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Van der Heyden J, Leclercq V, Duysburgh E, Cornelissen L, Desombere I, Roukaerts I, Gisle L. Prevalence of SARS-CoV-2 antibodies and associated factors in the adult population of Belgium: a general population cohort study between March 2021 and April 2022. Arch Public Health 2024; 82:72. [PMID: 38750563 PMCID: PMC11094959 DOI: 10.1186/s13690-024-01298-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 04/29/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND This study assessed seroprevalence trends of SARS-CoV-2 antibodies in the Belgian adult population between March 2021 and April 2022, and explored factors associated with seropositivity and seroreversion among the vaccinated and unvaccinated population. METHODS A prospective longitudinal surveillance study was conducted within a random sample of the general population (18 + years) in Belgium, selected from the national register through a multistage sampling design. Participants provided a saliva sample and completed a survey questionnaire on three occasions: at baseline and in two follow-up waves. Outcome variables included (1) seropositivity, defined as the presence of SARS-CoV-2 antibodies, assessed with a semi-quantitative measure of anti-RBD (Receptor Binding Domain) IgG ELISA and (2) seroreversion, defined as passing from a positive to a negative antibody test between two measurements. Trends in SARS-CoV-2 antibody prevalence were assessed using binary logistic regression with contrasts applying post-stratification. Potential determinants of seropositivity were assessed through multilevel logistic regressions. RESULTS In total 6,178 valid observations were obtained from 2,768 individuals. SARS-CoV-2 antibody prevalence increased from 25.1% in the beginning of the study period to 92.3% at the end. Among the vaccinated population, factors significantly associated with higher seropositivity rates were being younger, having a bachelor diploma, living with others, having had a vaccine in the last 3 months and having received a nucleic-acid vaccine or a combination. Lower seropositivity rates were observed among vaccinated people with a neurological disease and transplant patients. Factors significantly associated with higher seropositivity rates among the unvaccinated population were having non-O blood type and being non-smoker. Among vaccinated people, the seroreversion rate was much lower (0.3%) in those who had received their latest vaccine in the last 3 months compared to those who had received their latest vaccine more than 3 months ago (2.7%) (OR 0.13; 95%CI 0.04-0.42). CONCLUSIONS The rapid increase in antibody seropositivity in the general adult population in Belgium during the study period was driven by the vaccination campaign which ran at full speed during this period. Among vaccinated people, seropositivity varied in function of the time since last vaccine, the type of vaccine, sociodemographic features and health status.
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Affiliation(s)
- Johan Van der Heyden
- Epidemiology and public health, Sciensano Juliette Wytsmanstraat 14, Sciensano, Brussels, 1050, Belgium.
| | - Victoria Leclercq
- Epidemiology and public health, Sciensano Juliette Wytsmanstraat 14, Sciensano, Brussels, 1050, Belgium
| | - Els Duysburgh
- Epidemiology and public health, Sciensano Juliette Wytsmanstraat 14, Sciensano, Brussels, 1050, Belgium
| | - Laura Cornelissen
- Epidemiology and public health, Sciensano Juliette Wytsmanstraat 14, Sciensano, Brussels, 1050, Belgium
| | | | | | - Lydia Gisle
- Epidemiology and public health, Sciensano Juliette Wytsmanstraat 14, Sciensano, Brussels, 1050, Belgium
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Pouquet M, Decarreaux D, Di Domenico L, Sabbatini CE, Prévot-Monsacre P, Fourié T, Villarroel PMS, Priet S, Blanché H, Sebaoun JM, Deleuze JF, Turbelin C, Rossignol L, Werner A, Kochert F, Grosgogeat B, Rabiega P, Laupie J, Abraham N, Noël H, van der Werf S, Colizza V, Carrat F, Charrel R, de Lamballerie X, Blanchon T, Falchi A. SARS-CoV-2 infection prevalence and associated factors among primary healthcare workers in France after the third COVID-19 wave. Sci Rep 2024; 14:5418. [PMID: 38443618 PMCID: PMC10914718 DOI: 10.1038/s41598-024-55477-9] [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: 11/10/2023] [Accepted: 02/23/2024] [Indexed: 03/07/2024] Open
Abstract
Data on the SARS-CoV-2 infection among primary health care workers (PHCWs) are scarce but essential to reflect on policy regarding prevention and control measures. We assessed the prevalence of PHCWs who have been infected by SARS-CoV-2 in comparison with modeling from the general population in metropolitan France, and associated factors. A cross-sectional study was conducted among general practitioners (GPs), pediatricians, dental and pharmacy workers in primary care between May and August 2021. Participants volunteered to provide a dried-blood spot for SARS-CoV-2 antibody assessment and completed a questionnaire. The primary outcome was defined as the detection of infection-induced antibodies (anti-nucleocapsid IgG, and for non-vaccinees: anti-Spike IgG and neutralizing antibodies) or previous self-reported infection (positive RT-qPCR or antigenic test, or positive ELISA test before vaccination). Estimates were adjusted using weights for representativeness and compared with prediction from the general population. Poisson regressions were used to quantify associated factors. The analysis included 1612 PHCWs. Weighted prevalences were: 31.7% (95% CI 27.5-36.0) for GPs, 28.7% (95% CI 24.4-33.0) for pediatricians, 25.2% (95% CI 20.6-31.0) for dentists, and 25.5% (95% CI 18.2-34.0) for pharmacists. Estimates were compatible with model predictions for the general population. PHCWs more likely to be infected were: GPs compared to pharmacist assistants (adjusted prevalence ratio [aPR] = 2.26; CI 95% 1.01-5.07), those living in Île-de-France (aPR = 1.53; CI 95% 1.14-2.05), South-East (aPR = 1.57; CI 95% 1.19-2.08), North-East (aPR = 1.81; CI 95% 1.38-2.37), and those having an unprotected contact with a COVID-19 case within the household (aPR = 1.48; CI 95% 1.22-1.80). Occupational factors were not associated with infection. In conclusion, the risk of SARS-CoV-2 exposure for PHCWs was more likely to have occurred in the community rather than at their workplace.
