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J Med Virol . Proportion of asymptomatic coronavirus disease 2019 (COVID-19): a systematic review and meta-analysis

tetano

Editor, Senior Moderator
J Med Virol


. 2020 Jul 21.
doi: 10.1002/jmv.26326. Online ahead of print.
Proportion of asymptomatic coronavirus disease 2019 (COVID-19): a systematic review and meta-analysis


Jingjing He[SUP] 1 [/SUP], Yifei Guo[SUP] 1 [/SUP], Richeng Mao[SUP] 1 [/SUP], Jiming Zhang[SUP] 1 [/SUP]



Affiliations

Abstract

Objective: We aim to systematically review the characteristics of asymptomatic infection in the coronavirus disease 2019 (COVID-19).
Methods: PubMed and EMBASE were electronically searched to identify original studies containing the rate of asymptomatic infection in COVID-19 patients before 20 May 2020. Then mate-analysis was conducted using R version 3.6.2.
Results: A total of 50155 patients from 41 studies with confirmed COVID-19 were included. The pooled percentage of asymptomatic infection is 15.6% (95% CI: 10.1%-23.0%). Ten included studies contain the number of pre-symptomatic patients, who were asymptomatic at screening point and developed symptoms during follow-up. The pooled percentage of pre-symptomatic infection among 180 initially asymptomatic patients is 48.9% (95% CI: 31.6-66.2%). The pooled proportion of asymptomatic infection among 1152 COVID-19 children from 11 studies is 27.7% (95% CI: 16.4-42.7%), which is much higher than patients from all aged groups. Abnormal CT features are common in asymptomatic COVID-19 infection. For 36 patients from 4 studies that CT results were available, 15 (41.7%) patients had bilateral involvement and 14 (38.9%) had unilateral involvement in CT results. Reduced white blood cell count, increased lactate dehydrogenase, and increased C-reactive protein were also recorded.
Conclusion: About 15.6% of confirmed COVID-19 patients are asymptomatic. Nearly half of the patients with no symptoms at detection time will develop symptoms later. Children are likely to have a higher proportion of asymptomatic infection than adults. Asymptomatic COVID-19 patients could have abnormal laboratory and radiational manifestations which can be used as screening strategies to identify asymptomatic infection. This article is protected by copyright. All rights reserved.

Keywords: COVID-19; Coronavirus disease 2019; SARS-CoV-2; asymptomatic infection; children coronavirus disease 2019; pre-symptomatic infection.
 
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