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Allen UD, Barton M, Upton J, Bailey A, Campigotto A, Abdulnoor M, Julien JP, Gubbay J, Kissoon N, Litosh A, La Neve MR, Wong P, Allen A, Bailey R, Byrne W, Jagoowani R, Phillips C, Merreles-Pulcini M, Polack A, Prescod C, Siddiqi A, Summers A, Thompson K, Thompson S, James C. Disproportionate Rates of COVID-19 Among Black Canadian Communities: Lessons from a Cross-Sectional Study in the First Year of the Pandemic. J Racial Ethn Health Disparities 2024:10.1007/s40615-023-01903-z. [PMID: 38253978 DOI: 10.1007/s40615-023-01903-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 12/14/2023] [Accepted: 12/20/2023] [Indexed: 01/24/2024]
Abstract
BACKGROUND Racialized communities, including Black Canadians, have disproportionately higher COVID-19 cases. We examined the extent to which SARS-CoV-2 infection has affected the Black Canadian community and the factors associated with the infection. METHODS We conducted a cross-sectional survey in an area of Ontario (northwest Toronto/Peel Region) with a high proportion of Black residents along with 2 areas that have lower proportions of Black residents (Oakville and London, Ontario). SARS-CoV-2 IgG antibodies were determined using the EUROIMMUN assay. The study was conducted between August 15, 2020, and December 15, 2020. RESULTS Among 387 evaluable subjects, the majority, 273 (70.5%), were enrolled from northwest Toronto and adjoining suburban areas of Peel, Ontario. The seropositivity values for Oakville and London were comparable (3.3% (2/60; 95% CI 0.4-11.5) and 3.9% (2/51; 95% CI 0.5-13.5), respectively). Relative to these areas, the seropositivity was higher for the northwest Toronto/Peel area at 12.1% (33/273), relative risk (RR) 3.35 (1.22-9.25). Persons 19 years of age or less had the highest seropositivity (10/50; 20.0%, 95% CI 10.3-33.7%), RR 2.27 (1.23-3.59). There was a trend for an interaction effect between race and location of residence as this relates to the relative risk of seropositivity. INTERPRETATION During the early phases of the pandemic, the seropositivity within a COVID-19 high-prevalence zone was threefold greater than lower prevalence areas of Ontario. Black individuals were among those with the highest seroprevalence of SARS-CoV-2.
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Affiliation(s)
- Upton D Allen
- Division of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
| | - Michelle Barton
- Division of Infectious Diseases, Department of Paediatrics, London Health Sciences Centre, London, ON, Canada
| | - Julia Upton
- Division of Allergy and Immunology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Annette Bailey
- Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Aaron Campigotto
- Division of Microbiology, Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, ON, Canada
| | - Mariana Abdulnoor
- Division of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | | | | | - Niranjan Kissoon
- Department of Paediatrics, University of British Columbia, Vancouver, Canada
| | - Alice Litosh
- Division of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Maria-Rosa La Neve
- Division of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Peter Wong
- Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Andrew Allen
- Division of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Renee Bailey
- Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Walter Byrne
- Division of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Ranjeeta Jagoowani
- Division of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Chantal Phillips
- Division of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Manuela Merreles-Pulcini
- Division of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Alicia Polack
- Division of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Cheryl Prescod
- Black Creek Community Health Centre, Toronto, Ontario, Canada
| | - Arjumand Siddiqi
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | | | - Kimberly Thompson
- Division of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
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Wong SY, Wellens J, Helmus D, Marlow L, Brann S, Martinez Pazos V, Weinberg A, Moran HR, McGregor C, Vermeire S, Watanabe K, Kamikozuru K, Ahuja V, Vermani S, Lindsay JO, Kingston A, Dutta U, Kaur H, Silverberg MS, Milgrom R, Chien Ng S, Mak JWY, Cadwell K, Thompson C, Colombel JF, Satsangi J. Geography Influences Susceptibility to SARS-CoV-2 Serological Response in Patients With Inflammatory Bowel Disease: Multinational Analysis From the ICARUS-IBD Consortium. Inflamm Bowel Dis 2023; 29:1693-1705. [PMID: 37354560 DOI: 10.1093/ibd/izad097] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Indexed: 06/26/2023]
Abstract
BACKGROUND Beyond systematic reviews and meta-analyses, there have been no direct studies of serological response to COVID-19 in patients with inflammatory bowel disease (IBD) across continents. In particular, there has been limited data from Asia, with no data reported from India. The ICARUS-IBD (International study of COVID-19 Antibody Response Under Sustained immunosuppression in IBD) consortium assessed serological response to SARS-CoV-2 in patients with IBD in North America, Europe, and Asia. METHODS The ICARUS-IBD study is a multicenter observational cohort study spanning sites in 7 countries. We report seroprevalence data from 2303 patients with IBD before COVID-19 vaccination between May 2020 and November 2021. SARS-CoV-2 anti-spike and anti-nucleocapsid antibodies were analyzed. RESULTS The highest and lowest SARS-CoV-2 anti-spike seropositivity rates were found in Asia (81.2% in Chandigarh and 57.9% in Delhi, India; and 0% in Hong Kong). By multivariable analysis, country (India: odds ratio [OR], 18.01; 95% confidence interval [CI], 12.03-26.95; P < .0001; United Kingdom: OR, 2.43; 95% CI, 1.58-3.72; P < .0001; United States: OR, 2.21; 95% CI, 1.27-3.85; P = .005), male sex (OR, 1.46; 95% CI, 1.07-1.99; P = .016), and diabetes (OR, 2.37; 95% CI, 1.04-5.46; P = .039) conferred higher seropositivity rates. Biological therapies associated with lower seroprevalence (OR, 0.22; 95% CI, 0.15-0.33; P < .0001). Multiple linear regression showed associations between anti-spike and anti-nucleocapsid titers with medications (P < .0001) but not with country (P = .3841). CONCLUSIONS While the effects of medications on anti-SARS-CoV-2 antibody titers in patients with IBD were consistent across sites, geographical location conferred the highest risk of susceptibility to serologically detectable SARS-CoV-2 infection. Over half of IBD patients in India were seropositive prior to vaccination. These insights can help to inform shielding advice, therapeutic choices, and vaccine strategies in IBD patients for COVID-19 and future viral challenges.
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Affiliation(s)
- Serre-Yu Wong
- Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Judith Wellens
- Department of Gastroenterology and Hepatology, Leuven University Hospitals, Leuven, Belgium
| | - Drew Helmus
- Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Luke Marlow
- Translational Gastroenterology Unit, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Stephanie Brann
- Translational Gastroenterology Unit, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Vicky Martinez Pazos
- Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alan Weinberg
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Hunter R Moran
- Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Colleen McGregor
- Translational Gastroenterology Unit, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Séverine Vermeire
- Department of Gastroenterology and Hepatology, Leuven University Hospitals, Leuven, Belgium
| | - Kenji Watanabe
- Center for Inflammatory Bowel Disease, Division of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Koji Kamikozuru
- Center for Inflammatory Bowel Disease, Division of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Vineet Ahuja
- Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India
| | - Shubi Vermani
- Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India
| | - James O Lindsay
- Center for Immunobiology, Blizard Institute, Queen Mary University of London - Barts Health NHS Trust, London, United Kingdom
| | - Ashley Kingston
- Center for Immunobiology, Blizard Institute, Queen Mary University of London - Barts Health NHS Trust, London, United Kingdom
| | - Usha Dutta
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Harmandeep Kaur
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Mark S Silverberg
- Division of Gastroenterology, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Raquel Milgrom
- Division of Gastroenterology, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Siew Chien Ng
- Division of Gastroenterology and Hepatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Joyce Wing Yan Mak
- Division of Gastroenterology and Hepatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Ken Cadwell
- Division of Gastroenterology and Hepatology, Department of Medicine, Perelman School of Medicine of the University of Pennsylvania, Pennsylvania, PA, USA
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine of the University of Pennsylvania, Pennsylvania, PA, USA
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine of the University of Pennsylvania, Pennsylvania, PA, USA
| | - Craig Thompson
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Warwick, United Kingdom
| | - Jean-Frédéric Colombel
- Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jack Satsangi
- Translational Gastroenterology Unit, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
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Dali-Ali A, Derkaoui DK, Zina M, Oukebdane A. Seroprevalence of COVID-19 in Oran: Cross-Sectional Study. Microbiol Spectr 2023; 11:e0087623. [PMID: 37284756 PMCID: PMC10433985 DOI: 10.1128/spectrum.00876-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 05/22/2023] [Indexed: 06/08/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was introduced in Algeria in March 2020. This study aimed to estimate the seroprevalence of SARS-CoV-2 infection in Oran, Algeria, and to identify factors associated with seropositivity. This was a cross-sectional seroprevalence study conducted between 7 and 20 January 2021 across all 26 municipalities in the province of Oran. The study employed a random cluster sampling technique stratified by age and sex to select participants from households, who were then administered a rapid serological test. The overall seroprevalence and specific seroprevalences by municipality were calculated, and the number of COVID-19 cases in Oran was estimated. The correlation between population density and seroprevalence was also examined. Among the participants, 422 (35.6%; 95% confidence interval [CI], 32.9 to 38.4) had a positive serological test for SARS-CoV-2, and eight municipalities had seroprevalence rates above 73%. We found a strong positive correlation between population density and seroprevalence (r = 0.795, P < 0.001), indicating that areas with higher population density had higher numbers of positive COVID-19 cases. Our study provides evidence of a high seroprevalence of SARS-CoV-2 infection in Oran, Algeria. The estimated number of cases based on seroprevalence is much higher than the number of cases confirmed by PCR. Our findings suggest that a large proportion of the population has been infected with SARS-CoV-2, highlighting the need for continued surveillance and control measures to prevent further spread of the virus. IMPORTANCE This is the first and only seroprevalence study of COVID-19 conducted in the general population in Algeria prior to the national vaccination campaign against COVID-19. The significance of this study lies in its contribution to our understanding of the spread of the virus in the population before the implementation of the vaccination program.
