Epidemiological characterisation of asymptomatic carriers of COVID-19 in Colombia: a cross-sectional study

  1. Aníbal A. Teherán
  2. Gabriel Camero Ramos
  3. Ronald Prado de la Guardia
  4. Carolina Hernández
  5. Giovanny Herrera
  6. Luis M Pombo
  7. Albert Alejandro Avila
  8. Carolina Flórez
  9. Esther C Barros
  10. Luis Perez-Garcia
  11. Alberto Paniz-Mondolfi
  12. Juan David Ramírez

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Abstract

Asymptomatic carriers (AC) of the new SARS-CoV-2 represent an important source of spread for COVID-19. Early diagnosis of these cases is a powerful tool to control the pandemic. Our objective was to characterise patients with AC status and identify associated sociodemographic factors.

Methods

Using a cross-sectional design and the national database of daily occurrence of COVID-19, we characterised both socially and demographically all ACs. Additional correspondence analysis and logistic regression model were performed to identify characteristics associated with AC state (OR, 95% CI).

Results

76.162 ACs (12.1%; 95% CI 12.0% to 12.2%) were identified, mainly before epidemiological week 35. Age≤26 years (1.18; 1.09 to 1.28), male sex (1.51; 1.40 to 1.62), cases imported from Venezuela, Argentina, Brazil, Germany, Puerto Rico, Spain, USA or Mexico (12.6; 3.03 to 52.5) and autochthonous cases (22.6; 5.62 to 91.4) increased the risk of identifying ACs. We also identified groups of departments with moderate (1.23; 1.13 to 1.34) and strong (19.8; 18.6 to 21.0) association with ACs.

Conclusion

Sociodemographic characteristics strongly associated with AC were identified, which may explain its epidemiological relevance and usefulness to optimise mass screening strategies and prevent person-to-person transmission.

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  1. Version published to 10.1136/bmjopen-2020-042122
  2. ScreenIT

    SciScore for 10.1101/2020.06.18.20134734: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    The geographical origin and destination of imported cases was represented with a Sankey Plot (SankeyMATIC (BETA).
    BETA
    suggested: (BETA, RRID:SCR_007556)
    XLSTAT statistical and data analysis solution.
    XLSTAT
    suggested: (XLSTAT, RRID:SCR_016299)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    An adapted definition for AC in Colombia may address this limitation. Figure 1 shows that the majority of imported cases to Colombia came from Spain and USA, where AC rates have been estimated at 2.5% and 25%, respectively [14,15]. Although imported cases carry a distinctive genetic load that, population-wise, could manifest itself as a particular phenotype [16], currently there are no reports of genetic variants associated with AC in general or for any of the four AC subtypes described in the literature [17]. Subsequent research should be conducted on the possible association between ACs and phylogenetic variants (or other variables) to support the differential risk identified in imported cases from different regions of the world. We identified that imported cases from a group of 6 countries were strongly associated with AC (Figure 3, Table S1, Table 2), and although no interaction was established between the country of import and the destination department (data not shown), we observed that departments strongly associated with AC had less diversity of import origin. Such is the case of Meta and Amazonas, which exclusively imported cases from USA and Brazil/Peru, respectively (Figure 2). Among the demographic characteristics, the association between AC state and patients under 40 years of age stands out. Possible explanations for this observation include: (i) the lower presence of co-morbid conditions and baseline health issues within this age group and (ii) the higher risk ...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  3. Version published to 10.1101/2020.06.18.20134734v1 on medRxiv