Background

Severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and coronavirus disease 2019 (COVID-19) have caused substantial public health burdens and global health threats. Understanding the superspreading potential of a virus is important for characterizing transmission patterns and informing strategic decision-making in disease control. This systematic review aimed to summarize the existing evidence on superspreading features and to compare the heterogeneity in transmission within and among various coronavirus epidemics of SARS, MERS and COVID-19.

Methods

PubMed, Medline, and Embase databases were extensively searched for original studies on the transmission heterogeneity of SARS, MERS, and COVID-19 published in English between January 1, 2003, and February 10, 2021. After screening the articles, we extracted data pertaining to the estimated dispersion parameter (k) which has been a commonly-used measurement for transmission heterogeneity and superspreading potential.

Findings

We included a total of 60 estimates of transmission heterogeneity from 26 studies on outbreaks in 22 regions. The majority (90%) of the k estimates were small, with values less than 1, indicating an over-dispersed transmission pattern. The point estimates of k for SARS and MERS ranged from 0.12 to 0.20 and from 0.06 to 2.94, respectively. Among 45 estimates of individual-level transmission heterogeneity for COVID-19 from 17 articles, 91% were derived from Asian regions. The point estimates of k for COVID-19 ranged between 0.1 and 5.0.

Conclusions

We detected a substantial over-dispersed transmission pattern in all three coronaviruses, while the k estimates varied by differences in study design and public health capacity. Our findings suggested that even with a reduced R value, the epidemic still has a high resurgence potential due to transmission heterogeneity.

中文翻译：

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SARS、MERS 和 COVID-19 传播的超级传播和异质性：系统评价

背景

严重急性呼吸综合征 (SARS)、中东呼吸综合征 (MERS) 和 2019 年冠状病毒病 (COVID-19) 造成了巨大的公共卫生负担和全球健康威胁。了解病毒的超级传播潜力对于描述传播模式和为疾病控制的战略决策提供信息非常重要。本系统综述旨在总结有关超级传播特征的现有证据，并比较 SARS、MERS 和 COVID-19 等不同冠状病毒流行病内部和之间传播的异质性。

方法

广泛检索了 PubMed、Medline 和 Embase 数据库，查找 2003 年 1 月 1 日至 2021 年 2 月 10 日期间以英文发表的关于 SARS、MERS 和 COVID-19 传播异质性的原始研究。在筛选文章后，我们提取了相关数据估计的色散参数（k）是传输异质性和超级扩频潜力的常用测量方法。

发现

我们纳入了来自 22 个地区的 26 项疫情研究的 60 项传播异质性估计。大多数 (90%) k估计值都很小，其值小于 1，表明传输模式过于分散。SARS 和 MERS 的k点估计值分别为 0.12 至 0.20 和 0.06 至 2.94。在 17 篇文章中对 COVID-19 个体层面传播异质性的 45 项估计中，91% 来自亚洲地区。COVID-19 的k点估计值介于 0.1 和 5.0 之间。

结论

我们在所有三种冠状病毒中都检测到了严重的过度分散的传播模式，而k估计值因研究设计和公共卫生能力的差异而有所不同。我们的研究结果表明，即使R值降低，由于传播异质性，该流行病仍然具有很高的复发潜力。