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Affiliation(s)
- Abdessamad Dali-Ali
- University of Oran 1: Ahmed Ben Bella, Faculty of Medicine, Oran, Algeria
- Department of Epidemiology and Preventive Medicine at EHUO, Oran, Algeria
| | | | - Mohamed Zina
- Public Establishment of Proximity Care in Boutlellis, Department of Epidemiology and Preventive Medicine, Boutlellis, Oran, Algeria
| | - Asmaa Oukebdane
- Canastel Specialized Hospital, Ophthalmology Department, Oran, Algeria
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Bhattacharya J, Magness P, Kulldorff M. Understanding the exceptional pre-vaccination Era East Asian COVID-19 outcomes. Adv Biol Regul 2022; 86:100916. [PMID: 36328937 PMCID: PMC9575551 DOI: 10.1016/j.jbior.2022.100916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/05/2022] [Accepted: 09/17/2022] [Indexed: 11/05/2022]
Abstract
During the first year of the pandemic, East Asian countries have reported fewer infections, hospitalizations, and deaths from COVID-19 disease than most countries in Europe and the Americas. Our goal in this paper is to generate and evaluate hypothesis that may explain this striking fact. We consider five possible explanations: (1) population age structure (younger people tend to have less severe COVID-19 disease upon infection than older people); (2) the early adoption of lockdown strategies to control disease spread; (3) genetic differences between East Asian population and European and American populations that confer protection against COVID-19 disease; (4) seasonal and climactic contributors to COVID-19 spread; and (5) immunological differences between East Asian countries and the rest of the world. The evidence suggests that the first four hypotheses are unlikely to be important in explaining East Asian COVID-19 exceptionalism. Lockdowns, in particular, fail as an explanation because East Asian countries experienced similarly good infection outcomes despite vast differences in lockdown policies adopted by different countries to control the COVID-19 epidemic. The evidence to date is consistent with our fifth hypothesis - pre-existing immunity unique to East Asia - but there are still essential parts of this story left for scientists to check.
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Affiliation(s)
- Jay Bhattacharya
- Stanford University School of Medicine, National Bureau of Economic Research, USA.
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Kaur A, Singh N, Singh K, Sidhu SK, Kaur H, Jain P, Kaur M, Jairath M. SARS-CoV-2 IgG Antibody Seroprevalence in Children from the Amritsar District of Punjab. KOREAN JOURNAL OF CLINICAL LABORATORY SCIENCE 2022. [DOI: 10.15324/kjcls.2022.54.3.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Amandeep Kaur
- The Viral Research and Diagnostic Laboratory, Government Medical College, Amritsar, India
| | - Narinder Singh
- Department of Pediatrics, Government Medical College, Amritsar, India
| | - Kanwardeep Singh
- Department of Microbiology, Government Medical College, Amritsar, India
| | | | - Harleen Kaur
- The Viral Research and Diagnostic Laboratory, Government Medical College, Amritsar, India
| | - Poonam Jain
- The Viral Research and Diagnostic Laboratory, Government Medical College, Amritsar, India
| | - Manmeet Kaur
- Department of Pediatrics, Government Medical College, Amritsar, India
| | - Mohan Jairath
- The Viral Research and Diagnostic Laboratory, Government Medical College, Amritsar, India
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Hajissa K, Mussa A, Karobari MI, Abbas MA, Ibrahim IK, Assiry AA, Iqbal A, Alhumaid S, Mutair AA, Rabaan AA, Messina P, Scardina GA. The SARS-CoV-2 Antibodies, Their Diagnostic Utility, and Their Potential for Vaccine Development. Vaccines (Basel) 2022; 10:1346. [PMID: 36016233 PMCID: PMC9412318 DOI: 10.3390/vaccines10081346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/14/2022] [Accepted: 08/15/2022] [Indexed: 11/30/2022] Open
Abstract
Antibodies (Abs) are important immune mediators and powerful diagnostic markers in a wide range of infectious diseases. Understanding the humoral immunity or the development of effective antibodies against SARS-CoV-2 is a prerequisite for limiting disease burden in the community and aids in the development of new diagnostic, therapeutic, and vaccination options. Accordingly, the role of antiviral antibodies in the resistance to and diagnosis of SARS-CoV-2 infection was explored. Antibody testing showed the potential in adding important diagnostic value to the routine diagnosis and clinical management of COVID-19. They could also play a critical role in COVID-19 surveillance, allowing for a better understanding of the full scope of the disease. The development of several vaccines and the success of passive immunotherapy suggest that anti-SARS-CoV-2 antibodies have the potential to be used in the treatment and prevention of SARS-CoV-2 infection. In this review, we highlight the role of antibodies in the diagnosis of SARS-CoV-2 infection and provide an update on their protective roles in controlling SARS-CoV-2 infection as well as vaccine development.
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Affiliation(s)
- Khalid Hajissa
- Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia
- Department of Zoology, Faculty of Science and Technology, Omdurman Islamic University, Omdurman P.O. Box 382, Sudan
| | - Ali Mussa
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia
- Department of Biology, Faculty of Education, Omdurman Islamic University, Omdurman P.O. Box 382, Sudan
| | - Mohmed Isaqali Karobari
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia
- Department of Conservative Dentistry & Endodontics, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences University, Chennai 600077, Tamil Nadu, India
- Department of Restorative Dentistry & Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh 12211, Cambodia
| | - Muhammad Adamu Abbas
- Department of Medical Microbiology and Parasitology, College of Health Sciences, Bayero University Kano, Kano 3011, Nigeria
| | - Ibrahim Khider Ibrahim
- Department of Haematology, Faculty of Medical Laboratory Sciences, Al Neelain University, Khartoum 11111, Sudan
| | - Ali A Assiry
- Preventive Dental Science Department, Faculty of Dentistry, Najran University, Najran 55461, Saudi Arabia
| | - Azhar Iqbal
- Department of Restorative Dentistry, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia
| | - Saad Alhumaid
- Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 31982, Saudi Arabia
| | - Abbas Al Mutair
- Research Center, Almoosa Specialist Hospital, Al-Ahsa 36342, Saudi Arabia
- College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia
- School of Nursing, Wollongong University, Wollongong, NSW 2522, Australia
- Nursing Department, Prince Sultan Military College of Health Sciences, Dhahran 33048, Saudi Arabia
| | - Ali A. Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
- Department of Public Health and Nutrition, The University of Haripur, Haripur 22610, Pakistan
| | - Pietro Messina
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, 90133 Palermo, Italy
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Hajissa K, Islam MA, Hassan SA, Zaidah AR, Ismail N, Mohamed Z. Seroprevalence of SARS-CoV-2 Antibodies in Africa: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127257. [PMID: 35742506 PMCID: PMC9223681 DOI: 10.3390/ijerph19127257] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 05/31/2022] [Accepted: 06/06/2022] [Indexed: 02/06/2023]
Abstract
A reliable estimate of SARS-CoV-2-specific antibodies is increasingly important to track the spread of infection and define the true burden of the ongoing COVID-19 pandemic. A systematic review and a meta-analysis were conducted with the objective of estimating the seroprevalence of SARS-CoV-2 infection in Africa. A systematic search of the PubMed, Scopus, Web of Science and Google Scholar electronic databases was conducted. Thirty-five eligible studies were included. Using meta-analysis of proportions, the overall seroprevalence of anti-SARS-CoV-2 antibodies was calculated as 16% (95% CI 13.1-18.9%). Based on antibody isotypes, 14.6% (95% CI 12.2-17.1%) and 11.5% (95% CI 8.7-14.2%) were seropositive for SARS-CoV-2 IgG and IgM, respectively, while 6.6% (95% CI 4.9-8.3%) were tested positive for both IgM and IgG. Healthcare workers (16.3%) had higher seroprevalence than the general population (11.7%), blood donors (7.5%) and pregnant women (5.7%). The finding of this systematic review and meta-analysis (SRMA) may not accurately reflect the true seroprevalence status of SARS-CoV-2 infection in Africa, hence, further seroprevalence studies across Africa are required to assess and monitor the growing COVID-19 burden.
