The role of asymptomatic and pre-symptomatic infection in SARS-CoV-2 transmission—a living systematic review

Qiu, Xueting; Nergiz, Ali İhsan; Maraolo, Alberto Enrico; Bogoch, Isaac I.; Low, Nicola; Çevik, Müge

doi:10.1016/j.cmi.2021.01.011

Cited by 125 publications

(132 citation statements)

References 87 publications

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“…[27][28][29][30] Airborne transmission coupled with virus shedding in asymptomatic and presymptomatic persons, which has been shown to cause secondary attack rates of up to 32%, are other factors that likely contributed to the increased seroprevalence in this group. 31 Our observation is consistent with the Birmingham study, which reported the highest rate in housekeeping staff, with a prevalence of 34.5%, compared to 44% in this study. 6 Similar reasons for high seropositivity rates apply to the two groups of allied HCWs (eg, medical assistants and patient care technicians, social workers, nutritionists and therapists), whose job functions place them in intermittent but significant proximity with inpatients and outpatients.…”

Section: Discussionsupporting

confidence: 92%

SARS‐CoV‐2 Seroprevalence Among Healthcare Workers by Job Function and Work Location in a New York Inner‐City Hospital

Purswani¹,

Bucciarelli

Tiburcio

et al. 2021

Journal of Hospital Medicine

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OBJECTIVE: To describe the seroprevalence and risk for SARS-CoV-2 among healthcare workers (HCWs) by job function and work location following the pandemic’s first wave in New York City (NYC). METHODS: A cross-sectional study conducted between May 18 and June 26, 2020, during which HCWs at a large inner-city teaching hospital in NYC received voluntary antibody testing. The main outcome was presence of SARS-CoV-2 antibodies indicating previous infection. Seroprevalence and adjusted odds ratios (aORs) for seropositivity by type and location of work were calculated using logistic regression analyses. RESULTS: Of 2,749 HCWs tested, 831 tested positive, yielding a crude seroprevalence of 30.2% (95% CI, 29%-32%). Seroprevalence ranged from 11.1% for pharmacy staff to 44.0% for nonclinical HCWs comprised of patient transporters and housekeeping and security staff, with 37.5% for nurses and 20.9% for administrative staff. Compared to administrative staff, aORs (95% CIs) for seropositivity were 2.54 (1.64-3.94) for nurses; 2.51 (1.42-4.43) for nonclinical HCWs; between 1.70 and 1.83 for allied HCWs such as patient care technicians, social workers, registration clerks and therapists; and 0.80 (0.50-1.29) for physicians. Compared to office locations, aORs for the emergency department and inpatient units were 2.27 (1.53-3.37) and 1.48 (1.14-1.92), respectively. CONCLUSION: One-third of hospital-based HCWs were seropositive for SARS-CoV-2 by the end of the first wave in NYC. Seroprevalence differed by job function and work location, with the highest estimated risk for nurses and the emergency department, respectively. These findings support current nationwide policy prioritizing HCWs for receipt of newly authorized COVID-19 vaccines.

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Section: Discussionsupporting

confidence: 92%

SARS‐CoV‐2 Seroprevalence Among Healthcare Workers by Job Function and Work Location in a New York Inner‐City Hospital

Purswani¹,

Bucciarelli

Tiburcio

et al. 2021

Journal of Hospital Medicine

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“…Finally, the differences in pandemic scale between Poland and other countries may be due to the political decisions to test only symptomatic patients [ 12 ] and the lack of free tests for the presence of novel coronavirus for the general population. This excludes individuals with asymptomatic SARS-CoV-2 infection from official statistics and does not prevent emergence of new epidemic foci, since the asymptomatic SARS-CoV-2 infected persons still can infect others [ 3 , 15 , 16 ]. Furthermore, according to our results, as well as data presented by others, the asymptomatic rate can range from 20% to up to 80% [ 17 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Anti-SARS-CoV-2 Antibodies in Poznań, Poland, after the First Wave of the COVID-19 Pandemic

et al. 2021

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In comparison to other European countries, during the first months of the COVID-19 pandemic, Poland reported a relatively low number of confirmed cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. To estimate the scale of the pandemic in Poland, a serosurvey of antibodies against SARS-CoV-2 was performed after the first wave of COVID-19 in Europe (March–May 2020). Within this study, we collected samples from 28 July to 24 September 2020 and, based on the ELISA results, we found that 1.67% (25/1500, 95% CI 1.13–2.45) of the Poznan (Poland) metropolitan area’s population had antibodies against SARS-CoV-2 after the first wave of COVID-19. However, the presence of anti-SARS-CoV-2 IgG antibodies was confirmed with immunoblotting in 56% (14/25) samples, which finally resulted in a decrease in seroprevalence, i.e., 0.93% (14/1500, 95% CI 0.56–1.56). The positive anti-SARS-CoV-2 IgG results were associated with age, occupation involving constant contact with people, travelling abroad, non-compliance with epidemiological recommendations and direct contact with the novel coronavirus. Our findings confirm the low SARS-CoV-2 incidence in Poland and imply that the population had little herd immunity heading into the second and third wave of the pandemic, and therefore, that herd immunity contributed little to preventing the high numbers of SARS-CoV-2 infections and COVID-19-related deaths in Poland during these subsequent waves.

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“…Available data suggest that they have a similar viral load, 17,18 with conflicting reports about comparative duration of viral shedding. 16,18,19 However, even though their infectivity might be lower, 5 asymptomatics probably account for a substantial fraction of new infections, still not well quantified, 20 constituting a challenge in the prevention of transmission. In addition, the effect of SARS-CoV-2 vaccines on asymptomatic infections is still under study .…”

Section: Discussionmentioning

confidence: 99%

“…INTRODUCTION Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) results in a wide range of clinical manifestations. 1,2 While most infected individuals show symptoms of coronavirus disease 2019 (COVID- 19), around one third remain asymptomatic 3,4 and, despite their lower secondary attack rate, 5 constitute a serious challenge for the control of the pandemic. Little is known about the factors associated with asymptomatic SARS-CoV-2 infection, as most studies are based on clinical COVID-19 cases.…”

mentioning

confidence: 99%

ENE-COVID nationwide serosurvey served to characterize asymptomatic infections and to develop a symptom-based risk score to predict COVID-19

Pérez‐Gómez¹,

Pastor-Barriuso²,

Pérez‐Olmeda³

et al. 2021

Journal of Clinical Epidemiology

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The role of asymptomatic and pre-symptomatic infection in SARS-CoV-2 transmission—a living systematic review

Cited by 125 publications

References 87 publications

SARS‐CoV‐2 Seroprevalence Among Healthcare Workers by Job Function and Work Location in a New York Inner‐City Hospital

SARS‐CoV‐2 Seroprevalence Among Healthcare Workers by Job Function and Work Location in a New York Inner‐City Hospital

Prevalence of Anti-SARS-CoV-2 Antibodies in Poznań, Poland, after the First Wave of the COVID-19 Pandemic

ENE-COVID nationwide serosurvey served to characterize asymptomatic infections and to develop a symptom-based risk score to predict COVID-19

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