Asymptomatic people with SARS-CoV-2 play a critical role in the rapid spread of SARS-CoV-2 as an unseen carrier of COVID-19. Pooled prevalence analysis shows 1/2 (48.2%) of SARS-CoV-2 infected patients are asymptomatic (95% CI, 30%-67%), children and females are more likely to present as asymptomatic. The higher prevalence of asymptomatic COVID-19 cases suggests that only symptom-based screening might fail to identify a large proportion of SARS CoV-2 infections escalating the threat of rapid virus dissemination. Therefore, a mass surveillance system to track SARS-CoV-2 asymptomatic cases is critical, with special attention to females and children.

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