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Affiliation(s)
- Khalid Hajissa
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (K.H.); (S.A.H.); (A.R.Z.); (N.I.)
- Department of Zoology, Faculty of Science and Technology, Omdurman Islamic University, P.O. Box 382, Omdurman 14415, Sudan
| | - Md Asiful Islam
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham B15 2TT, UK
- Correspondence: or (M.A.I.); (Z.M.)
| | - Siti Asma Hassan
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (K.H.); (S.A.H.); (A.R.Z.); (N.I.)
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Abdul Rahman Zaidah
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (K.H.); (S.A.H.); (A.R.Z.); (N.I.)
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Nabilah Ismail
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (K.H.); (S.A.H.); (A.R.Z.); (N.I.)
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Zeehaida Mohamed
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (K.H.); (S.A.H.); (A.R.Z.); (N.I.)
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Correspondence: or (M.A.I.); (Z.M.)
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Assaid N, Arich S, Charoute H, Akarid K, Ezzikouri S, Maaroufi A, Sarih M. Anti-SARS-CoV-2 Antibody Responses 5 Months Post Complete Vaccination of Moroccan Healthcare Workers. Vaccines (Basel) 2022; 10:465. [PMID: 35335097 PMCID: PMC8952418 DOI: 10.3390/vaccines10030465] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/12/2022] [Accepted: 03/14/2022] [Indexed: 12/20/2022] Open
Abstract
Data about the duration of antibodies after vaccination show that the protection against SARS-CoV-2 infection begins to decline over time. This study aims to determine anti-SARS-CoV-2 anti-S IgG levels in healthcare workers five months after the second vaccination dose. We collected samples from 82 participants who were fully vaccinated with ChAdOx1 nCoV-19 or BBIBP-CorV. We assessed anti-SARS-CoV-2 IgG antibodies using a Euroimmun ELISA and an Abbott Architect ™ SARS-CoV-2 IgG test. Of the 82 participants, 65.85% were seropositive for IgG using ELISA, and 86.59% were positive for IgG according to the Abbott Architect ™ test. Individuals vaccinated with the ChAdOx1 nCoV-19 vaccine had a median anti-S1 antibody level of 1.810 AU/mL [interquartile range (IQR), 1.080-3.7340] and 171.7 AU/mL [79.9-684.6] according to the Euroimmun ELISA and Abbott Architect test, respectively. These tests indicated that people vaccinated with BBIBP-CorV had a median anti-S1 antibody level of 1.840 AU/mL [0.810-2.960] and 126.7 AU/mL [54.9-474.3], respectively. Statistical analysis showed no significant difference between the positivity rates of the vaccinated individuals, either for gender or for age. In addition, we found no significant difference between the two vaccines. Our study provides information on the longevity of the anti-SARS-CoV-2 IgG antibodies in people at least five months after vaccination.
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Affiliation(s)
- Najlaa Assaid
- Service de Parasitologie et des Maladies Vectorielles, Institut Pasteur du Maroc, Place Louis Pasteur, Casablanca 20360, Morocco; (N.A.); (S.A.); (A.M.)
- Health and Environment Laboratory, Molecular Genetics and Immunophysiopathology Research Team, Aïn Chock Faculty of Sciences, University of Hassan II Casablanca (UH2C), Casablanca 20100, Morocco;
| | - Soukaina Arich
- Service de Parasitologie et des Maladies Vectorielles, Institut Pasteur du Maroc, Place Louis Pasteur, Casablanca 20360, Morocco; (N.A.); (S.A.); (A.M.)
| | - Hicham Charoute
- Research Unit of Epidemiology, Biostatistics and Bioinformatics, Institut Pasteur du Maroc, Casablanca 20360, Morocco;
| | - Khadija Akarid
- Health and Environment Laboratory, Molecular Genetics and Immunophysiopathology Research Team, Aïn Chock Faculty of Sciences, University of Hassan II Casablanca (UH2C), Casablanca 20100, Morocco;
| | - Sayeh Ezzikouri
- Viral Hepatitis Laboratory, Virology Unit, Institut Pasteur du Maroc, Casablanca 20360, Morocco;
| | - Abderrahmane Maaroufi
- Service de Parasitologie et des Maladies Vectorielles, Institut Pasteur du Maroc, Place Louis Pasteur, Casablanca 20360, Morocco; (N.A.); (S.A.); (A.M.)
| | - M’hammed Sarih
- Service de Parasitologie et des Maladies Vectorielles, Institut Pasteur du Maroc, Place Louis Pasteur, Casablanca 20360, Morocco; (N.A.); (S.A.); (A.M.)
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9
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Guarino C, Larson E, Babasyan S, Rollins A, Joshi LR, Laverack M, Parrilla L, Plocharczyk E, Diel DG, Wagner B. Development of a quantitative COVID-19 multiplex assay and its use for serological surveillance in a low SARS-CoV-2 incidence community. PLoS One 2022; 17:e0262868. [PMID: 35061843 PMCID: PMC8782306 DOI: 10.1371/journal.pone.0262868] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/06/2022] [Indexed: 12/14/2022] Open
Abstract
A serological COVID-19 Multiplex Assay was developed and validated using serum samples from convalescent patients and those collected prior to the 2020 pandemic. After initial testing of multiple potential antigens, the SARS-CoV-2 nucleocapsid protein (NP) and receptor-binding domain (RBD) of the spike protein were selected for the human COVID-19 Multiplex Assay. A comparison of synthesized and mammalian expressed RBD proteins revealed clear advantages of mammalian expression. Antibodies directed against NP strongly correlated with SARS-CoV-2 virus neutralization assay titers (rsp = 0.726), while anti-RBD correlation was moderate (rsp = 0.436). Pan-Ig, IgG, IgA, and IgM against NP and RBD antigens were evaluated on the validation sample sets. Detection of NP and RBD specific IgG and IgA had outstanding performance (AUC > 0.90) for distinguishing patients from controls, but the dynamic range of the IgG assay was substantially greater. The COVID-19 Multiplex Assay was utilized to identify seroprevalence to SARS-CoV-2 in people living in a low-incidence community in Ithaca, NY. Samples were taken from a cohort of healthy volunteers (n = 332) in early June 2020. Only two volunteers had a positive result on a COVID-19 PCR test performed prior to serum sampling. Serological testing revealed an exposure rate of at least 1.2% (NP) or as high as 5.7% (RBD), higher than the measured incidence rate of 0.16% in the county at that time. This highly sensitive and quantitative assay can be used for monitoring community exposure rates and duration of immune response following both infection and vaccination.
