Clinico epidemiological profile of Omicron variant of SARS CoV2 in Rajasthan

Sharma, Ravi; Sharma, Pratibha; Singh, Ruchi; Sharma, Himanshu; Parsoya, Dinesh; Deba, Farah; Bhomia, Neha; N, Pal; Potdar, Varsha; Yadav, Pragya D; Gupta, Nivedita; Bhandari, Sudhir; Malhotra, Bharti

doi:10.1101/2022.02.11.22270698

Cited by 13 publications

(18 citation statements)

References 7 publications

(6 reference statements)

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“…Of these, 541 studies underwent full-text review. Eight studies [ 19 , 21 , 32 , 33 , 34 , 41 , 42 , 43 ] with information concerning the percentage of asymptomatic infections among SARS-CoV-2 Omicron variant-positive individuals were included in the final analysis ( Figure 1 ). The characteristics of the studies included in this systematic review and meta-analysis are shown in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…In our study, the pooled percentage of asymptomatic infections was 40.05% and 37.97% among the Omicron variant-positive individuals having a travel history and infected in the community, respectively. This finding suggested that screening and quarantine of asymptomatic infected travelers [ 19 , 43 , 50 ] are important to prevent community transmission. Routine screening of community residents, especially of those commuting frequently [ 3 ], may prevent some cluster epidemics or community transmission.…”

Section: Discussionmentioning

confidence: 99%

“… The Percentage of Asymptomatic Infections Among SARS-CoV-2 Omicron Variant-Positive Individuals [ 19 , 21 , 32 , 33 , 34 , 41 , 42 , 43 ]. …”

Section: Figurementioning

confidence: 99%

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Percentage of Asymptomatic Infections among SARS-CoV-2 Omicron Variant-Positive Individuals: A Systematic Review and Meta-Analysis

et al. 2022

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Background: Asymptomatic infections are potential sources of transmission for coronavirus disease 2019, especially during the epidemic of the SARS-CoV-2 Omicron variant. We aimed to assess the percentage of asymptomatic infections among SARS-CoV-2 Omicron variant-positive individuals detected by gene sequencing or specific polymerase chain reaction (PCR). Methods: We searched PubMed, EMBASE, and Web of Science from 26 November 2021 to 13 April 2022. This meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered with PROSPERO (CRD42022327894). Three researchers independently extracted data and two researchers assessed quality using pre-specified criteria. The pooled percentage with 95% confidence interval (CI) of asymptomatic infections of SARS-CoV-2 Omicron was estimated using random-effects models. Results: Our meta-analysis included eight eligible studies, covering 7640 Omicron variant-positive individuals with 2190 asymptomatic infections. The pooled percentage of asymptomatic infections was 32.40% (95% CI: 25.30–39.51%) among SARS-CoV-2 Omicron variant-positive individuals, which was higher in the population in developing countries (38.93%; 95% CI: 19.75–58.11%), with vaccine coverage ≥ 80% (35.93%; 95% CI: 25.36–46.51%), with a travel history (40.05%; 95% CI: 7.59–72.51%), community infection (37.97%; 95% CI: 10.07–65.87%), and with a median age < 20 years (43.75%; 95% CI: 38.45–49.05%). Conclusion: In this systematic review and meta-analysis, the pooled percentage of asymptomatic infections was 32.40% among SARS-CoV-2 Omicron variant-positive individuals. The people who were vaccinated, young (median age < 20 years), had a travel history, and were infected outside of a clinical setting (community infection) had higher percentages of asymptomatic infections. Screening is required to prevent clustered epidemics or sustained community transmission caused by asymptomatic infections of Omicron variants, especially for countries and regions that have successfully controlled SARS-CoV-2.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Percentage of Asymptomatic Infections among SARS-CoV-2 Omicron Variant-Positive Individuals: A Systematic Review and Meta-Analysis

et al. 2022

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“…Studies published in early 2022 are already reporting a wide range of estimates of asymptomatic omicron infection. In India, from the date of emergence of the omicron variant, 24 November 2021 to 4 January 2022, authors reported a high proportion of asymptomatic omicron variant infections (56.7% of 291) but did not report any follow-up and >80% of participants had been vaccinated [ 189 ]. In contrast, authors of a cohort study of an outbreak of omicron SARS-CoV-2 in Norway, found only 1 of 81 infections in a highly vaccinated group was asymptomatic after 10 days of follow-up [ 190 ].…”

Section: Discussionmentioning

confidence: 99%

Occurrence and transmission potential of asymptomatic and presymptomatic SARS-CoV-2 infections: Update of a living systematic review and meta-analysis

