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Vermeulen M, Mhlanga L, Sykes W, Cable R, Coleman C, Pietersen N, Swanevelder R, Glatt TN, Bingham J, van den Berg K, Grebe E, Welte A. The evolution and interpretation of seroprevalence of SARS-CoV-2 antibodies among South African blood donors from the Beta to Omicron variant-driven waves. Vox Sang 2024; 119:242-251. [PMID: 38156504 DOI: 10.1111/vox.13571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/14/2023] [Accepted: 11/17/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND AND OBJECTIVES Confirmed COVID-19 diagnoses underestimate the total number of infections. Blood donors can provide representative seroprevalence estimates, which can be leveraged into reasonable estimates of total infection counts and infection fatality rate (IFR). MATERIALS AND METHODS Blood donors who donated after each of three epidemic waves (Beta, Delta and first Omicron waves) were tested for anti-SARS-CoV-2 nucleocapsid antibodies using the Roche Elecsys anti-SARS-CoV-2 total immunoglobulin assay. Roche Elecsys anti-spike antibody testing was done for the post-Omicron sampling. Prevalence of antibodies was estimated by age, sex, race and province and compared to official case reporting. Province and age group-specific IFRs were estimated using external excess mortality estimates. RESULTS The nationally weighted anti-nucleocapsid seroprevalence estimates after the Beta, Delta and Omicron waves were 47% (46.2%-48.6%), 71% (68.8%-73.5%) and 87% (85.5%-88.4%), respectively. There was no variation by age and sex, but there were statistically and epidemiologically significant differences by province (except at the latest time point) and race. There was a 13-fold higher seroprevalence than confirmed case counts at the first time point. Age-dependent IFR roughly doubled for every 10 years of age increase over 6 decades from 0.014% in children to 6.793% in octogenarians. CONCLUSION Discrepancies were found between seroprevalence and confirmed case counts. High seroprevalence rates found among Black African donors can be ascribed to historical inequities. Our IFR estimates were useful in refining previous large disagreements about the severity of the epidemic in South Africa. Blood donor-based serosurveys provided a valuable and efficient way to provide near real-time monitoring of the ongoing SARS-CoV-2 outbreak.
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Affiliation(s)
- Marion Vermeulen
- South African National Blood Service, Johannesburg, South Africa
- University of the Free State, Bloemfontein, South Africa
| | - Laurette Mhlanga
- DSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa
- Northwestern University, Chicago, Illinois, USA
| | - Wendy Sykes
- South African National Blood Service, Johannesburg, South Africa
| | | | - Charl Coleman
- South African National Blood Service, Johannesburg, South Africa
| | | | | | - Tanya Nadia Glatt
- South African National Blood Service, Johannesburg, South Africa
- University of Johannesburg, Johannesburg, South Africa
| | - Jeremy Bingham
- DSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa
| | - Karin van den Berg
- South African National Blood Service, Johannesburg, South Africa
- University of the Free State, Bloemfontein, South Africa
- University of Cape Town, Rondebosch, South Africa
| | - Eduard Grebe
- DSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa
- Vitalant Research Institute, San Francisco, California, USA
- University of California San Francisco, San Francisco, California, USA
| | - Alex Welte
- DSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa
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Cherry N, Adisesh A, Burstyn I, Durand-Moreau Q, Galarneau JM, Labrèche F, Ruzycki SM, Zadunayski T. Cohort profile: recruitment and retention in a prospective cohort of Canadian healthcare workers during the COVID-19 pandemic. BMJ Open 2023; 13:e074716. [PMID: 37914305 PMCID: PMC10626826 DOI: 10.1136/bmjopen-2023-074716] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 10/10/2023] [Indexed: 11/03/2023] Open
Abstract
PURPOSE Healthcare workers were recruited early in 2020 to chart effects on their health as the COVID-19 pandemic evolved. The aim was to identify modifiable workplace risk factors for infection and mental ill health. PARTICIPANTS Participants were recruited from four Canadian provinces, physicians (medical doctors, MDs) in Alberta, British Columbia, Ontario and Quebec, registered nurses (RNs), licensed practical nurses (LPNs) and healthcare aides (HCAs) in Alberta and personal support workers (PSWs) in Ontario. Volunteers gave blood for serology testing before and after vaccination. Cases with COVID-19 were matched with up to four referents in a nested case-referent study. FINDINGS TO DATE Overall, 4964/5130 (97%) of those recruited joined the longitudinal cohort: 1442 MDs, 3136 RNs, 71 LPNs, 235 PSWs, 80 HCAs. Overall, 3812 (77%) were from Alberta. Prepandemic risk factors for mental ill health and respiratory illness differed markedly by occupation. Participants completed questionnaires at recruitment, fall 2020, spring 2021, spring 2022. By 2022, 4837 remained in the cohort (127 had retired, moved away or died), for a response rate of 89% (4299/4837). 4567/4964 (92%) received at least one vaccine shot: 2752/4567 (60%) gave postvaccine blood samples. Ease of accessing blood collection sites was a strong determinant of participation. Among 533 cases and 1697 referents recruited to the nested case-referent study, risk of infection at work decreased with widespread vaccination. FUTURE PLANS Serology results (concentration of IgG) together with demographic data will be entered into the publicly accessible database compiled by the Canadian Immunology Task Force. Linkage with provincial administrative health databases will permit case validation, investigation of longer-term sequelae of infection and comparison with community controls. Analysis of the existing dataset will concentrate on effects on IgG of medical condition, medications and stage of pregnancy, and the role of occupational exposures and supports on mental health during the pandemic.
