COVID-19 Diagnosis in Asymptomatic: RT-qPCR or any other Cost-Effective Method?

Abstract

On January 30^th, 2020, the World Health Organization announced the COVID-19 outbreak as a Public Health Emergency of International Concern. In the view of this pandemic, early diagnosis is the mainstay for halting the disease progression. Quantitative real-time Reverse Transcriptase-Polymerase Chain Reaction (RT-qPCR) has been established as the cornerstone for the diagnosis of COVID-19. However, the significance of RT-qPCR positivity in asymptomatic cases with travel history, mass screening purposes, or close contact tracing remains debatable as their period of infectivity is unknown. We present a case series of 42 asymptomatic patients, who tested positive for COVID-19 and were subjected to hospitalization until they tested negative as per Government guidelines. Through our case series, we have tried to establish that RT-qPCR testing as a diagnostic criterion for asymptomatic patients with no known contact history can lead to increased psychological and economic burden on the Government, the patient as well as his family. It also overburdens the health care resources and therefore, raises the question about its necessity among this cohort of asymptomatic cases and thus the possible role of other methods in the diagnosis and isolation of such cases.