无症状 SARS-CoV-2 感染的年龄分布：一项全球系统综述和荟萃分析。

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

机构信息

From the Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, Adelaide, South Australia, Australia.

Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.

出版信息

Pediatr Infect Dis J. 2023 Mar 1;42(3):232-239. doi: 10.1097/INF.0000000000003791. Epub 2022 Dec 1.

DOI:10.1097/INF.0000000000003791

PMID:36730054

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9935239/

Abstract

BACKGROUND

Asymptomatic SARS-CoV-2 infections have raised concerns for public health policies to manage epidemics. This systematic review and meta-analysis aimed to estimate the age-specific proportion of asymptomatic SARS-CoV-2 infected persons globally by year of age.

METHODS

We searched PubMed, Embase, medRxiv and Google Scholar on September 10, 2020, and March 1, 2021. We included studies conducted during January to December 2020, before routine vaccination against COVID-19. Because we expected the relationship between the asymptomatic proportion and age to be nonlinear, multilevel mixed-effects logistic regression (QR decomposition) with a restricted cubic spline was used to model asymptomatic proportions as a function of age.

RESULTS

A total of 38 studies were included in the meta-analysis. In total, 6556 of 14,850 cases were reported as asymptomatic. The overall estimate of the proportion of people who became infected with SARS-CoV-2 and remained asymptomatic throughout infection was 44.1% (6556/14,850, 95% CI: 43.3%-45.0%). The predicted asymptomatic proportion peaked in children (36.2%, 95% CI: 26.0%-46.5%) at 13.5 years, gradually decreased by age and was lowest at 90.5 years of age (8.1%, 95% CI: 3.4%-12.7%).

CONCLUSIONS

Given the high rates of asymptomatic carriage in adolescents and young adults and their active role in virus transmission in the community, heightened vigilance and public health strategies are needed among these individuals to prevent disease transmission.

摘要

背景

无症状的 SARS-CoV-2 感染引起了人们对管理传染病的公共卫生政策的关注。本系统评价和荟萃分析旨在估计全球按年龄划分的无症状 SARS-CoV-2 感染者的比例。

方法

我们于 2020 年 9 月 10 日和 2021 年 3 月 1 日在 PubMed、Embase、medRxiv 和 Google Scholar 上进行了搜索。我们纳入了 2020 年 1 月至 12 月期间进行的研究，这些研究是在常规接种 COVID-19 疫苗之前进行的。由于我们预计无症状比例与年龄之间的关系是非线性的，因此使用具有受限三次样条的多级混合效应逻辑回归（QR 分解）来模拟无症状比例作为年龄的函数。

结果

共有 38 项研究纳入荟萃分析。共有 14850 例病例中的 6556 例报告为无症状。感染 SARS-CoV-2 且整个感染过程中保持无症状的人群比例的总体估计为 44.1%（6556/14850，95%CI：43.3%-45.0%）。无症状比例的预测峰值出现在儿童（36.2%，95%CI：26.0%-46.5%），年龄为 13.5 岁，随着年龄的增长逐渐下降，在 90.5 岁时最低（8.1%，95%CI：3.4%-12.7%）。