Magnitude of asymptomatic COVID-19 cases throughout the course of infection: A systematic review and meta-analysis.

<h4>Background</h4>Asymptomatic SARS-CoV-2 infections are responsible for potentially significant transmission of COVID-19. Worldwide, a number of studies were conducted to estimate the magnitude of asymptomatic COVID-19 cases. However, there is a need for more robust and well-designed s...

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Main Authors: Muluneh Alene, Leltework Yismaw, Moges Agazhe Assemie, Daniel Bekele Ketema, Belayneh Mengist, Bekalu Kassie, Tilahun Yemanu Birhan
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2021-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0249090&type=printable
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author Muluneh Alene
Leltework Yismaw
Moges Agazhe Assemie
Daniel Bekele Ketema
Belayneh Mengist
Bekalu Kassie
Tilahun Yemanu Birhan
author_facet Muluneh Alene
Leltework Yismaw
Moges Agazhe Assemie
Daniel Bekele Ketema
Belayneh Mengist
Bekalu Kassie
Tilahun Yemanu Birhan
author_sort Muluneh Alene
collection DOAJ
description <h4>Background</h4>Asymptomatic SARS-CoV-2 infections are responsible for potentially significant transmission of COVID-19. Worldwide, a number of studies were conducted to estimate the magnitude of asymptomatic COVID-19 cases. However, there is a need for more robust and well-designed studies to have a relevant public health intervention. Synthesis of the available studies significantly strengthens the quality of evidences for public health practice. Thus, this systematic review and meta-analysis aimed to determine the overall magnitude of asymptomatic COVID-19 cases throughout the course of infection using available evidences.<h4>Methods</h4>We followed the PRISMA checklist to present this study. Two experienced review authors (MA and DBK) were systematically searched international electronic databases for studies. We performed meta-analysis using R statistical software. The overall weighted proportion of asymptomatic COVID-19 cases throughout the course infection was computed. The pooled estimates with 95% confidence intervals were presented using forest plot. Egger's tests were used to assess publication bias, and primary estimates were pooled using a random effects model. Furthermore, a sensitivity analysis was conducted to assure the robustness of the result.<h4>Results</h4>A total of 28 studies that satisfied the eligibility criteria were included in this systematic review and meta-analysis. Consequently, in the meta-analysis, a total of 6,071 COVID-19 cases were included. The proportion of asymptomatic infections among the included studies ranged from 1.4% to 78.3%. The findings of this meta-analysis showed that the weighted pooled proportion of asymptomatic COVID-19 cases throughout the course of infection was 25% (95%CI: 16-38). The leave-one out result also revealed that the weighted pooled average of asymptomatic SARS-CoV-2 infection was between 28% and 31.4%.<h4>Conclusions</h4>In conclusion, one-fourth of SARS-CoV-2 infections are remained asymptomatic throughout the course infection. Scale-up of testing, which targeting high risk populations is recommended to tackle the pandemic.
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spelling doaj-art-64969fc0a8c74480bcec864478cd17cb2025-08-20T02:00:51ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01163e024909010.1371/journal.pone.0249090Magnitude of asymptomatic COVID-19 cases throughout the course of infection: A systematic review and meta-analysis.Muluneh AleneLeltework YismawMoges Agazhe AssemieDaniel Bekele KetemaBelayneh MengistBekalu KassieTilahun Yemanu Birhan<h4>Background</h4>Asymptomatic SARS-CoV-2 infections are responsible for potentially significant transmission of COVID-19. Worldwide, a number of studies were conducted to estimate the magnitude of asymptomatic COVID-19 cases. However, there is a need for more robust and well-designed studies to have a relevant public health intervention. Synthesis of the available studies significantly strengthens the quality of evidences for public health practice. Thus, this systematic review and meta-analysis aimed to determine the overall magnitude of asymptomatic COVID-19 cases throughout the course of infection using available evidences.<h4>Methods</h4>We followed the PRISMA checklist to present this study. Two experienced review authors (MA and DBK) were systematically searched international electronic databases for studies. We performed meta-analysis using R statistical software. The overall weighted proportion of asymptomatic COVID-19 cases throughout the course infection was computed. The pooled estimates with 95% confidence intervals were presented using forest plot. Egger's tests were used to assess publication bias, and primary estimates were pooled using a random effects model. Furthermore, a sensitivity analysis was conducted to assure the robustness of the result.<h4>Results</h4>A total of 28 studies that satisfied the eligibility criteria were included in this systematic review and meta-analysis. Consequently, in the meta-analysis, a total of 6,071 COVID-19 cases were included. The proportion of asymptomatic infections among the included studies ranged from 1.4% to 78.3%. The findings of this meta-analysis showed that the weighted pooled proportion of asymptomatic COVID-19 cases throughout the course of infection was 25% (95%CI: 16-38). The leave-one out result also revealed that the weighted pooled average of asymptomatic SARS-CoV-2 infection was between 28% and 31.4%.<h4>Conclusions</h4>In conclusion, one-fourth of SARS-CoV-2 infections are remained asymptomatic throughout the course infection. Scale-up of testing, which targeting high risk populations is recommended to tackle the pandemic.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0249090&type=printable
spellingShingle Muluneh Alene
Leltework Yismaw
Moges Agazhe Assemie
Daniel Bekele Ketema
Belayneh Mengist
Bekalu Kassie
Tilahun Yemanu Birhan
Magnitude of asymptomatic COVID-19 cases throughout the course of infection: A systematic review and meta-analysis.
PLoS ONE
title Magnitude of asymptomatic COVID-19 cases throughout the course of infection: A systematic review and meta-analysis.
title_full Magnitude of asymptomatic COVID-19 cases throughout the course of infection: A systematic review and meta-analysis.
title_fullStr Magnitude of asymptomatic COVID-19 cases throughout the course of infection: A systematic review and meta-analysis.
title_full_unstemmed Magnitude of asymptomatic COVID-19 cases throughout the course of infection: A systematic review and meta-analysis.
title_short Magnitude of asymptomatic COVID-19 cases throughout the course of infection: A systematic review and meta-analysis.
title_sort magnitude of asymptomatic covid 19 cases throughout the course of infection a systematic review and meta analysis
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0249090&type=printable
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