）無症狀感染者的流行病學與臨床特徵

Epidemiological and Clinical Characteristics of Asymptomatic COVID-19 Infection

鄭志堅(Chih-Chien Cheng) ； 郭姿伶(Tzu-Ling Kuo) ； 邱婷芳(Ting-Fang Chiu) ； 徐愫萱(Su-Hsuan Hsu) ； 張詠森(Yung-Sen Chang) ； 璩大成(Dachen Chu) ； 黃遵誠(Tsun-Cheng Huang)

《北市醫學雜誌》 17卷4期 (2020/12) Pp. 372-379

https://doi.org/10.6200/TCMJ.202012_17(4).0002

摘要

目的：新型冠狀病毒自2019年12月在中國武漢發現後，不但傳播至其他省分，甚而導致周邊的國家及全世界的大流行。其中無症狀感染者可能的占率有多少？還有傳染力的強弱、是否可能引發社區感染，形成更大的風險？隨著疫情進展，越來越受到重視。方法：本文藉由回顧全球最新的文獻，整理分析其中數據，進而檢視無症狀感染者之占率及其傳播狀態。結果：無症狀之確診人數占率，一般群體有18～57%不等的報告，而在特定群體中，兒童為14%，妊娠孕婦33%，遊民88%。許多文獻顯示無症狀感染者可以傳播COVID-19，也有報告指出，無症狀感染者的可傳播性與有症狀感染者的可傳播性相當。確診病患遭到潛伏期無症狀感染者傳染的比例，新加坡是48∼66%，天津則是62∼77%。結論：無症狀感染者在確診案例中的高占率以及其高傳染性的特性，也許是COVID-19快速席捲全球的原因之一，也意味著我們應該重視無症狀者對疫情傳播的威脅。

關鍵字

新型冠狀病毒肺炎 ； 無症狀感染者 ； 占率及傳染力

並列摘要

Objectives: The purpose of this article is to describe the epidemiological and clinical characteristics of asymptomatic novel coronavirus pneumonia (COVID-19) patients. The outbreak of novel coronavirus disease 2019 has been widely discussed recently. Most of the current studies focused on clinical symptoms. However, COVID-19 infection might present as an asymptomatic carrier state. Adults seemed to represent the population with the highest infection rate; In addition, neonates, children, pregnant women, and elderly patients could also be infected by SARS-CoV-2 without symptoms noted. Moreover, nosocomial infection of hospitalized patients and healthcare personnel (HCP), and viral transmission from asymptomatic carriers were also possible. Methods: This article reviewed the current literature and analyzed the data to examine the proportion of asymptomatic infections and possible transmission. Results: The proportion of asymptomatic carriers ranged from 18 to 57% (14% among children and 33% in pregnant women). Many literature showed that asymptomatic infections might transmit COVID-19. There were also reports indicated that the asymptotic cases can transmit or deliver the virus like the symptomatic cases. Conclusions: Asymptomatic carrier state of COVID-19 is a possible cause of epidemic rebound. This article presents the available data about asymptomatic cases and their possible contributions to the overall epidemic of COVID-19. Emergence of a pandemic of COVID-19 caused by asymptomatic cases is likely to occur.

並列關鍵字

COVID-19 ； asymptomatic ； SARS-CoV-2 ； carriers ； transmission