Estimating the asymptomatic proportion of SARS-CoV-2 infection in the general population: Analysis of nationwide serosurvey data in the Netherlands
Background The proportion of SARS-CoV-2 positive persons who are asymptomatic—and whether this proportion is age-dependent—are still open research questions. Because an unknown proportion of reported symptoms among SARS-CoV-2 positives will be attributable to another infection or affliction, the obs...
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| Veröffentlicht in: | European journal of epidemiology 2021-07, Vol.36 (7), p.735-739 |
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| creator | McDonald, Scott A. Miura, Fuminari Vos, Eric R. A. van Boven, Michiel de Melker, Hester E. van der Klis, Fiona R. M. van Binnendijk, Rob S. den Hartog, Gerco Wallinga, Jacco |
| description | Background
The proportion of SARS-CoV-2 positive persons who are asymptomatic—and whether this proportion is age-dependent—are still open research questions. Because an unknown proportion of reported symptoms among SARS-CoV-2 positives will be attributable to another infection or affliction, the
observed
, or 'crude' proportion without symptoms may underestimate the proportion of persons without symptoms that are
caused
by SARS-CoV-2 infection.
Methods
Based on two rounds of a large population-based serological study comprising test results on seropositivity and self-reported symptom history conducted in April/May and June/July 2020 in the Netherlands (
n
= 7517), we estimated the proportion of reported symptoms among those persons infected with SARS-CoV-2 that is attributable to this infection, where the set of relevant symptoms fulfills the ECDC case definition of COVID-19, using inferential methods for the attributable risk (AR). Generalised additive regression modelling was used to estimate the age-dependent relative risk (RR) of reported symptoms, and the AR and asymptomatic proportion (AP) were calculated from the fitted RR.
Results
Using age-aggregated data, the 'crude' AP was 37% but the model-estimated AP was 65% (95% CI 63–68%). The estimated AP varied with age, from 74% (95% CI 65–90%) for |
| doi_str_mv | 10.1007/s10654-021-00768-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8191704</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2565932335</sourcerecordid><originalsourceid>FETCH-LOGICAL-c540t-ec0fcbb66a26ffaa9693d55c7864ed11edeee6757170d06d33b57c4d0d6556de3</originalsourceid><addsrcrecordid>eNp9UcuOFCEUJUbjtKM_4MKQuHGDQlFAlQuTTmd8JBNNHHVLaLjVw6QaSqgaU9_hD0t1z4yPhRsI555zuPcehJ4y-pJRql5lRqWoCa0YKU_ZkPkeWjGhOFFVU99HK8pbTqq2pSfoUc5XlNKGtuIhOuE1YzVr1Ar9PMuj35vRhx0eLwGbPO-HMS6IxUOKQ0yjjwHHDl-sP1-QTfxGKuxDB_aA-3CQ7SBAMj0e4jD1Zqm8xutg-jn7vGjDAfvhHeAMKeYpXcOMnRnNrcNHKGfqTXD5MXrQmT7Dk5v7FH19e_Zl856cf3r3YbM-J1bUdCRgaWe3WylNJbvOmFa23AlhVSNrcIyBAwCphGKKOiod51uhbO2ok0JIB_wUvTn6DtN2D85CGMsMekhlIWnW0Xj9dyX4S72L17phbfGsi8GLG4MUv0-QR7332UJfpoA4ZV2VPgWrRSMK9fk_1Ks4pbKhhSVFyyvOF1Z1ZNmyo5ygu2uGUb1kro-Z65K5PmSu5yJ69ucYd5LbkAuBHwm5lMIO0u-__2P7CyB3vBs</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2565932335</pqid></control><display><type>article</type><title>Estimating the asymptomatic proportion of SARS-CoV-2 infection in the general population: Analysis of nationwide serosurvey data in the Netherlands</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>McDonald, Scott A. ; Miura, Fuminari ; Vos, Eric R. A. ; van Boven, Michiel ; de Melker, Hester E. ; van der Klis, Fiona R. M. ; van Binnendijk, Rob S. ; den Hartog, Gerco ; Wallinga, Jacco</creator><creatorcontrib>McDonald, Scott A. ; Miura, Fuminari ; Vos, Eric R. A. ; van Boven, Michiel ; de Melker, Hester E. ; van der Klis, Fiona R. M. ; van Binnendijk, Rob S. ; den Hartog, Gerco ; Wallinga, Jacco</creatorcontrib><description>Background
The proportion of SARS-CoV-2 positive persons who are asymptomatic—and whether this proportion is age-dependent—are still open research questions. Because an unknown proportion of reported symptoms among SARS-CoV-2 positives will be attributable to another infection or affliction, the
observed
, or 'crude' proportion without symptoms may underestimate the proportion of persons without symptoms that are
caused
by SARS-CoV-2 infection.
