The Proportion of Asymptomatic Cases Among SARS-CoV-2 Infected Patients: A Systematic Review
European Journal of Clinical and Biomedical Sciences
Volume 6, Issue 5, October 2020, Pages: 84-89
Received: Aug. 4, 2020;
Accepted: Aug. 21, 2020;
Published: Sep. 7, 2020
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Abdi Birhanu, School of Medicine, Haramaya University, Harar, Ethiopia
Teka Obsa Feyisa, School of Medicine, Haramaya University, Harar, Ethiopia
Getahun Chala, School of Medicine, Haramaya University, Harar, Ethiopia
Even though some reports unveiled that coronavirus 2019 (COVID-19) cases can be manifested as asymptomatic, there is limited information on how much these cases are significant. Understanding the possible proportion of asymptomatic cases among confirmed patients might help in re-considering of who should be tested for the SARS-CoV-2 infection. Therefore, this study was aimed to summarize the proportion of asymptomatic cases among SARS-COV-2 infected people since the outbreak of COVID-19. Methods: Different studies were searched from databases (PubMed, Medline) by using searching terms. Finally, all eligible articles were selected by using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 flow diagram. Results: A total of 14 articles that reported asymptomatic cases of COVID-19 were included in this systematic review. The sample size of the studies was ranged from 8 to 2143. Out of the total cases, the overall proportion of asymptomatic cases was 25.9% that ranged from 3.23% to 78%. This systematic review also summarized that there was 17. 6%, 4.8%, and 3.23% to 62.2% of asymptomatic cases among pregnant mothers, children, and the adult general population, respectively. Conclusion and Remarks: This review showed that the proportion of asymptomatic SARS-CoV-2 infected people is high. Hence, to tackle COVID-19, all concerned bodies should strengthen the screening of asymptomatic cases as part of contact tracing efforts.
Teka Obsa Feyisa,
The Proportion of Asymptomatic Cases Among SARS-CoV-2 Infected Patients: A Systematic Review, European Journal of Clinical and Biomedical Sciences.
Vol. 6, No. 5,
2020, pp. 84-89.
Kuiken T, Fouchier RA, Schutten M, Rimmelzwaan GF, Van Amerongen G, van Riel D, et al. Newly discovered coronavirus as the primary cause of the severe acute respiratory syndrome. The Lancet. 2003; 362 (9380): 263-70.
Drosten C, Günther S, Preiser W, Van Der Werf S, Brodt H-R, Becker S, et al. Identification of a novel coronavirus in patients with severe acute respiratory syndrome. New England journal of medicine. 2003; 348 (20): 1967-76.
de Groot RJ, Baker SC, Baric RS, Brown CS, Drosten C, Enjuanes L, et al. Commentary: Middle East respiratory syndrome coronavirus (MERS-CoV): Announcement of the Coronavirus Study Group. Journal of virology. 2013; 87 (14): 7790-2.
Guo Y-R, Cao Q-D, Hong Z-S, Tan Y-Y, Chen S-D, Jin H-J, et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak–an update on the status. Military Medical Research. 2020; 7 (1): 1-10.
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet. 2020; 395 (10223): 507-13.
Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. New England Journal of Medicine. 2020.
ECfDPaC E. Novel coronavirus disease 2019 (COVID-19) pandemic: increased transmission in the EU/EEA and the UK – sixth update 12 March 2020. COVID-19 2020 [cited 2020 25 March]. 2020.
WHO 2020a. Coronavirus disease 2019 (COVID-19): situation report, 140.
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet. 2020.
Hu L, Chen S, Fu Y, Gao Z, Long H, Ren H-w, et al. Risk Factors Associated with Clinical Outcomes in 323 COVID-19 Patients in Wuhan, China. medRxiv. 2020.
R L. Risk factors for death from COVID-19 identified in Wuhan patients. Medscape. 2020.
