LAUSR

Abstract Background Containing COVID-19 has been difficult, due to both the large number of asymptomatic infected individuals and the long duration of infection. To best manage these challenges requires understanding of differences between asymptomatic versus symptomatic patients and those with a longer duration of infectivity. Methods Individuals from Los Angeles were tested for COVID-19, and a group positive for COVID-19 chose to have follow-up testing. Associations between symptoms and demographic factors, viral burden measured by cycle threshold (CT) value, and duration of PCR positivity were analyzed. Results 18.8% of patients were positive for COVID-19. Asymptomatic COVID-19 positive patients were significantly younger that symptomatic patients (2.6 years, p<0.001). There were no differences in average CT between asymptomatic and symptomatic patients. The estimated median duration of COVID-19 PCR positivity was 23 days. Being asymptomatic throughout the course of infection was the only factor associated with a shorter course of COVID-19 PCR positivity (21 versus 28 days, p=0.002). Conclusions We found important differences and similarities between asymptomatic and symptomatic COVID-19 positive patients, the most meaningful being a similar level of virus as measured by PCR, but a shorter duration of PCR positivity for asymptomatic patients. These findings suggest that asymptomatic patients may have more efficient clearance of virus, which may be relevant for management and screening.