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Affiliation(s)
- Cassandra Guarino
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States of America
| | - Elisabeth Larson
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States of America
| | - Susanna Babasyan
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States of America
| | - Alicia Rollins
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States of America
| | - Lok R. Joshi
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States of America
| | - Melissa Laverack
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States of America
| | - Lara Parrilla
- Cayuga Medical Center, Ithaca, NY, United States of America
| | | | - Diego G. Diel
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States of America
| | - Bettina Wagner
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States of America
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10
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Doi A, Iwata K, Kuroda H, Hasuike T, Nasu S, Nishioka H, Tomii K, Morimoto T, Kihara Y. A cross-sectional follow up study to estimate seroprevalence of coronavirus disease 2019 in Kobe, Japan. Medicine (Baltimore) 2021; 100:e28066. [PMID: 35049228 PMCID: PMC9191319 DOI: 10.1097/md.0000000000028066] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 11/09/2021] [Indexed: 11/26/2022] Open
Abstract
We conducted a study to estimate the seroprevalence of coronavirus disease 2019 (COVID-19) in Kobe, Japan with positive immunoglobulin G (IgG) rate of 3.3% (95% confidence interval [CI] 2.3%-4.6%) in April 2020. Because there were large concerns about the spread of COVID-19 among citizens thereafter, we conduct a follow-up cross-sectional study to estimate the seroprevalence, and we also added a validation study using a different assay.We conducted cross-sectional serologic testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody using 1000 samples from patients at outpatient settings who visited the clinic from May 26 to June 7, 2020, stratified by the decade of age and sex. We used both Kurabo and Abbott serology assays to identify IgG against SARS-CoV-2.There were 18 and 2 positive IgG among 1000 serum samples using Kurabo and Abbott serology assays, respectively (1.8%, 95% CI 1.1%-2.8%, and 0.2%, 95% CI 0.02%-0.7% respectively). By applying the latter figure to the census of Kobe City (population: 1,518,870), it is estimated that the number of people with positive IgG is 3038 (95% CI: 304-10,632) while a total of 285 patients were identified by polymerase chain reaction (PCR) testing at the end of the study period. Assuming Abbott assay as the reference, Kurabo assay had calculated sensitivity and specificity of 100% and 98.4% respectively. Age and sex adjusted prevalence of positivity was calculated to be 0.17%.We found a lower seroprevalence than 2 months before in Kobe city although the figures were still higher than those detected by PCR. Kurabo assay showed more false positives than true positives despite reasonable sensitivity and specificity, due to low prevalence in Kobe.
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Affiliation(s)
- Asako Doi
- Department of Infectious Diseases, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Kentaro Iwata
- Division of Infectious Diseases Therapeutics, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Hirokazu Kuroda
- Department of Infectious Diseases, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Toshikazu Hasuike
- Department of Infectious Diseases, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Seiko Nasu
- Department of Laboratory Medicine, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Hiroaki Nishioka
- Department of Infectious Diseases, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Keisuke Tomii
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Takeshi Morimoto
- Department of Clinical Epidemiology, Hyogo Medical College, Nishinomiya, Hyogo, Japan
| | - Yasuki Kihara
- Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
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11
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El-Sokkary RH, Daef E, El-Korashi LA, Khedr EM, Gad D, Mohamed-Hussein A, Zayed NE, Mostafa EF, Bahgat SM, Hassany SM, Amer MG, El-Mokhtar MA, Elantouny NG, Hassan SA, Zarzour AA, Hashem MK, Amin MT, Hassan HM. Sero-prevalence of anti-SARS-CoV-2 antibodies among healthcare workers: A multicenter study from Egypt. J Infect Public Health 2021; 14:1474-1480. [PMID: 34556461 PMCID: PMC8450145 DOI: 10.1016/j.jiph.2021.09.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/10/2021] [Accepted: 09/14/2021] [Indexed: 11/17/2022] Open
Abstract
Background Healthcare workers (HCWs) are at a high risk for disease exposure. Given the limited availability of nucleic acid testing by PCR in low resource settings, serological assays can provide useful data on the proportion of HCWs who have recently or previously been infected. Therefore, in this study, we conducted an immunologic study to determine the seroprevalence of anti-SARS-CoV-2 antibodies in two university hospitals in Egypt. Methods in this cross sectional study, HCWs who were working in SARS-CoV-2 Isolation Hospitals were interviewed. Estimating specific antibodies (IgM and IgG) against SARS-CoV-2 was carried out using an enzyme-linked immunosorbent assay targeting the Spike antigen of SARS-CoV-2 virus. Results Out of 111, 82 (74%) HCWs accepted to participate with a mean age of 31.5 ± 8.5 years. Anti-SARS-COV2 antibodies were detected in 38/82 (46.3%) of cases with a mean age of 31 years and female HCWs constituted 57.6% of cases. The highest rate of seropositivity was from the nurses (60.5%), and physicians (31.6%) with only (7.9%) technicians. Only 28/82 (34.1%) HCWs reported previous history of COVID19. We reported a statistically significant difference in the timing of exposure (p = 0.010) and the frequency of contact with COVID-19 cases (p = 0.040) between previously infected and on-infected HCWs. Longer time of recovery was reported from IgG positive HCWs (p = 0.036). Conclusion The high frequency of seropositive HCWs in investigated hospitals is alarming, especially among asymptomatic personnel. Confirmation of diseased HCWs (among seropositive ones) are warranted.
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Affiliation(s)
- Rehab H El-Sokkary
- Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Egypt.
| | - Enas Daef
- Medical Microbiology and Immunology Department, Faculty of Medicine, Assiut University, Egypt
| | - Lobna A El-Korashi
- Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Egypt
| | - Eman M Khedr
- Neurology and Psychiatry Department, Assiut University, Assiut, Egypt
| | - Doaa Gad
- Chest Department, Faculty of Medicine, Zagazig University, Egypt
| | | | - Niveen E Zayed
- Chest Department, Faculty of Medicine, Zagazig University, Egypt
| | - Ehab F Mostafa
- Tropical Medicine and Gastroenterology Department, Alrajhi University Hospital, Assiut University, Assiut, Egypt
| | | | - Sahar M Hassany
- Tropical Medicine and Gastroenterology Department, Alrajhi University Hospital, Assiut University, Assiut, Egypt
| | | | - Mohamed A El-Mokhtar
- Medical Microbiology and Immunology Department, Faculty of Medicine, Assiut University, Egypt
| | - Neveen G Elantouny
- Internal Medicine, Head Infectious Diseases Unit, Zagazig University, Egypt
| | - Shimaa A Hassan
- Anesthesia and Intensive Care, Assiut University, Assiut, Egypt
| | - Amro A Zarzour
- Anesthesia and Intensive Care, Assiut University, Assiut, Egypt
| | - Maiada K Hashem
- Chest Department, Faculty of Medicine, Assiut University, Egypt
| | | | - Hebatallah M Hassan
- Medical Microbiology and Immunology Department, Faculty of Medicine, Assiut University, Egypt
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12
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Traini MC, Caponi C, Ferrari R, De Socio GV. Modelling SARS-CoV-2 unreported cases in Italy: Analysis of serological survey and vaccination scenarios. Infect Dis Model 2021; 6:909-923. [PMID: 34278058 PMCID: PMC8276585 DOI: 10.1016/j.idm.2021.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 05/11/2021] [Accepted: 06/15/2021] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES Aim of the present paper is the study of the large unreported component, characterizing the SARS-CoV-2 epidemic event in Italy, taking advantage of the Istat survey. Particular attention is devoted to the sensitivity and specificity of the serological test and their effects. METHODS The model satisfactory reproduces the data of the Italian survey showing a relevant predictive power and relegating in a secondary position models which do not include, in the simulation, the presence of asymptomatic groups. The corrections due to the serological test sensitivity (in particular those ones depending on the symptoms onset) are crucial for a realistic analysis of the unreported (and asymptomatic) components. RESULTS The relevant presence of an unreported component during the second pandemic wave in Italy is confirmed and the ratio of reported to unreported cases is predicted to be roughly 1:4 in the last months of year 2020. A method to correct the serological data on the basis of the antibody sensitivity is suggested and systematically applied. The asymptomatic component is also studied in some detail and its amount quantified. A model analyses of the vaccination scenarios is performed confirming the relevance of a massive campaign (at least 80000 immunized per day) during the first six months of the year 2021, to obtain important immunization effects within August/September 2021.
