The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application
The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application
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DOI：
10.7326/m20-0504
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发表时间：
2020-05-05
影响因子：
39.2
通讯作者：
Lessler, Justin
中科院分区：
文献类型：
--
作者：
Lauer, Stephen A.;Grantz, Kyra H.;Lessler, Justin
背景：2019年12月在中国发现了一种新型人类冠状病毒--严重急性呼吸综合征冠状病毒2（SARS-CoV-2）。它的许多关键流行病学特征，包括临床疾病的潜伏期，（2019冠状病毒病[COVID-19]），这对监测和控制活动具有重要意义。目的：估计COVID-19的潜伏期长度，并描述其公共卫生影响。设计：对2020年1月4日至2020年2月24日期间报告的COVID-19确诊病例的汇总分析。设置：来自中国湖北省武汉市以外50个省、地区和国家的新闻报道和新闻稿。参与者：中国湖北省以外的确诊SARS-CoV-2感染者。测量：患者人口统计学特征以及可能暴露、症状发作、发热发作和住院的日期和时间。结果：有181例确诊病例具有可识别的暴露和症状发作窗口，以估计COVID-19的潜伏期。中位潜伏期估计为5.1天（95% CI，4.5至5.8天），97.5%出现症状的人将在感染后11.5天（CI，8.2至15.6天）内出现症状。这些估计意味着，在保守的假设下，每10000例中有101例（第99百分位数，482）将在主动监测或隔离14天后出现症状。局限性：公开报告的病例可能过多代表严重病例，其潜伏期可能与轻度病例不同。这项工作为COVID-19的中位潜伏期约为5天提供了额外的证据，类似于SARS。我们的研究结果支持目前的建议，隔离或积极监测可能暴露于SARS-CoV-2的人员，虽然在极端情况下，更长的监测期可能是合理的。
Background: A novel human coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified in China in December 2019. There is limited support for many of its key epidemiologic features, including the incubation period for clinical disease (coronavirus disease 2019 [COVID-19]), which has important implications for surveillance and control activities.Objective: To estimate the length of the incubation period of COVID-19 and describe its public health implications.Design: Pooled analysis of confirmed COVID-19 cases reported between 4 January 2020 and 24 February 2020.Setting: News reports and press releases from 50 provinces, regions, and countries outside Wuhan, Hubei province, China.Participants: Persons with confirmed SARS-CoV-2 infection outside Hubei province, China.Measurements: Patient demographic characteristics and dates and times of possible exposure, symptom onset, fever onset, and hospitalization.Results: There were 181 confirmed cases with identifiable exposure and symptom onset windows to estimate the incubation period of COVID-19. The median incubation period was estimated to be 5.1 days (95% CI, 4.5 to 5.8 days), and 97.5% of those who develop symptoms will do so within 11.5 days (CI, 8.2 to 15.6 days) of infection. These estimates imply that, under conservative assumptions, 101 out of every 10 000 cases (99th percentile, 482) will develop symptoms after 14 days of active monitoring or quarantine.Limitation: Publicly reported cases may overrepresent severe cases, the incubation period for which may differ from that of mild cases.Conclusion: This work provides additional evidence for a median incubation period for COVID-19 of approximately 5 days, similar to SARS. Our results support current proposals for the length of quarantine or active monitoring of persons potentially exposed to SARS-CoV-2, although longer monitoring periods might be justified in extreme cases.