Ci Zhang , Chao Zhou , Wanqing Xu , Shimin Zheng , Yanxiao Gao , Peiqi Li , Luojia Deng , Xuezhixing Zhang , Qianxue Jiang , Frank Qian , Xianhong Li , Honghong Wang , Huachun Zou , Yinglin Xia , Tao Wang , Hui Lu , Han-Zhu Qian
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The risk ratios (RRs) were calculated using random-effects models.</p></div><div><h3>Results</h3><p>Of 4923 records retrieved and reviewed, 15 studies including 3917 close contacts with asymptomatic indexes were eligible. The pooled transmission rates were 1.79 per 100 person-days (or 1.79%, 95% confidence interval [CI] 0.41%–3.16%) by asymptomatic index, which is significantly lower than by presymptomatic (5.02%, 95% CI 2.37%–7.66%; <em>p</em><0.001), and by symptomatic (5.27%, 95% CI 2.40%–8.15%; <em>p</em><0.001). Subgroup analyses showed that the household transmission rate of asymptomatic index was (4.22%, 95% CI 0.91%–7.52%), four times significantly higher than non-household transmission (1.03%, 95% CI 0.73%–1.33%; <em>p</em>=0.03), and the asymptomatic transmission rate in China (1.82%, 95% CI 0.11%–3.53%) was lower than in other countries (2.22%, 95% CI 0.67%–3.77%; <em>p</em>=0.01).</p></div><div><h3>Conclusions</h3><p>People with asymptomatic SARS-CoV-2 infection are at risk of transmitting the virus to their close contacts, particularly in household settings. The transmission potential of asymptomatic infection is lower than symptomatic and presymptomatic infections. This meta-analysis provides evidence for predicting the epidemic trend and promulgating vaccination and other control measures. 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引用次数: 0
摘要
背景需要综合全球关于无症状严重急性呼吸系统综合征冠状病毒2型感染传播的证据。方法检索截至2021年1月24日的4个电子数据库（PubMed、EMBASE、Cochrane Library和Web of Science数据库）。遵循系统评价和荟萃分析（PRISMA）指南的首选报告项目。包括报告无症状严重急性呼吸系统综合征冠状病毒2型病例密切接触者传播率的研究，并考虑了发生的传播活动。传播率由零膨胀的β分布汇总。使用随机效应模型计算风险比（RR）。结果在检索和审查的4923份记录中，15项研究符合条件，包括3917名无症状指数的密切接触者。按无症状指数计算，合并传播率为1.79/100人日（或1.79%，95%置信区间[CI]0.41%~3.16%），显著低于症状前（5.02%，95%可信区间2.37%-7.66%；p<；0.001），亚组分析显示，无症状指数的家庭传播率为（4.22%，95%CI 0.91%-7.52%），是非家庭传播的四倍（1.03%，95%CI 0.73%-133%；p=0.03），中国的无症状传播率（1.82%，95%CI0.11%-3.53%）低于其他国家（2.22%，95%CI0.67%-37.77%；p=0.01）。结论无症状严重急性呼吸系统综合征冠状病毒2型感染者有将病毒传播给其密切接触者的风险，尤其是在家庭环境中。无症状感染的传播潜力低于有症状和症状前感染。该荟萃分析为预测疫情趋势、公布疫苗接种和其他控制措施提供了证据。在PROSPERO国际系统评价前瞻性注册处注册，CRD42021269446；https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=269446.
Transmission risk of asymptomatic SARS-CoV-2 infection: a systematic review and meta-analysis
Background
Global evidence on the transmission of asymptomatic SARS-CoV-2 infection needs to be synthesized.
Methods
A search of 4 electronic databases (PubMed, EMBASE, Cochrane Library, and Web of Science databases) as of January 24, 2021 was performed. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Studies which reported the transmission rate among close contacts with asymptomatic SARS-CoV-2 cases were included, and transmission activities occurred were considered. The transmission rates were pooled by zero-inflated beta distribution. The risk ratios (RRs) were calculated using random-effects models.
Results
Of 4923 records retrieved and reviewed, 15 studies including 3917 close contacts with asymptomatic indexes were eligible. The pooled transmission rates were 1.79 per 100 person-days (or 1.79%, 95% confidence interval [CI] 0.41%–3.16%) by asymptomatic index, which is significantly lower than by presymptomatic (5.02%, 95% CI 2.37%–7.66%; p<0.001), and by symptomatic (5.27%, 95% CI 2.40%–8.15%; p<0.001). Subgroup analyses showed that the household transmission rate of asymptomatic index was (4.22%, 95% CI 0.91%–7.52%), four times significantly higher than non-household transmission (1.03%, 95% CI 0.73%–1.33%; p=0.03), and the asymptomatic transmission rate in China (1.82%, 95% CI 0.11%–3.53%) was lower than in other countries (2.22%, 95% CI 0.67%–3.77%; p=0.01).
Conclusions
People with asymptomatic SARS-CoV-2 infection are at risk of transmitting the virus to their close contacts, particularly in household settings. The transmission potential of asymptomatic infection is lower than symptomatic and presymptomatic infections. This meta-analysis provides evidence for predicting the epidemic trend and promulgating vaccination and other control measures. Registered with PROSPERO International Prospective Register of Systematic Reviews, CRD42021269446; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=269446.
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