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Published on: Jul 07, 2020
2 minute read
By: Dr Rajan Choudhary

Asymptomatic COVID Infections – Are You Safe?

Asymptomatic COVID infections – are you safe?

Patients with COVID usually exhibit signs of coughing, fever, and fatigue. This can develop into further respiratory problems including difficulty breathing, pneumonia in both lungs, and in severe cases the need to ventilate a patient in an intensive care setting. But what if you are asymptomatic? Do you need to worry? Surely you get the benefits of immunity without the dangers of life-threatening symptoms.

In our previous blog, we discussed how a study showed 41% of people with COVID were asymptomatic. However, they had the same viral load as their symptomatic counterparts. This paper published in Nature Medicine suggests that even the asymptomatic patients developed signs of lung inflammation without showing any outward symptoms. Could asymptomatic patients still be damaged by COVID? It's not easy to study this subset of patients, as they do not get tested routinely or present to hospital for examination or investigation.

This study looked at 37 individuals in the Wanzhou District who were diagnosed with COVID via swab test but did not show any symptoms before the test or during hospitalization. These patients were found through the extensive contact tracing program set up in Central China. Whilst in hospital 57% showed abnormalities in the lung fields on a CT scan, including the “ground glass” appearance classic for COVID pneumonia. These changes could be due to fluid or blood in the area or due to inflammation caused directly by the infection.

What does this mean for the individual in the long term? This is difficult to say, especially since COVID has only been around for a few months so long term follow up is simply impossible to state accurately. Depending on the size and severity of the inflammation it may resolve spontaneously with no lasting damage, or the inflammation could cause scarring of the lung tissue that only becomes evident several years or decades down the line. It's difficult to tell.

The study also looked at two other factors in these patients. Compared to their symptomatic counterparts, asymptomatic patients were found to shed viral particles for several more days. It is unclear the significance of this, or whether this makes them more infective or prone to transmitting the infection for a longer period of time. It does add support to the theory asymptomatic people should not believe themselves exempt from spreading the infection.

Secondly, the study looked at the prevalence of antibodies present in the patient's blood. These antibodies can be used as a surrogate for immunity. In theory, after infection occurs our body has the ability to rapidly produce these antibodies against the virus in the event of a second infection. This would neutralize the infection before it could develop into a serious disease.

Looking at these antibodies the researchers found antibody levels against the SARS and MERS virus to last over 2 years. However, against SARS-CoV-2, the antibody levels fall within 2-3 months, providing only a short duration of immunity. This is worrisome for individuals and countries hoping to achieve herd immunity or at least immunity to the virus after a mild or asymptomatic infection.

So what should we take away from this? Perhaps an asymptomatic infection is not the perfect scenario. Damage does occur to your lungs, albeit temporary damage. You are still able to spread it to vulnerable people. And your immunity may not last as long as other infections.

Therefore be safe. Maintain social distancing, follow government advice on wearing a mask. And if you can, avoid excessive socializing or close contact with lots of other people. The virus hasn’t gone away, and it is still dangerous.

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Shortness of Breath Causes: From Common Triggers to Serious Health Conditions

Shortness of breath, medically known as dyspnea, is a symptom that ranges from mild discomfort during exertion to a distressing sensation of not getting enough air. In India, increasing air pollution, lifestyle diseases and respiratory infections have made breathlessness a frequent complaint across age groups. Understanding shortness of breath causes is essential to identify when it is harmless and when it signals a medical emergency.

What Is Shortness of Breath?

Shortness of breath refers to difficulty breathing or a feeling of air hunger.

It may present as:

rapid breathing
shallow breathing
tightness in the chest
inability to take a deep breath

The sensation can develop suddenly or gradually.

Common and Benign Causes of Shortness of Breath

Physical Exertion

During exercise, the body demands more oxygen.

Temporary breathlessness during:

climbing stairs
running
heavy physical work

is normal and resolves with rest.

Anxiety and Panic Attacks

Stress and anxiety alter breathing patterns.

