Open AccessAsymptomatic SARS-CoV-2 infection: A systematic review and meta-analysis
Author(s) -
Pratha Sah,
Meagan C. Fitzpatrick,
Charlotte Zimmer,
Elaheh Abdollahi,
Lyndon Juden-Kelly,
Seyed M. Moghadas,
Burton H. Singer,
Alison P. Galvani
Publication year - 2021
Publication title -
proceedings of the national academy of sciences of the united states of america
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.011
H-Index - 771
eISSN - 1091-6490
pISSN - 0027-8424
DOI - 10.1073/pnas.2109229118
Subject(s) - asymptomatic , medicine , contact tracing , pandemic , meta analysis , public health , medline , vaccination , pediatrics , covid-19 , immunology , disease , pathology , infectious disease (medical specialty) , biology , biochemistry
Significance 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.