ArticleEClinicalMedicine2021
Descriptive epidemiology of SARS-CoV-2 infection in Karnataka state, South India: Transmission dynamics of symptomatic vs. asymptomatic infections.
Article in EClinicalMedicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers.
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Who cites it
41 citing papers in PubMed.
- Translational insights into Long-COVID: evaluation of preclinical animal models along the lung-brain-immune axis with focus on Golden Syrian Hamsters.Journal of neuroinflammation · 2026Review
- Sex- and Age-Dependent Neuroimmune Dysregulation and Early Neurodegenerative Signatures Following SARS-CoV-2 Infection in Golden Syrian Hamsters.Research square · 2026Article
- A state wise analysis of the socioeconomic and health impacts of the COVID-19 pandemic in India: lessons for future health system preparedness.Frontiers in public health · 2026Article
- Knowledge, Attitude, and Hesitance of COVID-19 Vaccination amongst Emergency Health Care Workers (EHCW) in Qassim Region, Kingdom of Saudi Arabia - A Cross-sectional Survey.Journal of pharmacy & bioallied sciences · 2025Article
- Comparing lagged impacts of mobility changes and environmental factors on COVID-19 waves in rural and urban India: A Bayesian spatiotemporal modelling study.PLOS global public health · 2025Article
- Challenges in conducting population-based seroepidemiology survey of COVID-19 in Lagos State, Nigeria.BMC public health · 2023Article
- Demographic Characteristics of Unvaccinated Asymptomatic and Symptomatic SARS-CoV-2 Cases in Barwon South West, Victoria, Australia.Pathogens (Basel, Switzerland) · 2023Article
- Vitamin D and Zinc Supplementation to Improve Treatment Outcomes among COVID-19 Patients in India: Results from a Double-Blind Randomized Placebo-Controlled Trial.Current developments in nutrition · 2023Article
- Assessing efficacy of instructor based orientation to donning doffing protocols and modifications to doffing area infrastructure in reducing SARS-CoV-2 infection among Doctors assigned to COVID-19 patient care.Infection prevention in practice · 2023Article
- Seroprevalence of SARS-CoV-2 specific Immunoglobin G antibodies in rural population of Western Maharashtra, India.Journal of global health · 2023Article
- Characteristics and outcomes of COVID-19 among people living with HIV at Eka Kotebe General Hospital, Addis Ababa, Ethiopia.IJID regions · 2022Article
- Evaluation of post-COVID health status using the EuroQol-5D-5L scale.Pathogens and global health · 2022Observational
- Antibody Response to ChAdOx1 nCoV-19 (AZD1222) Vaccine in Kidney Transplant Recipients.Vaccines · 2022Article
- Modelling the first wave of COVID-19 in India.PLoS computational biology · 2022Article
- Antibody response three months after SARS-CoV-2 infection.Journal of medical virology · 2022Article
- Article
- Factors associated with differential COVID-19 mortality rates in the SEAR nations: a narrative review.IJID regions · 2022Review
- Natural resistance against infections: focus on COVID-19.Trends in immunology · 2022Review
- Neurosurgical experiences of a Bengaluru teaching hospital during the COVID-19 pandemic.Surgical neurology international · 2022Article
- Use of COVID-19 Test Positivity Rate, Epidemiological, and Clinical Tools for Guiding Targeted Public Health Interventions.Frontiers in public health · 2022Article
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Authors and funding
9 authors.
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Abstract
backgroundThe huge surge in COVID-19 cases in Karnataka state, India, during early phase of the pandemic especially following return of residents from other states and countries required investigation with respect to transmission dynamics, clinical status, demographics, comorbidities and mortality. Knowledge on the role of symptomatic and asymptomatic cases in transmission of SARS-CoV-2 was not available.
methodsThe study included all the cases reported from March 8 - May 31, 2020. Individuals with a history of international or domestic travel from high burden states, Influenza-like Illness or Severe Acute Respiratory Illness and high-risk contacts of COVID-19 cases were included. Detailed analysis based on contact tracing data available from the line-list of state surveillance unit was performed using cluster network analysis software.
findingsAmongst the 3404 COVID-19 positive cases, 3096 (91%) were asymptomatic while 308 (9%) were symptomatic. Majority of asymptomatic cases were in the age range of 16 and 45 years while symptomatic cases were between 31 and 65 years. Mortality rate was especially higher among middle-aged and elderly cases with co-morbidities, 34/38 (89·4%). Cluster network analysis of 822 cases indicated that the secondary attack rate, size of the cluster and superspreading events were higher when the source case was symptomatic as compared to an asymptomatic.
interpretationOur findings indicate that both asymptomatic and symptomatic SARS-CoV-2 cases transmit the infection, although symptomatic cases were the main driving force within the state during the beginning of the pandemic. Considering the large proportion of asymptomatic cases, their ability to spread infection cannot be overlooked. Notwithstanding the limitations and bias in identifying asymptomatic cases, the findings have major implications for testing policies. Active search, early testing and treatment of symptomatic elderly patients with comorbidities should be prioritized for containing the spread of COVID-19 and reducing mortality.
fundingIntermediate Fellowship, Wellcome Trust-DBT India Alliance to Giridhara R Babu, Grant number: IA/CPHI/14/1/501499.
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