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http://conacyt.repositorioinstitucional.mx/jspui/handle/1000/8490| Asymptomatic SARS-CoV-2 infections: a living systematic review and meta-analysis | |
| Diana Buitrago-Garcia Dianne Egli-Gany Michel Jacques Counotte Stefanie Hossmann Hira Imeri Aziz Mert Ipekci Georgia Salanti Nicola Low | |
| Acceso Abierto | |
| Atribución-NoComercial-SinDerivadas | |
| https://doi.org/10.1101/2020.04.25.20079103 | |
| https://www.medrxiv.org/content/10.1101/2020.04.25.20079103v3 | |
| BACKGROUND There is disagreement about the level of asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We conducted a living systematic review and meta-analysis to address three questions: 1. amongst people who become infected with SARS-CoV-2, what proportion does not experience symptoms at all during their infection? 2. Amongst people with SARS-CoV-2 infection who are asymptomatic when diagnosed, what proportion will develop symptoms later? 3. What proportion of SARS-CoV-2 transmission is accounted for by people who are either asymptomatic throughout infection, or pre-symptomatic? METHODS AND FINDINGS We searched PubMed, Embase, bioRxiv and medRxiv using a database of SARS-CoV-2 literature that is updated daily, on 25 March 2020, 20 April 2020 and 10 June 2020. Studies of people with SARS-CoV-2 diagnosed by reverse transcriptase PCR that documented follow-up and symptom status at the beginning and end of follow-up, or modelling studies were included. One reviewer extracted data and a second verified the extraction, with disagreement resolved by discussion or a third reviewer. Risk of bias in empirical studies was assessed with an adapted checklist for case series and the relevance and credibility of modelling studies were assessed using a published checklist. We included a total of 94 studies. The overall estimate of the proportion of people who become infected with SARS-CoV-2 and remain asymptomatic throughout infection was 20% (95% CI 17-25) with a prediction interval of 3-67% in 79 studies that addressed this review question. There was some evidence that biases in the selection of participants influence the estimate. In seven studies of defined populations screened for SARS-CoV-2 and then followed, 31% (95% CI 26-37%, prediction interval 24-38%) remained asymptomatic. The proportion of people that is pre-symptomatic could not be summarised, owing to heterogeneity. The secondary attack rate was slightly lower in contacts of people with asymptomatic infection than those with symptomatic infection (relative risk 0.35, 95% CI 0.10-1.27). Modelling studies fit to data found a higher proportion of all SARS-CoV-2 infections resulting from transmission from pre-symptomatic individuals than from asymptomatic individuals. Limitations of the review include that most included studies were not designed to estimate the proportion of asymptomatic SARS-CoV-2 infections and were at risk of selection biases, we did not consider the pos | |
| 28-07-2020 | |
| Preimpreso | |
| Inglés | |
| Público en general | |
| VIRUS RESPIRATORIOS | |
| Versión publicada | |
| publishedVersion - Versión publicada | |
| Aparece en las colecciones: | Materiales de Consulta y Comunicados Técnicos |
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| Asymptomatic SARS-CoV-2 infections a living systematic review and meta-analysis.pdf | 2.02 MB | Adobe PDF | Visualizar/Abrir |