Estimated prevalence and viral transmissibility in subjects with asymptomatic SARS-CoV-2 infections in Wuhan, China

The role of subjects with asymptomatic SARS-CoV-2 infection in the current pandemic is not well-defined. Based on two different approaches to estimate the culminative attack rate (seroprevalence of antibodies against SARS-CoV-2, and a four compartment mathematical model) and the reported number of patients with COVID-19, the ratio of asymptomatic versus symptomatic SARS-CoV-2 infection was estimated to be 7 (95% CI: 2.8-12.4) in Wuhan, Hubei, China, the first epicenter of this pandemic, which has settled with no new cases. Together with detailed recording of the contact sources in a cohort of patients, and applying the estimations to an established mathematical model, the viral transmissibility of the subjects with asymptomatic SARS-CoV-2 infection is around 10% of that of the symptomatic patients (95% CI: 7.6%-12.3%). Public health measures/policies should address this important pool of infectious source in combat against this viral pandemic.