Methods
Based on two rounds of a large population-based serological study comprising test results on seropositivity and self-reported symptom history conducted in April/May and June/July 2020 in the Netherlands (
n
= 7517), we estimated the proportion of reported symptoms among those persons infected with SARS-CoV-2 that is attributable to this infection, where the set of relevant symptoms fulfills the ECDC case definition of COVID-19, using inferential methods for the attributable risk (AR). Generalised additive regression modelling was used to estimate the age-dependent relative risk (RR) of reported symptoms, and the AR and asymptomatic proportion (AP) were calculated from the fitted RR.
Results
Using age-aggregated data, the 'crude' AP was 37% but the model-estimated AP was 65% (95% CI 63–68%). The estimated AP varied with age, from 74% (95% CI 65–90%) for < 20 years, to 61% (95% CI 57–65%) for the 50–59 years age-group.
Conclusion
Whereas the 'crude' AP represents a lower bound for the proportion of persons infected with SARS-CoV-2 without COVID-19 symptoms, the AP as estimated via an attributable risk approach represents an upper bound. Age-specific AP estimates can inform the implementation of public health actions such as targetted virological testing and therefore enhance containment strategies.</description><identifier>ISSN: 0393-2990</identifier><identifier>EISSN: 1573-7284</identifier><identifier>DOI: 10.1007/s10654-021-00768-y</identifier><identifier>PMID: 34114187</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject>Adolescent ; Adult ; Age ; Aged ; Aged, 80 and over ; Antibodies, Viral - blood ; Asymptomatic ; Asymptomatic Infections - epidemiology ; Biomarkers - blood ; Cardiology ; Child ; Child, Preschool ; Coronaviruses ; COVID-19 ; COVID-19 - diagnosis ; COVID-19 - epidemiology ; COVID-19 - virology ; COVID-19 Serological Testing ; Epidemiology ; Female ; Humans ; Infant ; Infections ; Infectious Diseases ; Lower bounds ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Netherlands - epidemiology ; Oncology ; Poisson Distribution ; Population studies ; Public Health ; Regression Analysis ; Risk ; Risk Assessment ; SARS-CoV-2 - immunology ; Self Report ; Seroepidemiologic Studies ; Severe acute respiratory syndrome coronavirus 2 ; Upper bounds ; Viral diseases ; Young Adult</subject><ispartof>European journal of epidemiology, 2021-07, Vol.36 (7), p.735-739</ispartof><rights>The Author(s) 2021</rights><rights>2021. The Author(s).</rights><rights>The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c540t-ec0fcbb66a26ffaa9693d55c7864ed11edeee6757170d06d33b57c4d0d6556de3</citedby><cites>FETCH-LOGICAL-c540t-ec0fcbb66a26ffaa9693d55c7864ed11edeee6757170d06d33b57c4d0d6556de3</cites><orcidid>0000-0003-0788-6011</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10654-021-00768-y$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10654-021-00768-y$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34114187$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>McDonald, Scott A.</creatorcontrib><creatorcontrib>Miura, Fuminari</creatorcontrib><creatorcontrib>Vos, Eric R. A.</creatorcontrib><creatorcontrib>van Boven, Michiel</creatorcontrib><creatorcontrib>de Melker, Hester E.</creatorcontrib><creatorcontrib>van der Klis, Fiona R. M.</creatorcontrib><creatorcontrib>van Binnendijk, Rob S.</creatorcontrib><creatorcontrib>den Hartog, Gerco</creatorcontrib><creatorcontrib>Wallinga, Jacco</creatorcontrib><title>Estimating the asymptomatic proportion of SARS-CoV-2 infection in the general population: Analysis of nationwide serosurvey data in the Netherlands</title><title>European journal of epidemiology</title><addtitle>Eur J Epidemiol</addtitle><addtitle>Eur J Epidemiol</addtitle><description>Background
The proportion of SARS-CoV-2 positive persons who are asymptomatic—and whether this proportion is age-dependent—are still open research questions. Because an unknown proportion of reported symptoms among SARS-CoV-2 positives will be attributable to another infection or affliction, the
observed
, or 'crude' proportion without symptoms may underestimate the proportion of persons without symptoms that are
caused
by SARS-CoV-2 infection.
Methods
Based on two rounds of a large population-based serological study comprising test results on seropositivity and self-reported symptom history conducted in April/May and June/July 2020 in the Netherlands (
n
= 7517), we estimated the proportion of reported symptoms among those persons infected with SARS-CoV-2 that is attributable to this infection, where the set of relevant symptoms fulfills the ECDC case definition of COVID-19, using inferential methods for the attributable risk (AR). Generalised additive regression modelling was used to estimate the age-dependent relative risk (RR) of reported symptoms, and the AR and asymptomatic proportion (AP) were calculated from the fitted RR.
