key: cord-0869811-k30vuy1f authors: Moradi, Ghobad; Gholami, Fatemeh; Rasouli, Mohammad Aziz; Bagheri Amiri, Fahimeh; Moradi, Yousef title: How is the iceberg of COVID-19? Results from a rapid literature review date: 2021-06-16 journal: Med J Islam Repub Iran DOI: 10.47176/mjiri.35.77 sha: c9603abf31f99e3985741a314ccf4683b43f4ff1 doc_id: 869811 cord_uid: k30vuy1f Background: Given the various reports of the clinical spectrum of the disease, the aim of the present study was to determine possible scenarios of Coronavirus 2019 (COVID-19) iceberg using published articles. Methods: The present study was a rapid review of all international databases, including PubMed (Medline), Scopus, Web of Sciences, Embase, and Cochrane Library from January 1 to October 30, 2020. Results: In this review, 7 scenarios were considered for COVID-19 iceberg, in which the range of fatality percentage was estimated to be 0.5% to 7%, the range of asymptomatic cases 1% to 88.6%, the range of cases with mild symptoms 8% to 78%, no symptoms 1 % to 90 %, the range of intensive care unit (ICU) admission was 0.5% to 14.2%, and finally the intubation percentage was estimated to be 0.2% to 12.2%. The Scenarios Diamond Princess Cruise Ship and Iceland are closer to the reality of the clinical spectrum of COVID-19 around the world, which represent 0.6% and 0.5% of deaths, 0.7% and 1% of intubations, 2.5% and 9.7% of ICU admissions, 1.1% and 6% of hospitalizations, 15% and 31% of cases with mild symptoms, and finally 56.9% and 75% of asymptomatic cases of COVID-19, respectively, which should now be considered as the basis of the clinical knowledge of the disease. Conclusion: Understanding the clinical spectrum and natural knowledge of the disease and paying attention to asymptomatic or mild-symptom cases can help to make better decisions and develop more effective interventions to control COVID-19. In this study initial search Two studie (34)) conduc population us scenario, 75% cal symptoms patients were intubation ca low because served, fewer was less (Fig. Finally, the narios are sho In this re COVID-19, in In the fou asymptomatic respectively. mated to be 1 in these scena asymptomatic transmission and expanded results of the ios showed t identifying a percentage of and fatality r the clinical sp studies showe than what wa these studies find all spect be considered disease. In the sixth asymptomatic respectively. estimated to b rates vary fro world, and th tion, as many these 2 scena cause of their which has ide and mild case nominator of was reported scenarios are disease. In this study ios as the bes ease. In these asymptomatic trol. In studies a hospitalizatio iceberg was policymakers In addition, p the disease ca The high fa narios indica strategy, whi COVID-19 p with the dise Availab 2. Wu JT, Leun potential dom outbreak origi 2020 infection: the t 30. Moriarty LF cruise ships-Mortal Wkly R 31 COVID-19 usi Princess cruise 33 Ro Early Phase of 36. Lauer SA, G The incubation publicly repor Intern Med Mizumoto K asymptomatic cases on board 2020 Evid from Wuhan, C 41. Mahase E. C and MERS com 42. Onder G, characteristics JAMA Organization Coronavirus D 46. O'Grady NP, Maki DG, et catheter-relate Advisory Com Pediatrics Temporal in Canada and 49. Dudel C, Monitoring tre using decompo specific fatalit 50. Rajgor DD, many estimate 2020 Del Rio C, changing epid 52. Vincent J-L patients with C 53 mjiri.iums.ac.ir slam Repub