453. Frequency of Symptoms and Asymptomatic SARS-CoV-2 Infection in New Orleans, Louisiana

Background: Individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who do not report symptoms throughout the course of infection (asymptomatic) or those who are asymptomatic when they first contract the virus (presymptomatic) are a major public health concern However, few prevalence studies to date have targeted the question of asymptomatic frequency within a community Methods: A stratified, random sample of subjects were sent to testing sites to complete a verbal consent, survey, nasopharyngeal swab, and blood draw Swabs were tested for active viral shedding (PCR) and blood was tested for immunoglobulin G (IgG) specific to SARS-CoV-2 Disease progression and IgG antibody response Results: Of the 2,640 subjects, 24 (0 9%) were PCR-positive alone, 30 (1 1%) were PCR-positive and IgG-positive, and 129 (4 9%) were IgG-positive alone Subjects who reported anosmia were 17 times more likely to test positive Thirtyeight percent of subjects never experienced symptoms despite developing antibodies to the virus, and 75% did not experience symptoms in the early stage of infection Rates of reported asymptomatic infection and comorbidities statistically significantly increased with age Conclusion: This is the first randomized study that pairs PCR and IgG serology that addresses asymptomatic SARS-CoV-2 infection, showing a high frequency of asymptomatic disease More research is needed to clarify differences between symptomatic and asymptomatic disease Prevalence and outcomes studies of SARS-CoV-2 should include this group