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Affiliation(s)
- Nicola Cherry
- Department of Medicine, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
| | - Anil Adisesh
- Division of Occupational Medicine, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
| | - Igor Burstyn
- Department of Environmental and Occupational Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Quentin Durand-Moreau
- Department of Medicine, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
| | - Jean-Michel Galarneau
- Department of Medicine, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
- University of Calgary, Calgary, Alberta, Canada
| | | | - Shannon M Ruzycki
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- W21C, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Tanis Zadunayski
- Department of Medicine, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
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3
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Watts AW, Mâsse LC, Goldfarb DM, Irvine MA, Hutchison SM, Muttucomaroe L, Poon B, Barakauskas VE, O'Reilly C, Bosman E, Reicherz F, Coombs D, Pitblado M, O'Brien SF, Lavoie PM. SARS-CoV-2 cross-sectional seroprevalence study among public school staff in Metro Vancouver after the first Omicron wave in British Columbia, Canada. BMJ Open 2023; 13:e071228. [PMID: 37308276 DOI: 10.1136/bmjopen-2022-071228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Abstract
OBJECTIVE To determine the SARS-CoV-2 seroprevalence among school workers within the Greater Vancouver area, British Columbia, Canada, after the first Omicron wave. DESIGN Cross-sectional study by online questionnaire, with blood serology testing. SETTING Three main school districts (Vancouver, Richmond and Delta) in the Vancouver metropolitan area. PARTICIPANTS Active school staff enrolled from January to April 2022, with serology testing between 27 January and 8 April 2022. Seroprevalence estimates were compared with data obtained from Canadian blood donors weighted over the same sampling period, age, sex and postal code distribution. PRIMARY AND SECONDARY OUTCOMES SARS-CoV-2 nucleocapsid antibody testing results adjusted for test sensitivity and specificity, and regional variation across school districts using Bayesian models. RESULTS Of 1850 school staff enrolled, 65.8% (1214/1845) reported close contact with a COVID-19 case outside the household. Of those close contacts, 51.5% (625/1214) were a student and 54.9% (666/1214) were a coworker. Cumulative incidence of COVID-19 positive testing by self-reported nucleic acid or rapid antigen testing since the beginning of the pandemic was 15.8% (291/1845). In a representative sample of 1620 school staff who completed serology testing (87.6%), the adjusted seroprevalence was 26.5% (95% CrI 23.9% to 29.3%), compared with 32.4% (95% CrI 30.6% to 34.5%) among 7164 blood donors. CONCLUSION Despite frequent COVID-19 exposures reported, SARS-CoV-2 seroprevalence among school staff in this setting remained no greater than the community reference group. Results are consistent with the premise that many infections were acquired outside the school setting, even with Omicron.
