April 27, 2020

Presymptomatic SARS-CoV-2 Infections and Transmission in a Skilled Nursing Facility

Category: Article Summary

Topic: Transmission

• This study assessed transmission and evaluated the adequacy of symptom-based screening to identify infections in residents in a skilled nursing facility. Of the 48 residents registered for the study, 56% were asymptomatic at second testing and 50% subsequently developed symptoms. A RT-PCR sequencing of specimens isolated from 34 residents fitted into two clusters with a difference of one nucleotide. They concluded that there was rapid and widespread transmission of SARS-CoV-2 in this facility, with more than 50% positive test cases being asymptomatic. They warn that infection-control strategies based solely on symptomatic cases may not be sufficient to prevent transmission after SARS-CoV-2 introduction into the facility.

Arons et al. (April 23, 2020). Presymptomatic SARS-CoV-2 Infections and Transmission in a Skilled Nursing Facility. NEJM. https://doi.org/10.1056/NEJMoa2008457