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      The epidemiological and radiographical characteristics of asymptomatic infections with the novel coronavirus ( COVID-19): A systematic review and meta-analysis

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          Highlights

          • To provide a quantified understanding of the proportion of asymptomatic individuals among the COVID-19 infections.

          • To describe the targeted population who is prone to present asymptomatic.

          • The results in this study could be conductive to developing prevention and control strategies for asymptomatic individuals.

          Abstract

          Objectives

          The role of asymptomatic infections in the transmission of COVID-19 have drawn considerable attention. Here, we performed a meta-analysis to summarize the epidemiological and radiographical characteristics of asymptomatic infections with COVID-19.

          Methods

          Data on the epidemiological and radiographical characteristics of asymptomatic infections were extracted. Pooled proportions with 95% confidence intervals were calculated using a random effects model.

          Results

          A total of 104 studies involving 20,152 cases were included. The proportion of asymptomatic individuals among those with COVID-19 was 13.34% (10.86%-16.29%), among which the presymptomatic and covert infections were 7.64% (4.02%-14.04%) and 8.44% (5.12%-13.62%), respectively. The proportions of asymptomatic infections among infected children and healthcare workers were 32.24% (23.08%-42.13%) and 36.96% (18.51%-60.21%), respectively. The proportion of asymptomatic infections was significantly higher after 2020/02/29 than before (33.53% vs 10.19%) and in non-Asian regions than in Asia (28.76% vs 11.54%). The median viral shedding duration of asymptomatic infections was 14.14 days (11.25-17.04). A total of 47.62% (31.13%-72.87%) of asymptomatic infections showed lung abnormalities, especially ground-glass opacity 41.11% (19.7%-85.79%).

          Conclusions

          Asymptomatic infections were more often found in infected children and healthcare workers, and they increased after 2020/02/29 and in non-Asian regions. Chest radiographical imaging could be conducive to early identification of asymptomatic infections.

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          Author and article information

          Journal
          Int J Infect Dis
          Int J Infect Dis
          International Journal of Infectious Diseases
          The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.
          1201-9712
          1878-3511
          12 January 2021
          12 January 2021
          Affiliations
          [a ]State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, China
          [b ]Department of Laboratory Medicine, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, No 600 Yishan Road, Shanghai 200233, China
          [c ]Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06520, USA
          Author notes
          [* ]Corresponding authors at: 79 Qingchun Road, Hangzhou, China.
          [** ]Corresponding author at: Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06520, USA.
          [1]

          Can Chen and Changtai Zhu contributed equally.

          Article
          S1201-9712(21)00027-8
          10.1016/j.ijid.2021.01.017
          7833455
          33444755
          05dfe957-89a2-49b5-91ad-4f56fe015c48
          © 2021 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.

          Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

          History
          : 19 June 2020
          : 4 January 2021
          : 6 January 2021
          Categories
          Article

          Infectious disease & Microbiology
          covid-19,asymptomatic,presymptomatic,covert infections,epidemiological characteristics,radiographical findings

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