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Affiliation(s)
- Marco Claudio Traini
- Dipartimento di Fisica, Università Degli Studi di Trento, Via Sommarive 14, I-38123, Trento-Povo, Italy
| | - Carla Caponi
- Clinica Geriatrica, Azienda Ospedaliero-Universitaria, Piazzale Gambuli 1, 06132, Perugia, Italy
| | - Riccardo Ferrari
- Bilubah LLC, 30 N. Gould St, Suite 6739, Sheridan, WY, 82801, USA
| | - Giuseppe Vittorio De Socio
- Clinica Malattie Infettive, Azienda Ospedaliero-Universitaria, Piazzale Gambuli 1, 06132, Perugia, Italy
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13
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Fai KN, Corine TM, Bebell LM, Mboringong AB, Nguimbis EBPT, Nsaibirni R, Mbarga NF, Eteki L, Nikolay B, Essomba RG, Ndifon M, Ntone R, Hamadou A, Matchim L, Tchiasso D, Abah Abah AS, Essaka R, Peppa S, Crescence F, Ouamba JP, Koku MT, Mandeng N, Fanne M, Eyangoh S, Mballa GAE, Esso L, Epée E, Njouom R, Okomo Assoumou MC, Boum Y. Serologic response to SARS-CoV-2 in an African population. SCIENTIFIC AFRICAN 2021; 12:e00802. [PMID: 34095639 PMCID: PMC8164732 DOI: 10.1016/j.sciaf.2021.e00802] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 04/15/2021] [Accepted: 05/02/2021] [Indexed: 01/04/2023] Open
Abstract
Official case counts suggest Africa has not seen the expected burden of COVID-19 as predicted by international health agencies, and the proportion of asymptomatic patients, disease severity, and mortality burden differ significantly in Africa from what has been observed elsewhere. Testing for SARS-CoV-2 was extremely limited early in the pandemic and likely led to under-reporting of cases leaving important gaps in our understanding of transmission and disease characteristics in the African context. SARS-CoV-2 antibody prevalence and serologic response data could help quantify the burden of COVID-19 disease in Africa to address this knowledge gap and guide future outbreak response, adapted to the local context. However, such data are widely lacking in Africa. We conducted a cross-sectional seroprevalence survey among 1,192 individuals seeking COVID-19 screening and testing in central Cameroon using the Innovita antibody-based rapid diagnostic. Overall immunoglobulin prevalence was 32%, IgM prevalence was 20%, and IgG prevalence was 24%. IgM positivity gradually increased, peaking around symptom day 20. IgG positivity was similar, gradually increasing over the first 10 days of symptoms, then increasing rapidly to 30 days and beyond. These findings highlight the importance of diagnostic testing and asymptomatic SARS-CoV-2 transmission in Cameroon, which likely resulted in artificially low case counts. Rapid antibody tests are a useful diagnostic modality for seroprevalence surveys and infection diagnosis starting 5-7 days after symptom onset. These results represent the first step towards better understanding the SARS-CoV-2 immunological response in African populations.
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Affiliation(s)
| | | | - Lisa M Bebell
- Massachussetts General Hospital, Boston, United States
| | | | | | | | | | | | | | - Rene Ghislain Essomba
- National Public Health Laboratory, Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Cameroon
| | | | | | - Achta Hamadou
- Public Health Emergency Operation Center, Ministry of Health, Yaoundé, Cameroon
| | | | | | | | | | - Solange Peppa
- National Public Health Laboratory, Yaoundé, Cameroon
| | | | | | | | - Nadia Mandeng
- Public Health Emergency Operation Center, Ministry of Health, Yaoundé, Cameroon
| | - Mahamat Fanne
- Public Health Emergency Operation Center, Ministry of Health, Yaoundé, Cameroon
| | | | | | - Linda Esso
- Public Health Emergency Operation Center, Ministry of Health, Yaoundé, Cameroon
| | - Emilienne Epée
- Public Health Emergency Operation Center, Ministry of Health, Yaoundé, Cameroon
| | | | - Marie-Claire Okomo Assoumou
- National Public Health Laboratory, Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Cameroon
| | - Yap Boum
- Epicentre, Yaoundé, Cameroon
- Public Health Emergency Operation Center, Ministry of Health, Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Cameroon
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14
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Barchuk A, Skougarevskiy D, Titaev K, Shirokov D, Raskina Y, Novkunkskaya A, Talantov P, Isaev A, Pomerantseva E, Zhikrivetskaya S, Barabanova L, Volkov V. Seroprevalence of SARS-CoV-2 antibodies in Saint Petersburg, Russia: a population-based study. Sci Rep 2021; 11:12930. [PMID: 34155259 PMCID: PMC8217236 DOI: 10.1038/s41598-021-92206-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 06/04/2021] [Indexed: 01/08/2023] Open
Abstract
Properly conducted serological survey can help determine infection disease true spread. This study aims to estimate the seroprevalence of SARS-CoV-2 antibodies in Saint Petersburg, Russia accounting for non-response bias. A sample of adults was recruited with random digit dialling, interviewed and invited for anti-SARS-CoV-2 antibodies. The seroprevalence was corrected with the aid of the bivariate probit model that jointly estimated individual propensity to agree to participate in the survey and seropositivity. 66,250 individuals were contacted, 6,440 adults agreed to be interviewed and blood samples were obtained from 1,038 participants between May 27 and June 26, 2020. Naïve seroprevalence corrected for test characteristics was 9.0% (7.2-10.8) by CMIA and 10.5% (8.6-12.4) by ELISA. Correction for non-response decreased estimates to 7.4% (5.7-9.2) and 9.1% (7.2-10.9) for CMIA and ELISA, respectively. The most pronounced decrease in bias-corrected seroprevalence was attributed to the history of any illnesses in the past 3 months and COVID-19 testing. Seroconversion was negatively associated with smoking status, self-reported history of allergies and changes in hand-washing habits. These results suggest that even low estimates of seroprevalence can be an overestimation. Serosurvey design should attempt to identify characteristics that are associated both with participation and seropositivity.
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Affiliation(s)
- Anton Barchuk
- Institute for Interdisciplinary Health Research, European University at St. Petersburg, Shpalernaya Ulitsa, 1, St. Petersburg, Russia, 191187.
- N.N. Petrov National Research Medical Center of Oncology, Pesochny, Leningradskaya Ulitsa, 68, St. Petersburg, Russia, 197758.
- Health Sciences, Faculty of Social Sciences, Tampere University, Arvo Ylpön katu 34, 33520, Tampere, Finland.
| | - Dmitriy Skougarevskiy
- Institute for Interdisciplinary Health Research, European University at St. Petersburg, Shpalernaya Ulitsa, 1, St. Petersburg, Russia, 191187
| | - Kirill Titaev
- Institute for Interdisciplinary Health Research, European University at St. Petersburg, Shpalernaya Ulitsa, 1, St. Petersburg, Russia, 191187
| | - Daniil Shirokov
- Clinic "Scandinavia" (LLC Ava-Peter), Ilyushina Ulitsa, 4-1, St. Petersburg, Russia, 197372
- ITMO University, Kronverksky Prospekt, 49, St. Petersburg, Russia, 197101
| | - Yulia Raskina
- Institute for Interdisciplinary Health Research, European University at St. Petersburg, Shpalernaya Ulitsa, 1, St. Petersburg, Russia, 191187
| | - Anastasia Novkunkskaya
- Institute for Interdisciplinary Health Research, European University at St. Petersburg, Shpalernaya Ulitsa, 1, St. Petersburg, Russia, 191187
| | - Petr Talantov
- The Russian Academy of Sciences Commission for Counteracting the Falsification of Scientific Research, Leingradsky Prospekt, 14, Moscow, Russia, 119991
| | - Artur Isaev
- Human Stem Cells Institute, Ulitsa Gubkina, 3-2, Moscow, Russia, 119333
| | - Ekaterina Pomerantseva
- Center of Genetics and Reproductive Medicine GENETICO LLC, Ulitsa Gubkina, 3-1, Moscow, Russia, 119333
| | - Svetlana Zhikrivetskaya
- Center of Genetics and Reproductive Medicine GENETICO LLC, Ulitsa Gubkina, 3-1, Moscow, Russia, 119333
| | - Lubov Barabanova
- Clinic "Scandinavia" (LLC Ava-Peter), Ilyushina Ulitsa, 4-1, St. Petersburg, Russia, 197372
| | - Vadim Volkov
- Institute for Interdisciplinary Health Research, European University at St. Petersburg, Shpalernaya Ulitsa, 1, St. Petersburg, Russia, 191187
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15
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Bhattacharyya R, Kundu R, Bhaduri R, Ray D, Beesley LJ, Salvatore M, Mukherjee B. Incorporating false negative tests in epidemiological models for SARS-CoV-2 transmission and reconciling with seroprevalence estimates. Sci Rep 2021; 11:9748. [PMID: 33963259 PMCID: PMC8105357 DOI: 10.1038/s41598-021-89127-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 04/21/2021] [Indexed: 12/24/2022] Open
Abstract
Susceptible-Exposed-Infected-Removed (SEIR)-type epidemiologic models, modeling unascertained infections latently, can predict unreported cases and deaths assuming perfect testing. We apply a method we developed to account for the high false negative rates of diagnostic RT-PCR tests for detecting an active SARS-CoV-2 infection in a classic SEIR model. The number of unascertained cases and false negatives being unobservable in a real study, population-based serosurveys can help validate model projections. Applying our method to training data from Delhi, India, during March 15-June 30, 2020, we estimate the underreporting factor for cases at 34-53 (deaths: 8-13) on July 10, 2020, largely consistent with the findings of the first round of serosurveys for Delhi (done during June 27-July 10, 2020) with an estimated 22.86% IgG antibody prevalence, yielding estimated underreporting factors of 30-42 for cases. Together, these imply approximately 96-98% cases in Delhi remained unreported (July 10, 2020). Updated calculations using training data during March 15-December 31, 2020 yield estimated underreporting factor for cases at 13-22 (deaths: 3-7) on January 23, 2021, which are again consistent with the latest (fifth) round of serosurveys for Delhi (done during January 15-23, 2021) with an estimated 56.13% IgG antibody prevalence, yielding an estimated range for the underreporting factor for cases at 17-21. Together, these updated estimates imply approximately 92-96% cases in Delhi remained unreported (January 23, 2021). Such model-based estimates, updated with latest data, provide a viable alternative to repeated resource-intensive serosurveys for tracking unreported cases and deaths and gauging the true extent of the pandemic.