Risk assessment: Coronavirus disease 2019 (COVID-19) pandemic: increased transmission in the EU/EEA and the UK- eighth update. 2020.
WHO. Laboratory testing for coronavirus disease 2019 (COVID-19) in suspected human cases: interim guidance, 2 March 2020. 2020.
Adhikari SP, Meng S, Wu Y-J, Mao Y-P, Ye R-X, Wang Q-Z, et al. Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: a scoping review. Infectious Diseases of Poverty. 2020; 9 (1): 1-12.
Cascella M, Rajnik M, Cuomo A, Dulebohn SC, Di Napoli R. Features, evaluation and treatment coronavirus (COVID-19). StatPearls [Internet]: StatPearls Publishing; 2020.
Zhu Y, Chen YQ. On a Statistical Transmission Model in Analysis of the Early Phase of COVID-19 Outbreak. Statistics in Biosciences. 2020: 1-17.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009; 6 (7): e1000097.
Chen R, Zhang Y, Huang L, Cheng BH, Xia ZY, Meng QT. Safety and efficacy of different anesthetic regimens for parturients with COVID-19 undergoing Cesarean delivery: a case series of 17 patients. Can J Anaesth. 2020: 1-9.
Chen J, Qi T, Liu L, Ling Y, Qian Z, Li T, et al. Clinical progression of patients with COVID-19 in Shanghai, China. J Infect. 2020.
Mizumoto K, Kagaya K, Zarebski A, Chowell G. Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020. Euro Surveill. 2020; 25 (10).
Spiteri G, Fielding J, Diercke M, Campese C, Enouf V, Gaymard A, et al. First cases of coronavirus disease 2019 (COVID-19) in the WHO European Region, 24 January to 21 February 2020. Euro Surveill. 2020; 25 (9).
Gostic K, Gomez AC, Mummah RO, Kucharski AJ, Lloyd-Smith JO. Estimated effectiveness of symptom and risk screening to prevent the spread of COVID-19. Elife. 2020; 9.
Xing Y, Mo P, Xiao Y, Zhao O, Zhang Y, Wang F. Post-discharge surveillance and positive virus detection in two medical staff recovered from coronavirus disease 2019 (COVID-19), China, January to February 2020. Euro Surveill. 2020; 25 (10).
Hasan A, Mehmood N, Fergie J. Coronavirus Disease (COVID-19) and Pediatric Patients: A Review of Epidemiology, Symptomatology, Laboratory and Imaging Results to Guide the Development of a Management Algorithm. Cureus. 2020; 12 (3): e7485.
Li K, Fang Y, Li W, Pan C, Qin P, Zhong Y, et al. CT image visual quantitative evaluation and clinical classification of coronavirus disease (COVID-19). Eur Radiol. 2020.
Day M. Covid-19: four fifths of cases are asymptomatic, China figures indicate. Bmj. 2020; 369: 1375.
Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and epidemiological features of children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study. Lancet Infect Dis. 2020.
Nishiura H, Kobayashi T, Yang Y, Hayashi K, Miyama T, Kinoshita R, et al. The Rate of Underascertainment of Novel Coronavirus (2019-nCoV) Infection: Estimation Using Japanese Passengers Data on Evacuation Flights. J Clin Med. 2020; 9 (2).
Arons MM, Hatfield KM, Reddy SC, Kimball A, James A, Jacobs JR, et al. Presymptomatic SARS-CoV-2 infections and transmission in a skilled nursing facility. New England journal of medicine. 2020.
Kim SE, Jeong HS, Yu Y, Shin SU, Kim S, Oh TH, et al. Viral kinetics of SARS-CoV-2 in asymptomatic carriers and presymptomatic patients. International Journal of Infectious Diseases. 2020.
Ma Y, Xu Q-n, Wang F-l, Ma X-m, Wang X-y, Zhang X-g, et al. Characteristics of asymptomatic patients with SARS-CoV-2 infection in Jinan, China. Microbes and Infection. 2020.