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

Wang, Bing; Elliott, Salenna R.; Mohammed, Hassen; Lassi, Zohra S; Twigger, Ashley; Borgas, Chloe; Gunasekera, Shehani; Ladhani, Shamez; Marshall, Helen

doi:10.1097/inf.0000000000003791

Cited by 26 publications

(22 citation statements)

References 82 publications

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“…Among children and adolescents infected by SARS-CoV-2, a high rate of asymptomatic carriage has been observed [16], and the safety of current COVID-19 vaccines has remained acceptable [17].…”

Section: Discussionmentioning

confidence: 99%

COVID-19 and SARS-CoV-2 Vaccines: A Cameo Role for Headache

Martelletti

2023

IJERPH

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Headache is a very frequent symptom in COVID-19 and SARS-CoV-2 vaccination. Many studies have emphasized its clinical diagnostic and prognostic importance on the one hand, as in many cases these aspects have been completely ignored. It is therefore opportune to go back over these lines of research in order to gather what usefulness the headache symptom may or may not represent for the clinician dealing with COVID-19 or performing or following up on the clinical course following vaccination for SARS-CoV-2. The clinical evaluation of headache in COVID-19 is not fundamental in the diagnostic and prognostic process of the emergency departments; however, the risk of severe adverse events, although very rare, must be taken into account by the clinicians. For subjects presenting with severe, drug-resistant, and delayed-onset post-vaccination headache, it could represent a possible sign of central venous thrombosis or other thrombotic complications. Thus, a re-reading of the role of headache in COVID-19 and SARS-CoV-2 vaccination seems clinically useful.

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Section: Discussionmentioning

confidence: 99%

COVID-19 and SARS-CoV-2 Vaccines: A Cameo Role for Headache

Martelletti

2023

IJERPH

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“…The SMR or ‘due-to-C19’ fraction, equivalently, can further be compared to the ‘index of manifestation (of C19)’ μ C19 (‘Manifestationsindex’ [42]), which the RKI proposed to be the fraction of those actually showing symptoms of C19 among all those having received a positive NAA test; the RKI gives a range (across all age cohorts) μ C19 = 0.55 … 0.85 [42]; they had extracted these values from the literature until 29 November 2021. More recent sources have provided the following values: 59.5% [43], 35–86% [44] (interquartile ranges) and 56% [45]. Now applying the logic that a person can only die of C19 if C19 symptoms have become manifest, these μ C19 values can be directly compared to the ‘due-to-C19’ fraction (or the SMR): our estimated values false(1−false(1/σnormalPFfalse)false)⋅100normal% across all age cohorts are 46% (table 3) and 45% (table 5) for the whole-year intervals, and 66% (table 4) and 65% (table 6) for the flu season intervals.…”

Section: Discussionmentioning

confidence: 99%

Reports of deaths are an exaggeration: all-cause and NAA-test-conditional mortality in Germany during the SARS-CoV-2 era

Rockenfeller

Günther

Mörl³

2023

R. Soc. open sci.

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Counts of SARS-CoV-2-related deaths have been key numbers for justifying severe political, social and economical measures imposed by authorities world-wide. A particular focus thereby was the concomitant excess mortality (EM), i.e. fatalities above the expected all-cause mortality (AM). Recent studies, inter alia by the WHO, estimated the SARS-CoV-2-related EM in Germany between 2020 and 2021 as high as 200 000. In this study, we attempt to scrutinize these numbers by putting them into the context of German AM since the year 2000. We propose two straightforward, age-cohort-dependent models to estimate German AM for the ‘Corona pandemic’ years, as well as the corresponding flu seasons, out of historic data. For Germany, we find overall negative EM of about −18 500 persons for the year 2020, and a minor positive EM of about 7000 for 2021, unveiling that officially reported EM counts are an exaggeration. In 2022, the EM count is about 41 200. Further, based on NAA-test-positive related death counts, we are able to estimate how many Germans have died due to rather than with CoViD-19; an analysis not provided by the appropriate authority, the RKI. Through 2020 and 2021 combined, our due estimate is at no more than 59 500. Varying NAA test strategies heavily obscured SARS-CoV-2-related EM, particularly within the second year of the proclaimed pandemic. We compensated changes in test strategies by assuming that age-cohort-specific NAA-conditional mortality rates during the first pandemic year reflected SARS-CoV-2-characteristic constants.

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“…As a result of this, when the proportion of cases that were severe was fixed, the proportion chosen was relatively high (80%) to allow for the consideration of a value of α close to one. We acknowledge that it may be unrealistic for such a high percentage of cases to have severe symptoms, with the proportion of cases that are mild estimated to be 43% for influenza (where mild is defined as subclinical) [72] and 44% for SARS-CoV-2 (where mild is defined as asymptomatic) [73]. It may also be the case that such high values of α (i.e.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological and health economic implications of symptom propagation in respiratory pathogens: A mathematical modelling investigation

Asplin

Keeling

Mancy

et al. 2023

Preprint

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BackgroundRespiratory pathogens inflict a substantial burden on public health and the economy. Although the severity of symptoms caused by these pathogens can vary from asymptomatic to fatal, the factors that determine symptom severity are not fully understood. Correlations in symptoms between infector-infectee pairs, for which evidence is accumulating, can generate large-scale clusters of severe infections that could be devastating to those most at risk, whilst also conceivably leading to chains of mild or asymptomatic infections that generate widespread immunity with minimal cost to public health. Although this effect could be harnessed to amplify the impact of interventions that reduce symptom severity, the mechanistic representation of symptom propagation within mathematical and health economic modelling of respiratory diseases is understudied.Methods and FindingsWe propose a novel framework for incorporating different levels of symptom propagation into models of infectious disease transmission via a single parameter, α. Varying α tunes the model from having no symptom propagation (α=0, as typically assumed) to one where symptoms always propagate (α=1). For parameters corresponding to three respiratory pathogens — seasonal influenza, pandemic influenza and SARS-CoV-2 — we explored how symptom propagation impacted the relative epidemiological and health-economic performance of three interventions, conceptualised as vaccines with different actions: symptom-attenuating (labelled SA), infection-blocking (IB) and infection-blocking admitting only mild breakthrough infections (IB_MB). In the absence of interventions, with fixed underlying epidemiological parameters, stronger symptom propagation increased the proportion of cases that were severe. For SA and IB_MB, interventions were more effective at reducing prevalence (all infections and severe cases) for higher strengths of symptom propagation. For IB, symptom propagation had no impact on effectiveness, and for seasonal influenza this intervention type was more effective than SA at reducing severe infections for all levels of symptom propagation. For pandemic influenza and SARS-CoV-2, at low intervention uptake, SA was more effective than IB for all levels of symptom propagation; for high uptake, SA only became more effective under strong symptom propagation. Health economic assessments found that for SA-type interventions, the amount one could spend on control whilst maintaining a cost-effective intervention (termed threshold unit intervention cost) was very sensitive to the strength of symptom propagation.ConclusionsOverall, the preferred intervention type depended on the combination of the strength of symptom propagation and uptake. Given the importance of determining robust public health responses, we highlight the need to gather further data on symptom propagation, with our modelling framework acting as a template for future analysis.

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

Cited by 26 publications

References 82 publications

COVID-19 and SARS-CoV-2 Vaccines: A Cameo Role for Headache

COVID-19 and SARS-CoV-2 Vaccines: A Cameo Role for Headache

Reports of deaths are an exaggeration: all-cause and NAA-test-conditional mortality in Germany during the SARS-CoV-2 era

Epidemiological and health economic implications of symptom propagation in respiratory pathogens: A mathematical modelling investigation

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