{"id":49924,"date":"2020-06-29T21:21:03","date_gmt":"2020-06-29T21:21:03","guid":{"rendered":"https:\/\/virusreports.net\/an-enduring-coronavirus-mystery-why-do-only-some-get-sick\/"},"modified":"2020-06-29T21:21:03","modified_gmt":"2020-06-29T21:21:03","slug":"an-enduring-coronavirus-mystery-why-do-only-some-get-sick","status":"publish","type":"post","link":"https:\/\/virusreports.net\/an-enduring-coronavirus-mystery-why-do-only-some-get-sick\/","title":{"rendered":"An enduring coronavirus mystery: Why do only some get sick?"},"content":{"rendered":"
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Months into a pandemic that has caused more than 500,000 deaths worldwide<\/a>, scientists are still trying to answer crucial questions about the coronavirus.<\/p>\n

Chief among them: Everything about asymptomatic patients.<\/p>\n

People who contracted COVID-19 but did not get sick and had no symptoms have been one of the most confounding factors of the ongoing public health emergency. The United States currently has more than 2.5 million confirmed coronavirus cases, but it\u2019s likely that many asymptomatic people have fallen through the cracks of official counts.<\/p>\n

Now, scientists say that without a better understanding of how many people have been asymptomatically infected, it\u2019s difficult to know precisely how these individuals contribute to the spread of the virus and whether asymptomatic patients have developed antibodies or other protections that would confer some type of immunity against reinfection.<\/p>\n

Dr. Jorge Mercado, a pulmonologist and critical care doctor at New York University’s Langone Hospital Brooklyn, said most of these questions stem from the fact that scientists still aren\u2019t sure why some people who have been exposed to the virus get very sick, while others develop no symptoms.<\/p>\n

\u201cWe really don\u2019t know much about this disease,\u201d he said. \u201cWe know a little more than we did three months ago, but there are still a lot of things we don\u2019t have answers to.\u201d<\/p>\n

Public health officials are still struggling to get a handle on the true number of people who have been infected. The Centers for Disease Control and Prevention said Thursday that the number of COVID-19 cases in the U.S. \u2014 including those that are asymptomatic \u2014 may be 10 times higher than what has been reported<\/a>, meaning the true case count could be closer to 23 million.<\/p>\n

“Our best estimate right now is that for every case that’s reported, there actually are 10 other infections,” Dr. Robert Redfield, director of the CDC, said Thursday.<\/p>\n

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Early on, many asymptomatic cases went unnoticed because states were dealing with dire shortages of test kits and supplies that limited testing capacity to only the sickest patients. As such, many asymptomatic people likely had no idea they were ever positive, said Dr. Marybeth Sexton, an assistant professor of medicine at Emory University in Atlanta.<\/p>\n

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\u201cWe tend to pick up asymptomatic or mildly symptomatic people when we do contact tracing, so when we get someone who is positive and we start testing people they\u2019ve been in contact with,\u201d she said. \u201cI think it\u2019ll be a long time before we know for sure what the true percentage is.\u201d<\/p>\n

Sexton added that the virus\u2019 long incubation period has also led to some confusion over how \u201casymptomatic\u201d is defined. According to the CDC, it could take up to 14 days after exposure for someone to show any symptoms.<\/p>\n

\u201cThere are people who are positive but truly have no symptoms, and there are people who go on to develop very mild or atypical symptoms, and then there are people who think they are asymptomatic until you query them about some of the more unusual manifestations of COVID-19,\u201d she said. \u201cBut sometimes, these all get lumped together as \u2018asymptomatic.\u2019\u201d<\/p>\n

It\u2019s thought that people in all three of those categories \u2014 including those who are presymptomatic \u2014 can transmit the virus, though there was again some confusion on the nature of asymptomatic spread. In early June, the World Health Organization was forced to clarify that the coronavirus can be spread by people with no symptoms<\/a> after one of the agency\u2019s top infectious disease epidemiologists, Dr. Maria Van Kerkhove, stated that she thought asymptomatic spread of COVID-19 was \u201cvery rare.\u201d<\/p>\n