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Affiliation(s)
- Allison W Watts
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
- Department of Pediatrics, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Louise C Mâsse
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - David M Goldfarb
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Mike A Irvine
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Sarah M Hutchison
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
- Department of Pediatrics, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Lauren Muttucomaroe
- Department of Pediatrics, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Bethany Poon
- Department of Pediatrics, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Vilte E Barakauskas
- Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Else Bosman
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
- Department of Pediatrics, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Frederic Reicherz
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
- Department of Pediatrics, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Daniel Coombs
- Department of Mathematics and Institute of Applied Mathematics, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Mark Pitblado
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
- Department of Pediatrics, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Sheila F O'Brien
- Canadian Blood Services, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Pascal M Lavoie
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
- Department of Pediatrics, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
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4
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Asamoah-Boaheng M, Goldfarb DM, Karim ME, O’Brien SF, Wall N, Drews SJ, Barakauskas V, Jassem AN, Grunau B. The Relationship Between Anti-Spike SARS-CoV-2 Antibody Levels and Risk of Breakthrough COVID-19 Among Fully Vaccinated Adults. J Infect Dis 2022; 227:339-343. [PMID: 36197948 PMCID: PMC9619727 DOI: 10.1093/infdis/jiac403] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/26/2022] [Accepted: 10/03/2022] [Indexed: 02/04/2023] Open
Abstract
The relationship between antibodies to wild-type severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigens and the risk of breakthrough infections is unclear, especially during circulation of the Omicron strain. We investigated the association of anti-spike and anti-receptor binding domain antibody levels and the risk of subsequent breakthrough coronavirus disease 2019 (COVID-19). We included adult paramedics from an observational cohort study who received 2 mRNA vaccines but did not have COVID-19 before the blood collection. Higher postvaccination antibody levels to wild-type SARS-CoV-2 antigens were associated with a reduced risk of COVID-19. Further research into clinical utility of antibody levels, to inform a threshold for protection and timing of boosters, should be prioritized.
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Affiliation(s)
- Michael Asamoah-Boaheng
- Correspondence: Dr Michael Asamoah-Boaheng, Department of Emergency Medicine, University of British Columbia, 1190 Horby Street, Vancouver, British Columbia V6Z 2K5, Canada ()
| | - David M Goldfarb
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mohammad Ehsanul Karim
- Centre for Health Evaluation and Outcome Sciences, University of British Columbia, Vancouver, British Columbia, Canada,School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sheila F O’Brien
- Canadian Blood Services, Vancouver, British Columbia, Canada,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Nechelle Wall
- British Columbia Emergency Health Services, Vancouver, British Columbia, Canada
| | - Steven J Drews
- Canadian Blood Services, Vancouver, British Columbia, Canada,Division of Diagnostic and Applied Microbiology, Laboratory Medicine and Pathology, University of Alberta, Alberta, Canada
| | - Vilte Barakauskas
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Agatha N Jassem
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Grunau B, Tom J, Asamoah-Boaheng M, O’Brien SF, Drews SJ, Sediqi S, Lavoie PM, Barakauskas V, Goldfarb DM. Sensitivity of the Elecsys Nucleocapsid Assay for the Detection of Preceding SARS-CoV-2 Infections. Open Forum Infect Dis 2022; 9:ofac349. [PMID: 35937649 PMCID: PMC9350617 DOI: 10.1093/ofid/ofac349] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 07/24/2022] [Indexed: 11/26/2022] Open
Abstract
Nucleocapsid serological assay sensitivity to identify severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections among vaccinees and for Omicron cases is unclear. In this prospective study, the Elecsys nucleocapsid assay was 89% sensitive in identifying SARS-CoV-2 infections 14–607 days pre–blood collection. Sensitivity was similar when comparing by vaccination status, and in Omicron (vs pre-Omicron) cases.
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Affiliation(s)
- Brian Grunau
- Centre for Health Evaluation & Outcome Sciences, St. Paul’s Hospital , Vancouver , Canada
- Department of Emergency Medicine, University of British Columbia , Vancouver , Canada
- British Columbia Emergency Health Services , Vancouver, British Columbia , Canada
| | - Janessa Tom
- British Columbia Emergency Health Services , Vancouver, British Columbia , Canada
| | - Michael Asamoah-Boaheng
- Department of Emergency Medicine, University of British Columbia , Vancouver , Canada
- Faculty of Medicine, Memorial University of Newfoundland , St. John’s , Canada
| | | | - Steven J Drews
- Canadian Blood Services , Ottawa , Canada
- Laboratory Medicine and Pathology, University of Alberta , Edmonton , Canada
| | - Sadaf Sediqi
- Department of Pathology and Laboratory Medicine, University of British Columbia , Vancouver , Canada
| | - Pascal M Lavoie
- Department of Pediatrics, University of British Columbia , Vancouver , Canada
| | - Vilte Barakauskas
- Department of Pathology and Laboratory Medicine, University of British Columbia , Vancouver , Canada
| | - David M Goldfarb
- Department of Pathology and Laboratory Medicine, University of British Columbia , Vancouver , Canada
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