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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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Monkeypox Virus Symptoms: Early Signs, Disease Progression, and When to Seek Care

Monkeypox, now commonly referred to as mpox, is a viral infection that has gained global attention due to outbreaks beyond traditionally affected regions. Understanding monkeypox virus symptoms is essential for early detection, timely isolation and prevention of further spread.

According to the World Health Organization and Indian public health authorities, awareness of symptom patterns plays a critical role in controlling outbreaks and protecting vulnerable populations.

What Is the Monkeypox Virus?

Monkeypox is caused by the monkeypox virus, a member of the Orthopoxvirus family, which also includes smallpox. While generally less severe than smallpox, monkeypox can still cause significant illness and discomfort.

The virus spreads primarily through close physical contact.

Incubation Period of Monkeypox

After exposure, symptoms typically appear within:

5 to 21 days
most commonly 6 to 13 days

Individuals may feel well during this period but can become infectious once symptoms begin.

Early Monkeypox Virus Symptoms

Fever

Fever is usually the first symptom and may be:

sudden in onset
moderate to high grade
accompanied by chills

Fever signals the start of systemic infection.

Headache and Body Aches

Patients often experience:

severe headache
muscle aches
back pain

These symptoms resemble many viral illnesses.

Fatigue and Weakness

Marked tiredness and low energy levels are common and may limit daily activities.

Swollen Lymph Nodes

Swollen lymph nodes are a distinguishing feature of monkeypox.

Common sites include:

neck
armpits
groin

This helps differentiate monkeypox from chickenpox or smallpox.

Development of Monkeypox Rash

The skin rash usually appears:

1 to 3 days after fever onset

It may begin on the face or genital area and spread to other parts of the body.

Stages of Monkeypox Rash

The rash progresses through well-defined stages:

Macules

Flat red spots on the skin.

Papules

Raised, firm bumps.

Vesicles

Fluid-filled blisters.

Pustules

Pus-filled lesions that are painful.

Scabs

Lesions crust over and eventually fall off.

Complete healing occurs once scabs detach.

Distribution of Rash

Rash commonly affects:

face
hands and feet
mouth
genital and anal areas

The number of lesions can vary widely.

Pain and Discomfort

Rash lesions may be:

painful
itchy during healing

Pain severity differs between individuals.

Other Possible Symptoms

Additional symptoms may include:

sore throat
cough
nasal congestion

These reflect upper respiratory involvement.

Duration of Illness

Monkeypox symptoms typically last:

2 to 4 weeks

Recovery occurs gradually as lesions heal.

Who Is at Higher Risk of Severe Illness?

Higher risk groups include:

children
pregnant women
individuals with weakened immunity
people with chronic illness

Early care is crucial in these groups.

Complications of Monkeypox

Though uncommon, complications may include:

secondary bacterial skin infections
dehydration
pneumonia
eye involvement

Prompt medical guidance reduces risk.

How Monkeypox Is Transmitted

Transmission occurs through:

direct skin-to-skin contact
contact with lesions or bodily fluids
respiratory droplets during close contact
contaminated clothing or bedding

Understanding transmission helps prevent spread.

When to Seek Medical Care

Seek medical evaluation if:

fever is followed by rash
lymph nodes become swollen
rash appears in genital or facial areas

Early diagnosis supports isolation and care.

Diagnosis and Testing

Diagnosis may involve:

clinical examination
laboratory testing of lesion samples

Public health authorities guide testing protocols.

Prevention and Control Measures

Preventive steps include:

avoiding close contact with infected individuals
maintaining good hand hygiene
isolating during illness
following public health guidance

Vaccination may be recommended for high-risk groups.

Role of Public Awareness

Awareness of symptoms:

enables early detection
reduces stigma
supports timely care

WHO emphasises community education in outbreak control.

Conclusion

Monkeypox virus symptoms typically begin with fever, body aches and swollen lymph nodes, followed by a characteristic rash that progresses through defined stages. While most cases are self-limiting, early recognition, medical evaluation and isolation are essential to prevent complications and reduce transmission. Staying informed and acting promptly protects both individual and public health.

References

World Health Organization (WHO) – Mpox (Monkeypox) Clinical and Public Health Guidance
Indian Council of Medical Research (ICMR) – Emerging Viral Infections Reports
National Centre for Disease Control (NCDC), India – Monkeypox Advisories
Lancet – Clinical Features and Outcomes of Mpox
NITI Aayog – Public Health Preparedness and Infectious Disease Control

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