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Affiliation(s)
- Rupam Bhattacharyya
- Department of Biostatistics, School of Public Health, University of Michigan, 1420 Washington Heights, Ann Arbor, MI, 48109-2029, USA
| | - Ritoban Kundu
- Indian Statistical Institute, Kolkata, West Bengal, 700108, India
| | - Ritwik Bhaduri
- Indian Statistical Institute, Kolkata, West Bengal, 700108, India
| | - Debashree Ray
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, 21205, USA
- Department of Biostatistics, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Lauren J Beesley
- Department of Biostatistics, School of Public Health, University of Michigan, 1420 Washington Heights, Ann Arbor, MI, 48109-2029, USA
- Center for Precision Health Data Science, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Maxwell Salvatore
- Department of Biostatistics, School of Public Health, University of Michigan, 1420 Washington Heights, Ann Arbor, MI, 48109-2029, USA
- Center for Precision Health Data Science, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Bhramar Mukherjee
- Department of Biostatistics, School of Public Health, University of Michigan, 1420 Washington Heights, Ann Arbor, MI, 48109-2029, USA.
- Center for Precision Health Data Science, University of Michigan, Ann Arbor, MI, 48109, USA.
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16
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Ioannidis JPA. Reconciling estimates of global spread and infection fatality rates of COVID-19: An overview of systematic evaluations. Eur J Clin Invest 2021; 51:e13554. [PMID: 33768536 PMCID: PMC8250317 DOI: 10.1111/eci.13554] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/21/2021] [Accepted: 03/14/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Estimates of community spread and infection fatality rate (IFR) of COVID-19 have varied across studies. Efforts to synthesize the evidence reach seemingly discrepant conclusions. METHODS Systematic evaluations of seroprevalence studies that had no restrictions based on country and which estimated either total number of people infected and/or aggregate IFRs were identified. Information was extracted and compared on eligibility criteria, searches, amount of evidence included, corrections/adjustments of seroprevalence and death counts, quantitative syntheses and handling of heterogeneity, main estimates and global representativeness. RESULTS Six systematic evaluations were eligible. Each combined data from 10 to 338 studies (9-50 countries), because of different eligibility criteria. Two evaluations had some overt flaws in data, violations of stated eligibility criteria and biased eligibility criteria (eg excluding studies with few deaths) that consistently inflated IFR estimates. Perusal of quantitative synthesis methods also exhibited several challenges and biases. Global representativeness was low with 78%-100% of the evidence coming from Europe or the Americas; the two most problematic evaluations considered only one study from other continents. Allowing for these caveats, four evaluations largely agreed in their main final estimates for global spread of the pandemic and the other two evaluations would also agree after correcting overt flaws and biases. CONCLUSIONS All systematic evaluations of seroprevalence data converge that SARS-CoV-2 infection is widely spread globally. Acknowledging residual uncertainties, the available evidence suggests average global IFR of ~0.15% and ~1.5-2.0 billion infections by February 2021 with substantial differences in IFR and in infection spread across continents, countries and locations.
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Affiliation(s)
- John P. A. Ioannidis
- Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, and Meta‐Research Innovation Center at Stanford (METRICS)Stanford UniversityStanfordCAUSA
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17
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Levin AT, Hanage WP, Owusu-Boaitey N, Cochran KB, Walsh SP, Meyerowitz-Katz G. Assessing the age specificity of infection fatality rates for COVID-19: systematic review, meta-analysis, and public policy implications. Eur J Epidemiol 2020; 35:1123-1138. [PMID: 33289900 PMCID: PMC7721859 DOI: 10.1007/s10654-020-00698-1] [Citation(s) in RCA: 464] [Impact Index Per Article: 116.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 11/10/2020] [Indexed: 12/17/2022]
Abstract
Determine age-specific infection fatality rates for COVID-19 to inform public health policies and communications that help protect vulnerable age groups. Studies of COVID-19 prevalence were collected by conducting an online search of published articles, preprints, and government reports that were publicly disseminated prior to 18 September 2020. The systematic review encompassed 113 studies, of which 27 studies (covering 34 geographical locations) satisfied the inclusion criteria and were included in the meta-analysis. Age-specific IFRs were computed using the prevalence data in conjunction with reported fatalities 4 weeks after the midpoint date of the study, reflecting typical lags in fatalities and reporting. Meta-regression procedures in Stata were used to analyze the infection fatality rate (IFR) by age. Our analysis finds a exponential relationship between age and IFR for COVID-19. The estimated age-specific IFR is very low for children and younger adults (e.g., 0.002% at age 10 and 0.01% at age 25) but increases progressively to 0.4% at age 55, 1.4% at age 65, 4.6% at age 75, and 15% at age 85. Moreover, our results indicate that about 90% of the variation in population IFR across geographical locations reflects differences in the age composition of the population and the extent to which relatively vulnerable age groups were exposed to the virus. These results indicate that COVID-19 is hazardous not only for the elderly but also for middle-aged adults, for whom the infection fatality rate is two orders of magnitude greater than the annualized risk of a fatal automobile accident and far more dangerous than seasonal influenza. Moreover, the overall IFR for COVID-19 should not be viewed as a fixed parameter but as intrinsically linked to the age-specific pattern of infections. Consequently, public health measures to mitigate infections in older adults could substantially decrease total deaths.
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Affiliation(s)
- Andrew T Levin
- Dartmouth College, Hanover, USA
- National Bureau for Economic Research, Cambridge, USA
- Centre for Economic Policy Research, London, United Kingdom
| | | | | | | | | | - Gideon Meyerowitz-Katz
- University of Wollongong, Wollongong, Australia.
- Western Sydney Local Health District, PO Box 792, Seven Hills, NSW, 2147, Australia.
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18
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Meyerowitz-Katz G, Merone L. A systematic review and meta-analysis of published research data on COVID-19 infection fatality rates. Int J Infect Dis 2020; 101:138-148. [PMID: 33007452 PMCID: PMC7524446 DOI: 10.1016/j.ijid.2020.09.1464] [Citation(s) in RCA: 236] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/20/2020] [Accepted: 09/24/2020] [Indexed: 02/07/2023] Open
Abstract
An important unknown during the coronavirus disease-2019 (COVID-19) pandemic has been the infection fatality rate (IFR). This differs from the case fatality rate (CFR) as an estimate of the number of deaths and as a proportion of the total number of cases, including those who are mild and asymptomatic. While the CFR is extremely valuable for experts, IFR is increasingly being called for by policy makers and the lay public as an estimate of the overall mortality from COVID-19. METHODS Pubmed, Medline, SSRN, and Medrxiv were searched using a set of terms and Boolean operators on 25/04/2020 and re-searched on 14/05/2020, 21/05/2020 and 16/06/2020. Articles were screened for inclusion by both authors. Meta-analysis was performed in Stata 15.1 by using the metan command, based on IFR and confidence intervals extracted from each study. Google/Google Scholar was used to assess the grey literature relating to government reports. RESULTS After exclusions, there were 24 estimates of IFR included in the final meta-analysis, from a wide range of countries, published between February and June 2020. The meta-analysis demonstrated a point estimate of IFR of 0.68% (0.53%-0.82%) with high heterogeneity (p < 0.001). CONCLUSION Based on a systematic review and meta-analysis of published evidence on COVID-19 until July 2020, the IFR of the disease across populations is 0.68% (0.53%-0.82%). However, due to very high heterogeneity in the meta-analysis, it is difficult to know if this represents a completely unbiased point estimate. It is likely that, due to age and perhaps underlying comorbidities in the population, different places will experience different IFRs due to the disease. Given issues with mortality recording, it is also likely that this represents an underestimate of the true IFR figure. More research looking at age-stratified IFR is urgently needed to inform policymaking on this front.
