Asymptomatic patients as a source of COVID-19 infections: A systematic review and meta-analysis.
Asymptomatic patients as a source of COVID-19 infections: A systematic review and meta-analysis.
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DOI：
10.1016/j.ijid.2020.06.052
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发表时间：
2020-09
期刊：
影响因子：
--
通讯作者：
Shin JI
中科院分区：
文献类型：
--
作者：
Kronbichler A;Kresse D;Yoon S;Lee KH;Effenberger M;Shin JI
无症状的COVID-19患者往往更年轻，可能更活跃。大多数无症状病例的实验室检查结果不明显。大约一半的病例有肺部阴影，最常见的是磨玻璃样阴影。CT正常者较CT异常者年轻。2019冠状病毒病（COVID-19）的特点是不可预测的病程，从无症状到严重的危及生命的感染。已经描述了无症状的COVID-19感染，本系统性综述的目的是总结其表现形式。我们检索了PubMed®和Google®（2019年12月1日至2020年3月29日），并提取了年龄、实验室检查结果和计算机断层扫描（CT）。使用随机效应模型分析临床特征的合并发生率。总共确定了来自34项研究的506例无症状病程患者（68例单一病例和438例病例系列）。放射学检查正常的患者（19.59 ± 17.17岁）比放射学检查异常的患者（39.14 ± 26.70岁）年轻（p值= 0.013）。尽管无症状，但CT检查显示62.2%的病例存在异常;最常见的是毛玻璃样阴影（荟萃分析为43.09%）。大多数研究报告了正常的实验室检查结果（荟萃分析为61.74%）。在没有任何症状的患者中，超过一半的患者存在CT异常。无症状患者可能具有传染性，因此是COVID-19的潜在传播源。
Asymptomatic patients with COVID-19 tend to be younger and may be more socially active. Laboratory findings in most asymptomatic cases were unremarkable. Around half of the cases had lung opacities, most frequently ground glass opacities. Patients with normal CT were younger than patients with abnormal CT. Coronavirus Disease 2019 (COVID-19) is characterized by an unpredictable disease course, ranging from asymptomatic to severe, life-threatening infections. Asymptomatic COVID-19 infections have been described, and the aim of this systematic review was to summarise their presentation forms. We searched PubMed® and Google® (1 December 2019 to 29 March 2020) and extracted age, laboratory findings, and computed tomography (CT) scans. Pooled incidence rates of clinical characteristics were analyzed using random-effect models. In total, 506 patients from 34 studies (68 single cases and 438 from case-series) with an asymptomatic course were identified. Patients with normal radiology were younger (19.59 ± 17.17 years) than patients with abnormal radiology (39.14 ± 26.70 years) (p-value = 0.013). Despite being asymptomatic, CT investigations revealed abnormalities in 62.2% of the cases; ground-glass opacities were most frequently observed (43.09% by meta-analysis). Most studies reported normal laboratory findings (61.74% by meta-analysis). More than half of the patients without any symptoms present with CT abnormalities. Asymptomatic patients may be contagious and thus a potential source of transmission of COVID-19.
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