Mourmouris Panagiotis, Tzelves Lazaros, Roidi Christiana, Fotsali Anastasia
Second Department of Urology, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Osong Public Health Res Perspect. 2021 Apr;12(2):54-63. doi: 10.24171/j.phrp.2021.12.2.02. Epub 2021 Apr 29.
The objective of this study was to identify the potential and definite sources of transmission of coronavirus disease 2019 (COVID-19).
Due to time constraints and the acute nature of the pandemic, we searched only PubMed/Medline from inception until January 28, 2021. We analyzed the level of evidence and risk of bias in each category and made suggestions accordingly.
The virus was traced from its potential origin via possible ways of transmission to the last host. Symptomatic human-to-human transmission remains the driver of the epidemic, but asymptomatic transmission can potentially contribute in a substantial manner. Feces and fomites have both been found to contain viable virus; even though transmission through these routes has not been documented, their contribution cannot be ruled out. Finally, transmission from pregnant women to their children has been found to be low (up to 3%).
Even though robust outcomes cannot be easily assessed, medical personnel must maintain awareness of the main routes of transmission (via droplets and aerosols from even asymptomatic patients). This is the first attempt to systematically review the existing knowledge to produce a paper with a potentially significant clinical impact.
本研究的目的是确定2019冠状病毒病（COVID-19）的潜在和确定传播源。
由于时间限制和疫情的紧迫性，我们仅检索了从创刊至2021年1月28日的PubMed/Medline。我们分析了每类研究的证据水平和偏倚风险，并据此提出建议。
病毒从其潜在起源地通过可能的传播途径追踪至最后宿主。有症状的人传人仍是疫情的驱动因素，但无症状传播可能也起到了很大作用。粪便和污染物均被发现含有活病毒；尽管尚未记录通过这些途径的传播，但不能排除它们的作用。最后，已发现孕妇传给其子女的传播率较低（高达3%）。
尽管难以轻易评估确切结果，但医务人员必须对主要传播途径（即使来自无症状患者的飞沫和气溶胶）保持警惕。这是首次系统回顾现有知识以撰写一篇可能具有重大临床影响的论文。
