Asymptomatic SARS-CoV-2 infection: A systematic review and meta-analysis.
Asymptomatic SARS-CoV-2 infection: A systematic review and meta-analysis.
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DOI：
10.1073/pnas.2109229118
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发表时间：
2021-08-24
影响因子：
11.1
通讯作者：
Galvani AP
中科院分区：
文献类型：
--
作者：
Sah P;Fitzpatrick MC;Zimmer CF;Abdollahi E;Juden-Kelly L;Moghadas SM;Singer BH;Galvani AP
COVID-19的无症状感染已被广泛报道。然而，许多研究没有区分症状前阶段和真正的无症状感染。我们对报告实验室确诊感染的COVID-19文献进行了系统回顾和荟萃分析，以确定无症状感染的负担，并从我们的计算中删除了索引病例，以避免混淆。通过分析350多篇论文，我们估计超过三分之一的感染是真正无症状的。我们发现儿童的无症状性比老年人更强，合并症的无症状性比无基础疾病的低。更大的渐近性在年轻的年龄表明，需要提高警惕，这些人，以防止蔓延到更广泛的社区。量化无症状感染者是有效应对COVID-19大流行的公共卫生基础。关于渐近性程度的不确定性源于术语的不一致以及指数和次要病例的合并，这些合并偏向于较低的渐近性。我们检索了2020年1月1日至2021年4月2日期间关于COVID-19的PubMed、Embase、Web of Science和世界卫生组织全球研究数据库，以确定在检测时报告无症状感染的研究，无论是症状前感染还是无症状感染。删除了索引病例，以尽量减少可能导致高估重复性的代表性偏倚。通过分析350多项研究，我们估计从未出现临床症状的感染比例为35.1%（95% CI：30.7 - 39.9%）。在检测时，42.8%（95%预测区间：5.2%至91.1%）的病例没有表现出任何症状，其中包括无症状感染和症状前感染。老年人的动脉粥样硬化性显著较低，为19.7%（95% CI：12.7 - 29.4%），而儿童为46.7%（95% CI：32.0 - 62.0%）。我们还发现，与无基础疾病的病例相比，合并症的病例的渐近性显著降低。如果没有主动发现无症状感染的政策，如快速接触者追踪，即使在接种疫苗的情况下，也可能需要长期努力控制大流行。
Asymptomatic infections have been widely reported for COVID-19. However, many studies do not distinguish between the presymptomatic stage and truly asymptomatic infections. We conducted a systematic review and meta-analysis of COVID-19 literature reporting laboratory-confirmed infections to determine the burden of asymptomatic infections and removed index cases from our calculations to avoid conflation. By analyzing over 350 papers, we estimated that more than one-third of infections are truly asymptomatic. We found evidence of greater asymptomaticity in children compared with the elderly, and lower asymptomaticity among cases with comorbidities compared to cases with no underlying medical conditions. Greater asymptomaticity at younger ages suggests that heightened vigilance is needed among these individuals, to prevent spillover into the broader community. 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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影响因子：
8.5
作者：
Adorni F;Prinelli F;Bianchi F;Giacomelli A;Pagani G;Bernacchia D;Rusconi S;Maggi S;Trevisan C;Noale M;Molinaro S;Bastiani L;Fortunato L;Jesuthasan N;Sojic A;Pettenati C;Tavio M;Andreoni M;Mastroianni C;Antonelli Incalzi R;Galli M
通讯作者：
Galli M
影响因子：
4.5
作者：
Passarelli VC;Faico-Filho K;Moreira LVL;Luna LKS;Conte DD;Camargo C;Perosa AH;Bellei N
通讯作者：
Bellei N
DOI：
10.11604/pamj.supp.2020.37.28.26312
发表时间：
2020
期刊：
The Pan African medical journal
影响因子：
--
作者：
Adetola HH;Ishola D;Afolabi MO;Bangura J;Sesay IG;Pearce R;Garrick I;Kamara B;Leigh B;Greenwood B;Watson-Jones D
通讯作者：
Watson-Jones D
影响因子：
15.1
作者：
Almazeedi, Sulaiman;Al-Youha, Sarah;Al-Sabah, Salman
通讯作者：
Al-Sabah, Salman
影响因子：
1.8
作者：
Agresti, A;Coull, BA
通讯作者：
Coull, BA