Symptoms include:

rapid breathing
chest tightness
dizziness

These episodes often resolve with calming techniques.

Respiratory Causes of Shortness of Breath

Asthma

Asthma causes airway narrowing and inflammation.

Symptoms include:

wheezing
chest tightness
breathlessness during exertion or at night

Asthma is a leading cause of chronic breathlessness.

Chronic Obstructive Pulmonary Disease

COPD includes chronic bronchitis and emphysema.

Risk factors include:

smoking
indoor air pollution
occupational exposure

WHO identifies COPD as a major cause of breathlessness in adults.

Respiratory Infections

Infections such as pneumonia and bronchitis reduce lung capacity.

Breathlessness may be accompanied by:

cough
fever
chest pain

Severe infections require urgent treatment.

Heart-Related Causes of Shortness of Breath

Heart Failure

The heart fails to pump blood efficiently.

This leads to:

fluid accumulation in lungs
breathlessness on exertion
breathlessness while lying flat

ICMR data shows heart disease as a major contributor to unexplained breathlessness.

Coronary Artery Disease

Reduced blood supply to the heart can cause:

breathlessness
chest discomfort
fatigue

This may occur even without chest pain in some individuals.

Blood and Metabolic Causes

Anemia

Low hemoglobin reduces oxygen delivery.

Common symptoms include:

fatigue
breathlessness on mild activity
pale skin

NFHS-5 highlights anemia as highly prevalent in India.

Thyroid Disorders

Hyperthyroidism increases metabolic demand, causing breathlessness.

Hypothyroidism may contribute indirectly through weight gain and reduced stamina.

Lung Circulation Disorders

Pulmonary Embolism

A blood clot in the lungs causes sudden, severe breathlessness.

This is a medical emergency and may be accompanied by:

chest pain
coughing blood
fainting

Immediate treatment is critical.

Lifestyle-Related Causes

Obesity

Excess body weight restricts lung expansion.

Breathlessness occurs due to:

increased oxygen demand
reduced lung volumes

Weight management improves breathing efficiency.

Sedentary Lifestyle

Poor physical conditioning reduces respiratory muscle strength.

Even mild exertion may cause breathlessness.

Environmental and Occupational Factors

Air Pollution

Pollutants irritate airways and reduce lung function.

Urban populations experience higher rates of breathlessness.

Workplace Exposure

Dust, chemicals and fumes increase respiratory risk.

Protective measures are essential in high-risk occupations.

When Shortness of Breath Is a Warning Sign

Seek urgent care if breathlessness:

starts suddenly
worsens rapidly
occurs at rest
is associated with chest pain, bluish lips or confusion

These may indicate life-threatening conditions.

How Shortness of Breath Is Diagnosed

Evaluation may include:

physical examination
chest imaging
blood tests
lung function tests
heart evaluation

Diagnosis focuses on identifying the root cause.

Preventive Measures and Lifestyle Care

Prevention includes:

regular physical activity
pollution protection
smoking cessation
weight control
managing chronic conditions

Preventive healthcare reduces long-term risk.

Importance of Early Medical Evaluation

Delayed diagnosis can worsen outcomes, especially in:

heart disease
lung infections
anemia

Early care improves treatment success.

Conclusion

Shortness of breath causes range from temporary exertion and anxiety to serious heart, lung and blood disorders. While occasional breathlessness may be harmless, persistent or sudden symptoms should never be ignored. Understanding the underlying causes and seeking timely medical evaluation can prevent complications and save lives. Paying attention to changes in breathing is an essential step toward protecting overall health and wellbeing.

References

Indian Council of Medical Research (ICMR) – Respiratory and Cardiac Health Reports
World Health Organization (WHO) – Breathlessness and Chronic Disease Guidelines
National Family Health Survey (NFHS-5) – Anemia and Respiratory Health Data
Lancet – Dyspnea Evaluation and Outcomes Research
NITI Aayog – Non-Communicable Disease Prevention Reports
Statista – Respiratory Disease and Air Pollution Trends

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