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An open letter to Oran and Topol, and the Annals of Internal Medicine

Muge Cevik; Isaac I Bogoch; Gail Carson; Eric D'Ortenzio; Krutika Kuppali; Nicola Low; Sara Loree; Alasdair Munro; Lina Moses; Harish Nair; Piero Olliaro; Louise Sigfrid; Renaud Vatrineton; on behalf of the CORRE Network (International COVID-19 Rapid Evidence Reviews Group)

An open letter to Oran and Topol, authors of 

“Presence of Asymptomatic SARS-CoV-2 Infection: A Narrative Review” Annals of Internal Medicine. 2020 June 3. https://doi.org/10.7326/M20-3012

and Christine Laine (editor-in-chief The Annals of Internal Medicine)

There is a clear need to better understand the contribution of asymptomatic SARS-CoV-2 infections (those with no symptoms at all throughout the infection) in driving the current pandemic. However, there are caveats that in our opinion are pertinent when interpreting the reported findings of this review, including the lack of clear definition of asymptomatic infection and selective inclusion of cross-sectional studies. In addition, there is a problematic interpretation of a narrative review containing a dearth of poor-quality evidence resulting in an overestimate of asymptomatic infections, which might misinform policy response.

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