Van Kerkhove\u2019s assessment was roundly criticized by scientists around the world. A day later, she explained that her response was based on several studies that had not undergone peer review and made clear that the WHO\u2019s guidance still stands.<\/p>\n

Yet, even if scientists are sure that asymptomatic people can be so-called silent spreaders \u2014 transmitting COVID-19 even if they show no symptoms \u2014 it\u2019s not known to what degree these individuals are contributing to the outbreaks.<\/p>\n

\u201cIt\u2019s been very hard thus far to nail down how much of transmission is due to asymptomatic people and how much is due to people who get quite sick,\u201d Sexton said.<\/p>\n

Another big unknown is how asymptomatic people\u2019s immune systems respond to the coronavirus, and whether they will develop antibodies or other protections against the virus.<\/p>\n

A study published June 18 in the journal Nature Medicine<\/a> was the first to examine the immune responses in asymptomatic coronavirus patients. The researchers followed 37 asymptomatic individuals in China\u2019s Wanzhou district and compared them to 37 people who had symptoms.<\/p>\n

Though it was a small study, the scientists found that the asymptomatic patients did develop antibodies, which are protective proteins that are produced by the immune system in response to an infection. But the researchers discovered that antibody levels among these individuals diminished within two to three months.<\/p>\n

It\u2019s not yet known if COVID-19 antibodies confer any kind of immunity, but if they do, the recent results suggest that those protections may not last long \u2014 particularly among those who are asymptomatic.<\/p>\n

Mercado said it\u2019s possible that even low antibody levels could afford some protection, though more studies are needed to know for sure.<\/p>\n

\u201cThere\u2019s a glimmer of hope that an antibody response can at least decrease the chances that you\u2019ll progress to a severe disease,\u201d he said.<\/p>\n

Dr. Daniel Kuritzkes, chief of the Division of Infectious Diseases at Brigham and Women\u2019s Hospital in Boston, said it\u2019s not altogether surprising that asymptomatic patients would have a more modest immune response. But, he noted one intriguing finding from the Nature Medicine study that further muddies the definition of \u201casymptomatic\u201d coronavirus patients.<\/p>\n

In CT scans of all the study participants, the researchers found signs of lung inflammation, known as pulmonary infiltrates, even in people who showed no symptoms. Signatures of inflammation were observed in 57 percent of the asymptomatic group, a \u201csurprising\u201d find because it\u2019s not common to conduct CT scans on people who aren\u2019t exhibiting symptoms of a respiratory infection, according to Kuritzkes.<\/p>\n

\u201cIt makes you wonder if they really were asymptomatic, because clearly they had some pneumonia,\u201d he said. \u201cIt just goes to show that the absence of symptoms is not the absence of infection.\u201d<\/p>\n

Sexton said the recent study, though small, reveals some insights into the immune responses of asymptomatic patients, but the results also show how much remains unknown about this population.<\/p>\n

\u201cUntil we know how much transmission asymptomatic people are responsible for, it makes an incredible amount of sense to keep stressing that everyone should wear a mask,\u201d she said. \u201cIf you happen to be in that category and you\u2019re wearing a mask, that\u2019s going to keep you from infecting people and putting those viral particles out in the environment. And everyone else wearing a mask is doing the same for you.\u201d<\/p>\n<\/div>\n

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Months into a pandemic that has caused more than 500,000 deaths worldwide, scientists are still trying to answer crucial questions about the coronavirus.Chief among them: Everything about asymptomatic patients.People who contracted COVID-19 but did not get sick and had no symptoms have been one of the most confounding factors of the ongoing public health emergency.…<\/p>\n","protected":false},"author":1,"featured_media":49925,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"tdm_status":"","tdm_grid_status":"","footnotes":""},"categories":[24],"tags":[5,6607],"class_list":{"0":"post-49924","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health","8":"tag-coronavirus","9":"tag-enduring"},"yoast_head":"\nAn enduring coronavirus mystery: Why do only some get sick? - Virus Reports<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/virusreports.net\/an-enduring-coronavirus-mystery-why-do-only-some-get-sick\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"An enduring coronavirus mystery: Why do only some get sick? 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