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Affiliation(s)
| | - Lea Merone
- James Cook University, Australia; Tropical Public Health Service, Cairns, Australia
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19
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Ho HL, Wang FY, Lee HR, Huang YL, Lai CL, Jen WC, Hsieh SL, Chou TY. Seroprevalence of COVID-19 in Taiwan revealed by testing anti-SARS-CoV-2 serological antibodies on 14,765 hospital patients. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2020; 3:100041. [PMID: 34173603 PMCID: PMC7546957 DOI: 10.1016/j.lanwpc.2020.100041] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/20/2020] [Accepted: 09/22/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Coronavirus Disease 2019 (COVID-19) has become a worldwide pandemic and affected more than 227 countries or territories, resulting in more than 25 million cases with over 0•85 million deaths, as of September 2, 2020. Taiwan has been successful in countering the COVID-19 outbreak, however, the potential risk for asymptomatic infections and the prevalence rates remain unknown. We aimed to estimate the seroprevalence of COVID-19 in Taiwan via serologically testing hospital patients with neither symptoms indicative of nor positive nucleic acid test for SARS-CoV-2 infection. METHODS Residual specimens from laboratory blood tests for outpatient and emergency department patients visiting a medical centre in Taipei, Taiwan, within one week in May and another in July, 2020, were collected. We used Elecsys Anti-SARS-CoV-2 Assay to screen and further validated cases with high cutoff index by a confirmatory ELISA assay. We also analysed antibody responses against SARS-CoV-2 along disease progression in four nucleic acid test confirmed COVID-19 patients. FINDINGS Blood samples from a total of 14,765 patients were tested. The unweighted seroprevalence of anti-SARS-CoV-2 antibodies was 0•07% [95% CI, 0•04%-0•13%]; after weighting with the population demographics of Taiwan, the estimated overall seroprevalence was 0•05% [95% CI, 0•02%-0•10%]. Furthermore, based on data of the four COVID-19 cases, the seroconversion dates for IgM were as early as 9 days and that for IgG 11 days after symptoms onset. INTERPRETATION We screened the anti-SARS-CoV-2 antibodies in a small-scale population-based study and observed an approximately 0•05% seroprevalence of COVID-19, indicating that the current containment protocols emphasising mask wearing, hand washing, social distancing and mandatory quarantine for all incomers are effective in Taiwan. FUNDING Taipei Veterans General Hospital, Taipei, Taiwan.
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Affiliation(s)
- Hsiang-Ling Ho
- The Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, 201, Section 2, Shipai Road, Taipei 11217, Taiwan
- The Department of Biotechnology and Laboratory Science in Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Fang-Yu Wang
- The Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, 201, Section 2, Shipai Road, Taipei 11217, Taiwan
| | - Hao-Ru Lee
- The Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, 201, Section 2, Shipai Road, Taipei 11217, Taiwan
| | - Ya-Lan Huang
- The Genomics Research Center, Academia Sinica, Taipei, Taiwan
| | - Chien-Liang Lai
- The Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, 201, Section 2, Shipai Road, Taipei 11217, Taiwan
| | - Wen-Chin Jen
- The Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, 201, Section 2, Shipai Road, Taipei 11217, Taiwan
| | - Shie-Liang Hsieh
- The Genomics Research Center, Academia Sinica, Taipei, Taiwan
- The Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Teh-Ying Chou
- The Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, 201, Section 2, Shipai Road, Taipei 11217, Taiwan
- The Department of Biotechnology and Laboratory Science in Medicine, National Yang-Ming University, Taipei, Taiwan
- The Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
- The Institute of Biochemistry and Molecular Biology, National Yang-Ming University, Taipei, Taiwan
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20
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La Marca A, Capuzzo M, Paglia T, Roli L, Trenti T, Nelson SM. Testing for SARS-CoV-2 (COVID-19): a systematic review and clinical guide to molecular and serological in-vitro diagnostic assays. Reprod Biomed Online 2020; 41:483-499. [PMID: 32651106 PMCID: PMC7293848 DOI: 10.1016/j.rbmo.2020.06.001] [Citation(s) in RCA: 233] [Impact Index Per Article: 58.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 05/23/2020] [Accepted: 06/02/2020] [Indexed: 02/08/2023]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its associated coronavirus disease 2019 (COVID-19) pandemic has demanded rapid upscaling of in-vitro diagnostic assays to enable mass screening and testing of high-risk groups, and simultaneous ascertainment of robust data on past SARS-CoV-2 exposure at an individual and a population level. To meet the exponential demand in testing, there has been an accelerated development of both molecular and serological assays across a plethora of platforms. The present review discusses the current literature on these modalities, including nucleic acid amplification tests, direct viral antigen tests and the rapidly expanding laboratory-based and point of care serological tests. This suite of complementary tests will inform crucial decisions by healthcare providers and policy makers, and understanding their strengths and limitations will be critical to their judicious application for the development of algorithmic approaches to treatment and public health strategies.
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Affiliation(s)
- Antonio La Marca
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy.
| | - Martina Capuzzo
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Tiziana Paglia
- Department of Anesthesiology, Hesperia Hospital, Modena, Italy
| | - Laura Roli
- Department of Laboratory Medicine and Pathology, Azieda USL, Modena, Italy
| | - Tommaso Trenti
- Department of Laboratory Medicine and Pathology, Azieda USL, Modena, Italy
| | - Scott M Nelson
- School of Medicine, University of Glasgow, Glasgow, UK; NIHR Bristol Biomedical Research Centre Bristol, UK; The Fertility Partnership, Oxford, UK
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21
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Nomura S, Yoneoka D, Shi S, Tanoue Y, Kawashima T, Eguchi A, Matsuura K, Makiyama K, Ejima K, Taniguchi T, Sakamoto H, Kunishima H, Gilmour S, Nishiura H, Miyata H. An assessment of self-reported COVID-19 related symptoms of 227,898 users of a social networking service in Japan: Has the regional risk changed after the declaration of the state of emergency? LANCET REGIONAL HEALTH-WESTERN PACIFIC 2020; 1:100011. [PMID: 34173594 PMCID: PMC7453215 DOI: 10.1016/j.lanwpc.2020.100011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/10/2020] [Accepted: 07/19/2020] [Indexed: 01/10/2023]
Abstract
Background In the absence of widespread testing, symptomatic monitoring efforts may allow for understanding the epidemiological situation of the spread of coronavirus disease 2019 (COVID-19) in Japan. We obtained data from a social networking service (SNS) messaging application that monitors self-reported COVID-19 related symptoms in real time in Fukuoka Prefecture, Japan. We aimed at not only understanding the epidemiological situation of COVID-19 in the prefecture, but also highlighting the usefulness of symptomatic monitoring approaches that rely on self-reporting using SNS during a pandemic, and informing the assessment of Japan's emergency declaration over COVID-19. Methods We analysed symptoms data (fever over 37.5° and a strong feeling of weariness or shortness of breath), reported voluntarily via SNS chatbot by 227,898 residents of Fukuoka Prefecture during March 27 to May 3, 2020, including April 7, when a state of emergency was declared. We estimated the spatial correlation coefficient between the number of the self-reported cases of COVID-19 related symptoms and the number of PCR confirmed COVID-19 cases in the period (obtained from the prefecture website); and estimated the empirical Bayes age- and sex-standardised incidence ratio (EBSIR) of the symptoms in the period, compared before and after the declaration. The number of symptom cases was weighted by age and sex to reflect the regional population distribution according to the 2015 national census. Findings Of the participants, 3.47% reported symptoms. There was a strong spatial correlation of 0.847 (p < 0.001) at municipality level between the weighted number of self-reported symptoms and the number of COVID-19 cases for both symptoms. The EBSIR at post-code level was not likely to change remarkably before and after the declaration of the emergency, but the gap in EBSIR between high-risk and low-risk areas appeared to have increased after the declaration. Interpretation While caution is necessary as the data was limited to SNS users, the self-reported COVID-19 related symptoms considered in the study had high epidemiological evaluation ability. In addition, though based on visual assessment, after the declaration of the emergency, regional containment of the infection risk might have strengthened to some extent. SNS, which can provide a high level of real-time, voluntary symptom data collection, can be used to assess the epidemiology of a pandemic, as well as to assist in policy assessments such as emergency declarations. Funding The present work was supported in part by a grant from the Ministry of Health, Labour and Welfare of Japan (H29-Gantaisaku-ippan-009).