Results
Using age-aggregated data, the 'crude' AP was 37% but the model-estimated AP was 65% (95% CI 63–68%). The estimated AP varied with age, from 74% (95% CI 65–90%) for < 20 years, to 61% (95% CI 57–65%) for the 50–59 years age-group.
Conclusion
Whereas the 'crude' AP represents a lower bound for the proportion of persons infected with SARS-CoV-2 without COVID-19 symptoms, the AP as estimated via an attributable risk approach represents an upper bound. Age-specific AP estimates can inform the implementation of public health actions such as targetted virological testing and therefore enhance containment strategies.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antibodies, Viral - blood</subject><subject>Asymptomatic</subject><subject>Asymptomatic Infections - epidemiology</subject><subject>Biomarkers - blood</subject><subject>Cardiology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - diagnosis</subject><subject>COVID-19 - epidemiology</subject><subject>COVID-19 - virology</subject><subject>COVID-19 Serological Testing</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Humans</subject><subject>Infant</subject><subject>Infections</subject><subject>Infectious Diseases</subject><subject>Lower bounds</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Netherlands - epidemiology</subject><subject>Oncology</subject><subject>Poisson Distribution</subject><subject>Population studies</subject><subject>Public Health</subject><subject>Regression Analysis</subject><subject>Risk</subject><subject>Risk Assessment</subject><subject>SARS-CoV-2 - immunology</subject><subject>Self Report</subject><subject>Seroepidemiologic Studies</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Upper bounds</subject><subject>Viral diseases</subject><subject>Young Adult</subject><issn>0393-2990</issn><issn>1573-7284</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9UcuOFCEUJUbjtKM_4MKQuHGDQlFAlQuTTmd8JBNNHHVLaLjVw6QaSqgaU9_hD0t1z4yPhRsI555zuPcehJ4y-pJRql5lRqWoCa0YKU_ZkPkeWjGhOFFVU99HK8pbTqq2pSfoUc5XlNKGtuIhOuE1YzVr1Ar9PMuj35vRhx0eLwGbPO-HMS6IxUOKQ0yjjwHHDl-sP1-QTfxGKuxDB_aA-3CQ7SBAMj0e4jD1Zqm8xutg-jn7vGjDAfvhHeAMKeYpXcOMnRnNrcNHKGfqTXD5MXrQmT7Dk5v7FH19e_Zl856cf3r3YbM-J1bUdCRgaWe3WylNJbvOmFa23AlhVSNrcIyBAwCphGKKOiod51uhbO2ok0JIB_wUvTn6DtN2D85CGMsMekhlIWnW0Xj9dyX4S72L17phbfGsi8GLG4MUv0-QR7332UJfpoA4ZV2VPgWrRSMK9fk_1Ks4pbKhhSVFyyvOF1Z1ZNmyo5ygu2uGUb1kro-Z65K5PmSu5yJ69ucYd5LbkAuBHwm5lMIO0u-__2P7CyB3vBs</recordid><startdate>20210701</startdate><enddate>20210701</enddate><creator>McDonald, Scott A.</creator><creator>Miura, Fuminari</creator><creator>Vos, Eric R. A.</creator><creator>van Boven, Michiel</creator><creator>de Melker, Hester E.</creator><creator>van der Klis, Fiona R. M.</creator><creator>van Binnendijk, Rob S.</creator><creator>den Hartog, Gerco</creator><creator>Wallinga, Jacco</creator><general>Springer Netherlands</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7T2</scope><scope>7TK</scope><scope>7TS</scope><scope>7U7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-0788-6011</orcidid></search><sort><creationdate>20210701</creationdate><title>Estimating the asymptomatic proportion of SARS-CoV-2 infection in the general population: Analysis of nationwide serosurvey data in the Netherlands</title><author>McDonald, Scott A. ; Miura, Fuminari ; Vos, Eric R. A. ; van Boven, Michiel ; de Melker, Hester E. ; van der Klis, Fiona R. M. ; van Binnendijk, Rob S. ; den Hartog, Gerco ; Wallinga, Jacco</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c540t-ec0fcbb66a26ffaa9693d55c7864ed11edeee6757170d06d33b57c4d0d6556de3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antibodies, Viral - blood</topic><topic>Asymptomatic</topic><topic>Asymptomatic Infections - epidemiology</topic><topic>Biomarkers - blood</topic><topic>Cardiology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>COVID-19 - diagnosis</topic><topic>COVID-19 - epidemiology</topic><topic>COVID-19 - virology</topic><topic>COVID-19 Serological Testing</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Humans</topic><topic>Infant</topic><topic>Infections</topic><topic>Infectious Diseases</topic><topic>Lower bounds</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Netherlands - epidemiology</topic><topic>Oncology</topic><topic>Poisson Distribution</topic><topic>Population studies</topic><topic>Public Health</topic><topic>Regression Analysis</topic><topic>Risk</topic><topic>Risk Assessment</topic><topic>SARS-CoV-2 - immunology</topic><topic>Self Report</topic><topic>Seroepidemiologic Studies</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><topic>Upper bounds</topic><topic>Viral diseases</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>McDonald, Scott A.