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Meta-Analysis
. 2022 Dec;94(12):5790-5801.
doi: 10.1002/jmv.28066. Epub 2022 Aug 24.

Proportion of asymptomatic infection and nonsevere disease caused by SARS-CoV-2 Omicron variant: A systematic review and analysis

Weien Yu  1 , Yifei Guo  1 , Shenyan Zhang  1 , Yide Kong  1 , Zhongliang Shen  1   2   3 , Jiming Zhang  1   2   3
Affiliations
Meta-Analysis

Proportion of asymptomatic infection and nonsevere disease caused by SARS-CoV-2 Omicron variant: A systematic review and analysis

Weien Yu et al. J Med Virol. 2022 Dec.

Abstract

SARS-CoV-2 Omicron variant seemed to cause milder disease compared to previous predominated variants. We aimed to conduct a meta-analysis to assess the pooled proportion of nonsevere disease and asymptomatic infection among COVID-19 patients infected with Omicron and Delta. We searched PubMed, Embase, Web of Science, and China National Knowledge Infrastructure (CNKI) databases. We included studies of SARS-CoV-2 Omicron infection from November 1, 2021, to April 18, 2022, and studies of Delta infection from October 1, 2020, to June 30, 2022. Studies without corresponding data, with less than 50 patients, or obviously biased concerning main outcome were excluded. Meta-analysis was performed in R 4.2.0 with the "meta" package. Subgroup analyses were conducted by study group and vaccination status. The pooled proportion of asymptomatic infection and nonsevere disease with Omicron were 25.5% (95% confidence interval [CI] 17.0%-38.2%) and 97.9% (95% CI 97.1%-98.7%), significantly higher than those of Delta with 8.4% (95% CI 4.4%-16.2%) and 91.4% (95% CI 87.0%-96.0%). During Omicron wave, children and adolescents had higher proportion of asymptomatic infection, SOTR and the elderly had lower proportion of nonsevere disease, vaccination of a booster dose contributed to higher proportion of both asymptomatic infection and nonsevere disease. This study estimates the pooled proportion of asymptomatic infection and nonsevere disease caused by SARS-CoV-2 Omicron compared to other predominant variants. The result has important implications for future policy making.

Keywords: COVID-19; SARS-CoV-2 variants; asymptomatic infection; clinical severity; meta-analysis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
A PRISMA flow diagram of the systematic review and meta‐analysis on the Omicron variant
Figure 2
Figure 2
Forest plot of the proportion of asymptomatic infection in COVID‐19 Omicron patients
Figure 3
Figure 3
Subgroup analysis of the proportion of asymptomatic infection in COVID‐19 Omicron patients by study group
Figure 4
Figure 4
Subgroup analysis of the proportion of asymptomatic infection in COVID‐19 Omicron patients by vaccination status
Figure 5
Figure 5
Forest plot of the proportion of nonsevere disease in COVID‐19 Omicron patients
Figure 6
Figure 6
Subgroup analysis of the proportion of nonsevere disease in COVID‐19 Omicron patients by study group
Figure 7
Figure 7
Subgroup analysis of the proportion of nonsevere disease in COVID‐19 Omicron patients by vaccination status
Figure 8
Figure 8
Proportion of asymptomatic infection and proportion of nonsevere disease among COVID‐19 Omicron patients were significantly higher than among Delta patients. (A) proportion of asymptomatic infection (B) proportion of nonsevere disease.
See this image and copyright information in PMC

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