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Affiliation(s)
- Shuhei Nomura
- Department of Health Policy and Management, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.,Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Daisuke Yoneoka
- Department of Health Policy and Management, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.,Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Shoi Shi
- Department of Systems Pharmacology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Laboratory for Synthetic Biology, RIKEN Center for Biosystems Dynamics Research, Osaka, Japan
| | - Yuta Tanoue
- Institute for Business and Finance, Waseda University, Tokyo, Japan
| | - Takayuki Kawashima
- Department of Mathematical and Computing Science, Tokyo Institute of Technology, Tokyo, Japan
| | - Akifumi Eguchi
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Kentaro Matsuura
- Department of Management Science, Graduate School of Engineering, Tokyo University of Science, Tokyo, Japan.,HOXO-M Inc., Tokyo, Japan
| | - Koji Makiyama
- HOXO-M Inc., Tokyo, Japan.,Yahoo Japan Corporation, Tokyo, Japan
| | - Keisuke Ejima
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, USA
| | | | - Haruka Sakamoto
- Department of Health Policy and Management, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.,Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroyuki Kunishima
- Department of Infectious Diseases, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Stuart Gilmour
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Hiroshi Nishiura
- Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Hiroaki Miyata
- Department of Health Policy and Management, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
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22
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Pollán M, Pérez-Gómez B, Pastor-Barriuso R, Oteo J, Hernán MA, Pérez-Olmeda M, Sanmartín JL, Fernández-García A, Cruz I, Fernández de Larrea N, Molina M, Rodríguez-Cabrera F, Martín M, Merino-Amador P, León Paniagua J, Muñoz-Montalvo JF, Blanco F, Yotti R. Prevalence of SARS-CoV-2 in Spain (ENE-COVID): a nationwide, population-based seroepidemiological study. Lancet 2020; 396:535-544. [PMID: 32645347 PMCID: PMC7336131 DOI: 10.1016/s0140-6736(20)31483-5] [Citation(s) in RCA: 1162] [Impact Index Per Article: 290.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/14/2020] [Accepted: 06/17/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Spain is one of the European countries most affected by the COVID-19 pandemic. Serological surveys are a valuable tool to assess the extent of the epidemic, given the existence of asymptomatic cases and little access to diagnostic tests. This nationwide population-based study aims to estimate the seroprevalence of SARS-CoV-2 infection in Spain at national and regional level. METHODS 35 883 households were selected from municipal rolls using two-stage random sampling stratified by province and municipality size, with all residents invited to participate. From April 27 to May 11, 2020, 61 075 participants (75·1% of all contacted individuals within selected households) answered a questionnaire on history of symptoms compatible with COVID-19 and risk factors, received a point-of-care antibody test, and, if agreed, donated a blood sample for additional testing with a chemiluminescent microparticle immunoassay. Prevalences of IgG antibodies were adjusted using sampling weights and post-stratification to allow for differences in non-response rates based on age group, sex, and census-tract income. Using results for both tests, we calculated a seroprevalence range maximising either specificity (positive for both tests) or sensitivity (positive for either test). FINDINGS Seroprevalence was 5·0% (95% CI 4·7-5·4) by the point-of-care test and 4·6% (4·3-5·0) by immunoassay, with a specificity-sensitivity range of 3·7% (3·3-4·0; both tests positive) to 6·2% (5·8-6·6; either test positive), with no differences by sex and lower seroprevalence in children younger than 10 years (<3·1% by the point-of-care test). There was substantial geographical variability, with higher prevalence around Madrid (>10%) and lower in coastal areas (<3%). Seroprevalence among 195 participants with positive PCR more than 14 days before the study visit ranged from 87·6% (81·1-92·1; both tests positive) to 91·8% (86·3-95·3; either test positive). In 7273 individuals with anosmia or at least three symptoms, seroprevalence ranged from 15·3% (13·8-16·8) to 19·3% (17·7-21·0). Around a third of seropositive participants were asymptomatic, ranging from 21·9% (19·1-24·9) to 35·8% (33·1-38·5). Only 19·5% (16·3-23·2) of symptomatic participants who were seropositive by both the point-of-care test and immunoassay reported a previous PCR test. INTERPRETATION The majority of the Spanish population is seronegative to SARS-CoV-2 infection, even in hotspot areas. Most PCR-confirmed cases have detectable antibodies, but a substantial proportion of people with symptoms compatible with COVID-19 did not have a PCR test and at least a third of infections determined by serology were asymptomatic. These results emphasise the need for maintaining public health measures to avoid a new epidemic wave. FUNDING Spanish Ministry of Health, Institute of Health Carlos III, and Spanish National Health System.
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Affiliation(s)
- Marina Pollán
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain.
| | - Beatriz Pérez-Gómez
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Roberto Pastor-Barriuso
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Jesús Oteo
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain; Spanish Network for Research in Infectious Diseases (REIPI), Institute of Health Carlos III, Madrid, Spain
| | - Miguel A Hernán
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA; Department of Biostatistics, Harvard T H Chan School of Public Health, Boston, MA, USA; Harvard-MIT Division of Health Sciences and Technology, Boston, MA, USA
| | - Mayte Pérez-Olmeda
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
| | - Jose L Sanmartín
- Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain
| | - Aurora Fernández-García
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain; Department of Clinical Microbiology, Hospital Clínico San Carlos, Madrid, Spain
| | - Israel Cruz
- National School of Public Health, Institute of Health Carlos III, Madrid, Spain
| | - Nerea Fernández de Larrea
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Marta Molina
- General Secretary of Health, Ministry of Health, Madrid, Spain
| | | | - Mariano Martín
- Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain
| | | | | | | | - Faustino Blanco
- General Secretary of Health, Ministry of Health, Madrid, Spain
| | - Raquel Yotti
- Directorate, Institute of Health Carlos III, Madrid, Spain
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23
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Song SK, Lee DH, Nam JH, Kim KT, Do JS, Kang DW, Kim SG, Cho MR. IgG Seroprevalence of COVID-19 among Individuals without a History of the Coronavirus Disease Infection in Daegu, Korea. J Korean Med Sci 2020; 35:e269. [PMID: 32715672 PMCID: PMC7384903 DOI: 10.3346/jkms.2020.35.e269] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 07/09/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Seroprevalence studies of coronavirus disease 2019 (COVID-19) from many countries have shown that the number of undiagnosed missing cases is much larger than that of confirmed cases, irrespective of seroprevalence levels. Considering the strategy of Korea entailing massive testing and contact tracing from the beginning of epidemic, the number of undiagnosed missing cases in Korea may be negligible. This study was conducted to estimate the seroprevalence of COVID-19 among individuals who were never diagnosed with COVID-19 in Daegu, the epicenter of COVID-19 epidemic in Korea. METHODS Serologic testing for immunoglobulin G antibody based on immunochromatographic assay was conducted in 103 patients and 95 guardians aged 18 to 82 years without any history of COVID-19 diagnosis, who visited outpatient clinics of a single university-affiliated hospital from May 25 to June 5, 2020. RESULTS The estimated seroprevalence was 7.6% (95% confidence interval, 4.3%-12.2%) with 15 positive cases. Among them, only one had a polymerase chain reaction (PCR)-confirmed case among their close contacts and 13 did not experience COVID-19-related symptoms. Seroprevalence was similar between patients and guardians. Based on this figure, the number of undiagnosed missing cases in Daegu was estimated to be a dozen times more than the number of confirmed cases based on PCR testing. CONCLUSION Despite the limitation of a small and unrepresentative sample, this is the first study on seroprevalence of COVID-19 in Korea. Our study suggested that the number of undiagnosed missing cases was substantial even with the stringent strategy adopted in Korea, similar to that of other countries.
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Affiliation(s)
- Suk Kyoon Song
- Department of Orthopedics, Daegu Catholic University Hospital, Daegu, Korea
| | - Duk Hee Lee
- Department of Preventive Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jun Ho Nam
- Department of Orthopedics, Daegu Catholic University Hospital, Daegu, Korea
| | - Kyung Tae Kim
- Department of Orthopedics, Daegu Catholic University Hospital, Daegu, Korea
| | - Jung Suk Do
- Department of Orthopedics, Daegu Catholic University Hospital, Daegu, Korea
| | - Dae Won Kang
- Department of Orthopedics, Daegu Catholic University Hospital, Daegu, Korea
| | - Sang Gyung Kim
- Department of Laboratory Medicine, Daegu Catholic University Hospital, Daegu, Korea.
| | - Myung Rae Cho
- Department of Orthopedics, Daegu Catholic University Hospital, Daegu, Korea.
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