</creatorcontrib><creatorcontrib>Miura, Fuminari</creatorcontrib><creatorcontrib>Vos, Eric R. A.</creatorcontrib><creatorcontrib>van Boven, Michiel</creatorcontrib><creatorcontrib>de Melker, Hester E.</creatorcontrib><creatorcontrib>van der Klis, Fiona R. M.</creatorcontrib><creatorcontrib>van Binnendijk, Rob S.</creatorcontrib><creatorcontrib>den Hartog, Gerco</creatorcontrib><creatorcontrib>Wallinga, Jacco</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Neurosciences Abstracts</collection><collection>Physical Education Index</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European journal of epidemiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>McDonald, Scott A.</au><au>Miura, Fuminari</au><au>Vos, Eric R. A.</au><au>van Boven, Michiel</au><au>de Melker, Hester E.</au><au>van der Klis, Fiona R. M.</au><au>van Binnendijk, Rob S.</au><au>den Hartog, Gerco</au><au>Wallinga, Jacco</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Estimating the asymptomatic proportion of SARS-CoV-2 infection in the general population: Analysis of nationwide serosurvey data in the Netherlands</atitle><jtitle>European journal of epidemiology</jtitle><stitle>Eur J Epidemiol</stitle><addtitle>Eur J Epidemiol</addtitle><date>2021-07-01</date><risdate>2021</risdate><volume>36</volume><issue>7</issue><spage>735</spage><epage>739</epage><pages>735-739</pages><issn>0393-2990</issn><eissn>1573-7284</eissn><abstract>Background
The proportion of SARS-CoV-2 positive persons who are asymptomatic—and whether this proportion is age-dependent—are still open research questions. Because an unknown proportion of reported symptoms among SARS-CoV-2 positives will be attributable to another infection or affliction, the
observed
, or 'crude' proportion without symptoms may underestimate the proportion of persons without symptoms that are
caused
by SARS-CoV-2 infection.
Methods
Based on two rounds of a large population-based serological study comprising test results on seropositivity and self-reported symptom history conducted in April/May and June/July 2020 in the Netherlands (
n
= 7517), we estimated the proportion of reported symptoms among those persons infected with SARS-CoV-2 that is attributable to this infection, where the set of relevant symptoms fulfills the ECDC case definition of COVID-19, using inferential methods for the attributable risk (AR). Generalised additive regression modelling was used to estimate the age-dependent relative risk (RR) of reported symptoms, and the AR and asymptomatic proportion (AP) were calculated from the fitted RR.
Results
Using age-aggregated data, the 'crude' AP was 37% but the model-estimated AP was 65% (95% CI 63–68%). The estimated AP varied with age, from 74% (95% CI 65–90%) for < 20 years, to 61% (95% CI 57–65%) for the 50–59 years age-group.
Conclusion
Whereas the 'crude' AP represents a lower bound for the proportion of persons infected with SARS-CoV-2 without COVID-19 symptoms, the AP as estimated via an attributable risk approach represents an upper bound. Age-specific AP estimates can inform the implementation of public health actions such as targetted virological testing and therefore enhance containment strategies.</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><pmid>34114187</pmid><doi>10.1007/s10654-021-00768-y</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0003-0788-6011</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Adolescent Adult Age Aged Aged, 80 and over Antibodies, Viral - blood Asymptomatic Asymptomatic Infections - epidemiology Biomarkers - blood Cardiology Child Child, Preschool Coronaviruses COVID-19 COVID-19 - diagnosis COVID-19 - epidemiology COVID-19 - virology COVID-19 Serological Testing Epidemiology Female Humans Infant Infections Infectious Diseases Lower bounds Male Medicine Medicine & Public Health Middle Aged Netherlands - epidemiology Oncology Poisson Distribution Population studies Public Health Regression Analysis Risk Risk Assessment SARS-CoV-2 - immunology Self Report Seroepidemiologic Studies Severe acute respiratory syndrome coronavirus 2 Upper bounds Viral diseases Young Adult |
| title | Estimating the asymptomatic proportion of SARS-CoV-2 infection in the general population: Analysis of nationwide serosurvey data in the Netherlands |
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