Virologist Clementi explains it to Gazzetta Active: “Asymptomatics exist in all viral infections, it is not a peculiarity of this infection. The disease is an infection with symptoms”
Asymptomatic and paucisymptomatic: with the pandemic of Covid-19 these terms are increasingly used. But what exactly is meant? And how contagious are asymptomatic or paucisymptomatic people? “In this particular infection there is a tendency to get confused when it comes to new infections: they get confused infection and disease. But asymptomatics exist in all viral infections, it is not a peculiarity of this infection “, Professor Massimo Clementi, Professor of Microbiology and Virology of the Vita-Salute San Raffaele University and director of the Laboratory of Microbiology and Virology of San Raffaele, explains to Gazzetta Active. ‘San Raffaele Hospital in Milan. “A very common infection in the past was thehepatitis A, that form of orofecally transmitted hepatitis that is acquired through contaminated food or drink. Out of ten people who become infected and emit the virus only one has hepatitis, the actual disease. The other nine are totally asymptomatic, but shed the virus in their feces, contributing to the spread of the infection. Similar the case of polio, which now no longer exists with us: here too there were about 90 percent asymptomatic, but only 10 percent were those who developed the neurological syndrome which in many cases led to paralysis and sometimes even death. In all viral infections the asymptomatic (i.e. those who, having the infection, do not develop symptoms) they are a part of the infected population. The disease is an infection with symptoms “, underlines Professor Clementi.
Is the viral load linked to the presence of symptoms?
“It has been seen that in the asymptomatic (which are about 60% of all those who become infected with the virus) there are asymptomatics who infect little because they have a low viral load in their oropharynx and emit viruses for a few days. There are also other asymptomatic, but fortunately they are the minority, which emit a lot of viruses, the so-called super speakers: they are those who infect many people without having any symptoms “.
Is it known why some asymptomatic are highly contagious and others not?
“From what you can know it depends on how much the virus is replica in the air mucous membranes and is probably in turn related to amount of virus with which the asymptomatic came into contact at the time of the infection. If a person becomes infected with a low viral load the infectious dose is low and therefore develops a modest infection. If the individual is infected with a high viral load they will develop an infection with a lot of viruses. But sometimes there are also individual differences ”.
Coming to the paucisymptomatics with Covid-19, what are their symptoms and how do they differ from the actual symptoms?
“The paucisymptomatic sufferers have one or two days of usually not high fever (high fever is what characterizes an infection that develops into pneumonia), cough, flu-like muscle pain. The main difference between those who are properly symptomatic and i paucisintomatici is that in the latter there are no respiratory problems, there is no pneumonia. The paucisymptomatic is a person with mild flu-like symptoms that does not require hospitalization, can be isolated at home. For this reason the recommendation is not to rush to the emergency room, since there is no need for hospitalization. Patients with symptoms are treated at home or, if they cannot be isolated at home, in non-hospital facilities prepared for this, such as some hotels in Milan. The paucisymptomatics can live with this infection until they recover ”.
Do paucisymptomatics have a higher viral load than asymptomatic ones?
“It’s not for sure. Sometimes yes, but not always ”.
One of the most frightening aspects of Covid-19 is shortness of breath, that sense of suffocation that affects the sick in the most severe forms of the disease. Is there this risk in symptomatic paucis?
“No, there isn’t because by definition there is no pneumonia. Shortness of breath and therefore the reduction of oxygen saturation occurs when a process is triggered viral pneumonia. But in that case it is good to resort to hospitalization. In paucisymptomatic coughs are not worrying. Pulse oximeters, which can be purchased in pharmacies, are also a good way to monitor the health of people who have the infection ”.
What are the values that need to worry?
“Values between 95% and 100% oxygen saturation are fine. Below 90% have to worry ”.
Read also: Covid-19, are you immune after infection? The virologist answers
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10 November 2020 (modified November 10, 2020 | 17:37)
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