Asymptomatic and Presymptomatic SARS-CoV-2 Infections in Residents of a Long-Term Care Skilled Nursing Facility — King County, Washington, March 2020

摘要: Older adults are susceptible to severe coronavirus disease 2019 (COVID-19) outcomes as a consequence of their age and, in some cases, underlying health conditions (1). A COVID-19 outbreak long-term care skilled nursing facility (SNF) King County, Washington that was first identified on February 28, 2020, highlighted the potential for rapid spread among residents these types facilities (2). On March 1, provider at second (facility A) Washington, had positive test result SARS-CoV-2, novel causes COVID-19, after working while symptomatic 26 and 28. By 6, seven this were results SARS-CoV-2. 13, CDC performed symptom assessments SARS-CoV-2 testing 76 (93%) 82 evaluate utility screening identification SNF residents. Residents categorized asymptomatic or time testing, based absence presence fever, cough, shortness breath, other symptoms day during preceding 14 days. Among 23 (30%) with results, 10 (43%) date 13 (57%) asymptomatic. Seven days previously developed recategorized presymptomatic testing. The reverse transcription-polymerase chain reaction (RT-PCR) cycle threshold (Ct) values indicated large quantities viral RNA asymptomatic, presymptomatic, residents, suggesting transmission regardless symptoms. Symptom-based SNFs could fail identify approximately half COVID-19. Long-term should take proactive steps prevent introduction (3). Once confirmed case is an SNF, all be placed isolation precautions if possible (3), considerations extended use reuse personal protective equipment (PPE) needed (4).