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Pratha Sah, Meagan C. Fitzpatrick, Charlotte Zimmer, Elaheh Abdollahi, Lyndon Juden-Kelly, Seyed M. Moghadas, Burton H. Singer, Alison P. Galvani
Quantification of asymptomatic infections is fundamental for effective public health responses to the COVID-19 pandemic. Discrepancies regarding the extent of asymptomaticity have arisen from inconsistent terminology as well as conflation of index and secondary cases which biases toward lower asymptomaticity. We searched PubMed, Embase, Web of Science, and World Health Organization Global Research Database on COVID-19 between January 1, 2020 and April 2, 2021 to identify studies that reported silent infections at the time of testing, whether presymptomatic or asymptomatic. Index cases were removed to minimize representational bias that would result in overestimation of symptomaticity. By analyzing over 350 studies, we estimate that the percentage of infections that never developed clinical symptoms, and thus were truly asymptomatic, was 35.1% (95% CI: 30.7 to 39.9%). At the time of testing, 42.8% (95% prediction interval: 5.2 to 91.1%) of cases exhibited no symptoms, a group comprising both asymptomatic and presymptomatic infections. Asymptomaticity was significantly lower among the elderly, at 19.7% (95% CI: 12.7 to 29.4%) compared with children at 46.7% (95% CI: 32.0 to 62.0%). We also found that cases with comorbidities had significantly lower asymptomaticity compared to cases with no underlying medical conditions. Without proactive policies to detect asymptomatic infections, such as rapid contact tracing, prolonged efforts for pandemic control may be needed even in the presence of vaccination.
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Sah, P., Fitzpatrick, M. C., Zimmer, C., Abdollahi, E., Juden-Kelly, L., Moghadas, S. M., Singer, B. H., & Galvani, A. P. (2021). Asymptomatic SARS-CoV-2 infection: A systematic review and meta-analysis. Proceedings of the National Academy of Sciences, 118(34). https://doi.org/10.1073/pnas.2109229118
Sah, Pratha, et al. "Asymptomatic SARS-CoV-2 infection: A systematic review and meta-analysis." Proceedings of the National Academy of Sciences, vol. 118, no. 34, 2021, https://doi.org/10.1073/pnas.2109229118.
Sah, Pratha, Meagan C. Fitzpatrick, Charlotte Zimmer, Elaheh Abdollahi, Lyndon Juden-Kelly, Seyed M. Moghadas, Burton H. Singer, and Alison P. Galvani. "Asymptomatic SARS-CoV-2 infection: A systematic review and meta-analysis." Proceedings of the National Academy of Sciences 118, no. 34 (2021). https://doi.org/10.1073/pnas.2109229118.
Sah P., Fitzpatrick M. C., Zimmer C. [и др.] Asymptomatic SARS-CoV-2 infection: A systematic review and meta-analysis // Proceedings of the National Academy of Sciences. — 2021. — Vol. 118, № 34. — URL: https://doi.org/10.1073/pnas.2109229118
@article{sah2021asymptomatic,
title = {{Asymptomatic SARS-CoV-2 infection: A systematic review and meta-analysis}},
author = {Pratha Sah and Meagan C. Fitzpatrick and Charlotte Zimmer and Elaheh Abdollahi and Lyndon Juden-Kelly and Seyed M. Moghadas and Burton H. Singer and Alison P. Galvani},
journal = {Proceedings of the National Academy of Sciences},
year = {2021},
volume = {118},
number = {34},
doi = {10.1073/pnas.2109229118},
url = {https://doi.org/10.1073/pnas.2109229118}
}TY - JOUR AU - Sah, Pratha AU - Fitzpatrick, Meagan C. AU - Zimmer, Charlotte AU - Abdollahi, Elaheh AU - Juden-Kelly, Lyndon AU - Moghadas, Seyed M. AU - Singer, Burton H. AU - Galvani, Alison P. TI - Asymptomatic SARS-CoV-2 infection: A systematic review and meta-analysis JO - Proceedings of the National Academy of Sciences VL - 118 IS - 34 PY - 2021 DA - 2021/08/10 DO - 10.1073/pnas.2109229118 UR - https://doi.org/10.1073/pnas.2109229118 ER -
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