The contribution of asymptomatic SARS-CoV-2 infections to transmission on the Diamond Princess cruise ship.
The contribution of asymptomatic SARS-CoV-2 infections to transmission on the Diamond Princess cruise ship.
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DOI：
10.7554/elife.58699
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发表时间：
2020-08-24
期刊：
影响因子：
7.7
通讯作者：
Houben RM
中科院分区：
文献类型：
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作者：
Emery JC;Russell TW;Liu Y;Hellewell J;Pearson CA;CMMID COVID-19 Working Group;Knight GM;Eggo RM;Kucharski AJ;Funk S;Flasche S;Houben RM
SARS-CoV-2的一个关键未知因素是无症状感染如何促进传播。我们使用了一个具有无症状和症状前状态的传播模型，根据钻石公主号游轮疫情的疾病发作和检测频率数据进行校准，以量化无症状感染对传播的贡献。该模型估计74%（70- 78%，95%后验区间）的感染无症状进行。尽管进行了密集的检测，但仍有53%（51-56%）的感染未被发现，其中大多数无症状。无症状个体是所有感染的69%（20-85%）的来源。这些数据无法识别无症状感染者的传染性，但低范围（0-25%）要求通过症状前和症状阶段进展的个体的净繁殖数至少为15。无症状的SARS-CoV-2感染可能在很大程度上促进传播。控制措施和预测其潜在影响的模型，如果要理解和解决持续传播，就需要超越症状病例。
A key unknown for SARS-CoV-2 is how asymptomatic infections contribute to transmission. We used a transmission model with asymptomatic and presymptomatic states, calibrated to data on disease onset and test frequency from the Diamond Princess cruise ship outbreak, to quantify the contribution of asymptomatic infections to transmission. The model estimated that 74% (70–78%, 95% posterior interval) of infections proceeded asymptomatically. Despite intense testing, 53% (51–56%) of infections remained undetected, most of them asymptomatic. Asymptomatic individuals were the source for 69% (20–85%) of all infections. The data did not allow identification of the infectiousness of asymptomatic infections, however low ranges (0–25%) required a net reproduction number for individuals progressing through presymptomatic and symptomatic stages of at least 15. Asymptomatic SARS-CoV-2 infections may contribute substantially to transmission. Control measures, and models projecting their potential impact, need to look beyond the symptomatic cases if they are to understand and address ongoing transmission.