et al. 2022

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Background Debate about the level of asymptomatic Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection continues. The amount of evidence is increasing and study designs have changed over time. We updated a living systematic review to address 3 questions: (1) Among people who become infected with SARS-CoV-2, what proportion does not experience symptoms at all during their infection? (2) What is the infectiousness of asymptomatic and presymptomatic, compared with symptomatic, SARS-CoV-2 infection? (3) What proportion of SARS-CoV-2 transmission in a population is accounted for by people who are asymptomatic or presymptomatic? Methods and findings The protocol was first published on 1 April 2020 and last updated on 18 June 2021. We searched PubMed, Embase, bioRxiv, and medRxiv, aggregated in a database of SARS-CoV-2 literature, most recently on 6 July 2021. Studies of people with PCR-diagnosed SARS-CoV-2, which documented symptom status at the beginning and end of follow-up, or mathematical modelling studies were included. Studies restricted to people already diagnosed, of single individuals or families, or without sufficient follow-up were excluded. One reviewer extracted data and a second verified the extraction, with disagreement resolved by discussion or a third reviewer. Risk of bias in empirical studies was assessed with a bespoke checklist and modelling studies with a published checklist. All data syntheses were done using random effects models. Review question (1): We included 130 studies. Heterogeneity was high so we did not estimate a mean proportion of asymptomatic infections overall (interquartile range (IQR) 14% to 50%, prediction interval 2% to 90%), or in 84 studies based on screening of defined populations (IQR 20% to 65%, prediction interval 4% to 94%). In 46 studies based on contact or outbreak investigations, the summary proportion asymptomatic was 19% (95% confidence interval (CI) 15% to 25%, prediction interval 2% to 70%). (2) The secondary attack rate in contacts of people with asymptomatic infection compared with symptomatic infection was 0.32 (95% CI 0.16 to 0.64, prediction interval 0.11 to 0.95, 8 studies). (3) In 13 modelling studies fit to data, the proportion of all SARS-CoV-2 transmission from presymptomatic individuals was higher than from asymptomatic individuals. Limitations of the evidence include high heterogeneity and high risks of selection and information bias in studies that were not designed to measure persistently asymptomatic infection, and limited information about variants of concern or in people who have been vaccinated. Conclusions Based on studies published up to July 2021, most SARS-CoV-2 infections were not persistently asymptomatic, and asymptomatic infections were less infectious than symptomatic infections. Summary estimates from meta-analysis may be misleading when variability between studies is extreme and prediction intervals should be presented. Future studies should determine the asymptomatic proportion of SARS-CoV-2 infections caused by variants of concern and in people with immunity following vaccination or previous infection. Without prospective longitudinal studies with methods that minimise selection and measurement biases, further updates with the study types included in this living systematic review are unlikely to be able to provide a reliable summary estimate of the proportion of asymptomatic infections caused by SARS-CoV-2. Review protocol Open Science Framework (https://osf.io/9ewys/)

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“…Seven (33%) children had generalised tonic-clonic seizures on presentation, of whom three had pre-existing epilepsy and one each was attributed to a typical febrile seizure, intracranial bleed with Dural venous sinus thrombosis and suspected IEM with hypoglycaemia. A study by Sharma et al in Rajasthan, India showed most of Omicron patients (adult and paediatric) were asymptomatic (56.7%) or had mild disease (33%) while 9.2% had moderate symptoms and 0.7% had severe disease requiring hospitalization [ 10 ]. Two deaths in children under four years of age were reported from the US between December 19, 2021-January 31, 2022 when Omicron was the predominant variant.…”

Section: Discussionmentioning

confidence: 99%

Clinical Profile and Outcome of Hospitalized Confirmed Cases of Omicron Variant of SARS-CoV-2 Among Children in Pune, India

Kinikar¹,

Vartak²,

Dawre³

et al. 2022

Cureus

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Background The Omicron variant of SARS-CoV-2 infection was seen to be more infectious but less severe in children than adults with reduced hospitalization rates. There is a paucity of data on hospitalized children with confirmed Omicron variant. Objective We describe demographic, epidemiologic, clinical, radiological, laboratory features and outcomes of children with confirmed Omicron variant of SARS-CoV-2 infection admitted to a tertiary care teaching hospital in Pune, India. Methodology Children who tested positive for SARS-CoV-2 - Omicron variant and were admitted between 1st December 2021 and 28th February 2022 were included in the study. Results Out of a total of 37 Covid-positive children admitted during the study period, 16 underwent genome sequencing of which 14 were confirmed to be Omicron variant and two were Delta variant. The age range was one month to 12 years and seven (50%) were male. Common presenting features were fever (n=13, 93%), cough (n=7, 50%), seizures (n=7, 50%) and coryza (n=5, 36%). Comorbidities noted were epilepsy (n=3, 21%) and one each with Thalassemia Major, suspected inborn error of metabolism (IEM), operated anorectal malformation with hypospadias, chronic suppurative otitis media with complications (mastoiditis and facial nerve palsy), neonatal cholestasis and intracranial bleed with dural venous sinus thrombosis. Malnutrition was noted in 42%, pallor in 10 cases (71%). Severe anaemia (n=10, 71%), elevated ferritin (n=6, 43%), positive C-Reactive Protein (n=4, 28%) and deranged D-dimer (n=11, 78%) were noted. The Neutrophil to Lymphocyte ratio (NLR) was >3.3 in five (36%) children. Four (28%) had evidence of pneumonia on the chest radiograph. Oxygen therapy was needed in nine (64%) while two children (14%) required mechanical ventilation. There were two deaths (14%) in children with multiorgan dysfunction and refractory shock. Intravenous immunoglobulin and methylprednisolone were administered to one patient respectively (14%). The median hospital stay was 10 days (Interquartile range = 8). Conclusion Hospitalized children with Omicron variant of SARS-CoV-2 who have underlying comorbidities may have severe presentations needing ICU care. Mortality rates are low with appropriate ICU care.

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Clinico epidemiological profile of Omicron variant of SARS CoV2 in Rajasthan

Cited by 13 publications

References 7 publications

Percentage of Asymptomatic Infections among SARS-CoV-2 Omicron Variant-Positive Individuals: A Systematic Review and Meta-Analysis

Percentage of Asymptomatic Infections among SARS-CoV-2 Omicron Variant-Positive Individuals: A Systematic Review and Meta-Analysis

Occurrence and transmission potential of asymptomatic and presymptomatic SARS-CoV-2 infections: Update of a living systematic review and meta-analysis

Clinical Profile and Outcome of Hospitalized Confirmed Cases of Omicron Variant of SARS-CoV-2 Among Children in Pune, India

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