What the data says about asymptomatic COVID infections

The issue with putting a reliable figure on the rate of asymptomatic COVID-19 is distinguishing between people who are asymptomatic and pre-symptomatic, says Krutika Kuppalli, an infectious-disease researcher at Stanford University School of Medicine in California. “Asymptomatic is someone who never developed symptoms ever throughout the course of their disease, and pre-symptomatic is somebody who has mild symptoms before they do go on to develop symptoms,” Kuppalli says. There is also no standardized accepted definition of that, she says.

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Research early in the pandemic suggested that the rate of asymptomatic infections could be as high as 81%. But a meta-analysis published last month1, which included 13 studies involving 21,708 people, calculated the rate of asymptomatic presentation to be 17%. The analysis defined asymptomatic people as those who showed none of the key COVID-19 symptoms during the entire follow-up period, and the authors included only studies that followed participants for at least seven days. Evidence suggests that most people develop symptoms in 7–13 days, says lead author Oyungerel Byambasuren, a biomedical researcher at the Institute for Evidence-Based Healthcare at Bond University in Gold Coast, Australia.

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