High prevalence of symptoms among Brazilian subjects with antibodies against SARS-CoV-2

Ana M.B. Menezes, Cesar G. Victora, Fernando P. Hartwig, Mariângela F. Silveira, Bernardo L. Horta, Aluísio J.D. Barros, Marilia A. Mesenburg, Fernando C. Wehrmeister, Lúcia C. Pellanda, Odir A. Dellagostin, Cláudio J. Struchiner, Marcelo N. Burattini, Fernando C. Barros, Pedro C. Hallal

Research output: Contribution to journalArticlepeer-review


Since the beginning of the pandemic of COVID-19, there has been a widespread assumption that most infected persons are asymptomatic. Using data from the recent wave of the EPICOVID19 study, a nationwide household-based survey including 133 cities from all states of Brazil, we estimated the proportion of people with and without antibodies for SARS-CoV-2 who were asymptomatic, which symptoms were most frequently reported, number of symptoms and the association with socio-demographic characteristics. We tested 33,205 subjects using a rapid antibody test previously validated. Information was collected before participants received the test result. Out of 849 (2.7%) participants positive for SARS-CoV-2 antibodies, only 12.1% (95% CI 10.1–14.5) reported no symptoms, compared to 42.2% (95% CI 41.7–42.8) among those negative. The largest difference between the two groups was observed for changes in smell/taste (56.5% versus 9.1%, a 6.2-fold difference). Changes in smell/taste, fever and body aches were most likely to predict positive tests as suggested by recursive partitioning tree analysis. Among individuals without any of these three symptoms, only 0.8% tested positive, compared to 18.3% of those with both fever and changes in smell or taste. Most subjects with antibodies against SARS-CoV-2 are symptomatic, even though most present only mild symptoms.

Original languageEnglish (US)
Article number13279
JournalScientific reports
Issue number1
StatePublished - Dec 2021
Externally publishedYes

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