Incubation period of COVID-19: a rapid systematic review and meta-analysis of observational research

ObjectivesThe aim of this study was to conduct a rapid systematic review and meta-analysis of estimates of the incubation period of COVID-19.DesignRapid systematic review and meta-analysis of observational research.SettingInternational studies on incubation period of COVID-19.ParticipantsSearches we...

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Bibliographic Details
Published in:BMJ open Vol. 10; no. 8; p. e039652
Main Authors: McAloon, Conor, Collins, Áine, Hunt, Kevin, Barber, Ann, Byrne, Andrew W, Butler, Francis, Casey, Miriam, Griffin, John, Lane, Elizabeth, McEvoy, David, Wall, Patrick, Green, Martin, O'Grady, Luke, More, Simon J
Format: Journal Article
Language:English
Published: England British Medical Journal Publishing Group 16.08.2020
BMJ Publishing Group LTD
BMJ Publishing Group
Series:Original research
Subjects:
Betacoronavirus
Clinical Decision-Making
Coronavirus Infections - transmission
Coronaviruses
COVID-19
Epidemiology
Humans
Infectious Disease Incubation Period
Logistic Models
Meta-analysis
Observational studies
Pandemics
Pathology
Pneumonia, Viral - transmission
Public health
SARS-CoV-2
Software
Systematic review
epidemiology
public health
ISSN:2044-6055, 2044-6055
Online Access:Get full text
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Summary:ObjectivesThe aim of this study was to conduct a rapid systematic review and meta-analysis of estimates of the incubation period of COVID-19.DesignRapid systematic review and meta-analysis of observational research.SettingInternational studies on incubation period of COVID-19.ParticipantsSearches were carried out in PubMed, Google Scholar, Embase, Cochrane Library as well as the preprint servers MedRxiv and BioRxiv. Studies were selected for meta-analysis if they reported either the parameters and CIs of the distributions fit to the data, or sufficient information to facilitate calculation of those values. After initial eligibility screening, 24 studies were selected for initial review, nine of these were shortlisted for meta-analysis. Final estimates are from meta-analysis of eight studies.Primary outcome measuresParameters of a lognormal distribution of incubation periods.ResultsThe incubation period distribution may be modelled with a lognormal distribution with pooled mu and sigma parameters (95% CIs) of 1.63 (95% CI 1.51 to 1.75) and 0.50 (95% CI 0.46 to 0.55), respectively. The corresponding mean (95% CIs) was 5.8 (95% CI 5.0 to 6.7) days. It should be noted that uncertainty increases towards the tail of the distribution: the pooled parameter estimates (95% CIs) resulted in a median incubation period of 5.1 (95% CI 4.5 to 5.8) days, whereas the 95th percentile was 11.7 (95% CI 9.7 to 14.2) days.ConclusionsThe choice of which parameter values are adopted will depend on how the information is used, the associated risks and the perceived consequences of decisions to be taken. These recommendations will need to be revisited once further relevant information becomes available. Accordingly, we present an R Shiny app that facilitates updating these estimates as new data become available.
Bibliography:Original research
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ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2020-039652