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Asymptomatic SARS-CoV-2 Infection by Age: A Global Systematic Review and Meta-analysis.

Bing Wang1,2, Prabha Andraweera1,2, Salenna Elliott1,2

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The proportion of asymptomatic SARS-CoV-2 infections was 44.1% globally in 2020. Children and adolescents had the highest rates of asymptomatic infection, highlighting the need for targeted public health strategies.

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Area of Science:

  • Epidemiology
  • Infectious Diseases

Background:

  • Asymptomatic SARS-CoV-2 infections pose challenges for epidemic management.
  • Understanding age-specific asymptomatic rates is crucial for public health policy.

Approach:

  • Systematic review and meta-analysis of 38 studies (January-December 2020).
  • Multilevel mixed-effects logistic regression with restricted cubic splines modeled age-specific asymptomatic proportions.
  • Searched PubMed, Embase, medRxiv, and Google Scholar.

Key Points:

  • Overall asymptomatic SARS-CoV-2 infection rate was 44.1% (14,850 cases).
  • Asymptomatic proportion peaked in 13.5-year-olds (36.2%).
  • Rates were lowest in older adults (8.1% at 90.5 years).

Conclusions:

  • High asymptomatic rates in adolescents and young adults necessitate focused public health interventions.
  • These age groups play a significant role in community virus transmission.
  • Heightened vigilance is required to prevent further disease spread.