Towards an accurate and systematic characterisation of persistently asymptomatic infection with SARS-CoV-2.
Towards an accurate and systematic characterisation of persistently asymptomatic infection with SARS-CoV-2.
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朝着准确和系统地描述持续无症状的SARS-CoV-2感染的方向
DOI：
10.1016/s1473-3099(20)30837-9
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发表时间：
2021-06
期刊：
影响因子：
--
通讯作者：
Cevik M
中科院分区：
文献类型：
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作者：
Meyerowitz EA;Richterman A;Bogoch II;Low N;Cevik M
持续无症状的严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）感染者在整个感染过程中没有症状，症状前个体在报告症状前几天就具有传染性。SARS-CoV-2从没有症状的个体传播有助于大流行的传播，但从持续无症状的个体传播的程度仍然未知。我们描述了三个方法上的问题，阻碍试图估计这一比例。首先，不完全的症状评估可能高估了无症状的分数。其次，随访不充分的研究对症状前个体进行了错误分类。第三，血清学研究可能会识别出以前未被识别的感染者，但依赖于定义不清的抗体反应和回顾性症状评估可能会导致错误分类。我们提供有关定义、检测、记录和随访的建议，以改善对持续无症状SARS-CoV-2感染者及其接触者的识别和评估。准确描述感染者中持续无症状部分的特征可能有助于了解COVID-19的发病机制和传播动态，并为公共卫生应对提供信息。
People with persistently asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection experience no symptoms throughout the course of infection, and pre-symptomatic individuals become infectious days before they report symptoms. Transmission of SARS-CoV-2 from individuals without symptoms contributes to pandemic spread, but the extent of transmission from persistently asymptomatic individuals remains unknown. We describe three methodological issues that hinder attempts to estimate this proportion. First, incomplete symptom assessment probably overestimates the asymptomatic fraction. Second, studies with inadequate follow-up misclassify pre-symptomatic individuals. Third, serological studies might identify people with previously unrecognised infection, but reliance on poorly defined antibody responses and retrospective symptom assessment might result in misclassification. We provide recommendations regarding definitions, detection, documentation, and follow-up to improve the identification and evaluation of people with persistently asymptomatic SARS-CoV-2 infection and their contacts. Accurate characterisation of the persistently asymptomatic fraction of infected individuals might shed light on COVID-19 pathogenesis and transmission dynamics, and inform public health responses.