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Affiliation(s)
- Marie Pouquet
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France.
| | - Dorine Decarreaux
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
- Laboratoire de Virologie, Université de Corse Pascal Paoli, UR7310 Bioscope, 20250, Corte, France
- Unité Des Virus Emergents, Aix Marseille University, IRD 190, INSERM U1207, 13005, Marseille, France
| | - Laura Di Domenico
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
| | - Chiara E Sabbatini
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
| | - Pol Prévot-Monsacre
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
| | - Toscane Fourié
- Unité Des Virus Emergents, Aix Marseille University, IRD 190, INSERM U1207, 13005, Marseille, France
| | | | - Stephane Priet
- Unité Des Virus Emergents, Aix Marseille University, IRD 190, INSERM U1207, 13005, Marseille, France
| | | | | | | | - Clément Turbelin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
| | - Louise Rossignol
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
| | - Andréas Werner
- Association Française de Pédiatrie Ambulatoire (AFPA), Zone de la Fouquetière, 155 Rue Edouard Branly, 44150, Ancenis-Saint-Géréon, France
| | - Fabienne Kochert
- Association Française de Pédiatrie Ambulatoire (AFPA), Zone de la Fouquetière, 155 Rue Edouard Branly, 44150, Ancenis-Saint-Géréon, France
| | - Brigitte Grosgogeat
- Faculté d'Odontologie, Université Claude Bernard Lyon 1, Université de Lyon, 69000, Lyon, France
- Laboratoire des Multimatériaux et Interfaces, UMR CNRS 5615, Université Claude Bernard Lyon 1, Université de Lyon, 69000, Lyon, France
- Réseau ReCOL, Association Dentaire Française, 75000, Paris, France
- Service d'Odontologie, Hospices Civils de Lyon, 69007, Lyon, France
| | | | - Julien Laupie
- Réseau ReCOL, Association Dentaire Française, 75000, Paris, France
| | | | - Harold Noël
- Infectious Diseases Division, Santé Publique France, 94410, Saint Maurice, France
| | - Sylvie van der Werf
- Institut Pasteur, Université Paris Cité, CNRS UMR3569, Molecular Genetics of RNA Viruses Unit, 75015, Paris, France
- Institut Pasteur, Université Paris Cité, National Reference Center for Respiratory Viruses, 75015, Paris, France
| | - Vittoria Colizza
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
| | - Fabrice Carrat
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
- Département de Santé Publique, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, Sorbonne Université, 75012, Paris, France
| | - Remi Charrel
- Unité Des Virus Emergents, Aix Marseille University, IRD 190, INSERM U1207, 13005, Marseille, France
- LE Service de Prévention du Risque Infectieux (LESPRI), CLIN AP-HM Hôpitaux Universitaires de Marseille, 13005, Marseille, France
| | - Xavier de Lamballerie
- Unité Des Virus Emergents, Aix Marseille University, IRD 190, INSERM U1207, 13005, Marseille, France
| | - Thierry Blanchon
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
| | - Alessandra Falchi
- Laboratoire de Virologie, Université de Corse Pascal Paoli, UR7310 Bioscope, 20250, Corte, France
- Unité Des Virus Emergents, Aix Marseille University, IRD 190, INSERM U1207, 13005, Marseille, France
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Hanane G, Amine Z, Roomila N, Prazuck T, Amirouche A, Olivier V, Benyamina A, Serreau R. COVID-19 seroprevalence among local authority workers from Orléans Métropole, the Community of Communes of the Terres du Val de Loire, the local public service management centre of the Loiret department and the Region Centre Val de Loire: a prospective epidemiological study. BMJ Open 2023; 13:e066504. [PMID: 37217267 DOI: 10.1136/bmjopen-2022-066504] [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: 05/24/2023] Open
Abstract
OBJECTIVE To evaluate the SARS-CoV-2 seroprevalence among local authority workers, depending on their position and potential interaction with the public. METHODS A cohort of volunteer participants was recruited among local authority workers of the Centre Val de Loire region in France, to be tested using a rapid serological test (COVID-PRESTO). The collected data were analysed by comparing different parameters including, gender, age, position held, and contact or not with the public. The study was carried out from August to December 2020 and included 3228 participants (n=3228), from 18 to 65 years old. RESULTS The seroprevalence of SARS-CoV-2 among local authority workers was estimated at 3.04%. No significant difference could be observed according to the position held by the workers and whether they were or not in contact with the public. Nevertheless, a significant difference was observed between the different investigating centres, in correlation with the geographical location. CONCLUSION Contact with members of the public was not a critical parameter for SARS-CoV-2 seroprevalence as long as protective measures are applied. Among the population included in the study, childcare workers were more at risk of getting infected by the virus. TRIAL REGISTRATION NUMBER NCT04387968.
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Affiliation(s)
| | - Zaouia Amine
- Unite de recherche clinique PARADICT-O, Orléans, France
| | | | - Thierry Prazuck
- Department of Infectious Diseases, Centre Hospitalier Regional d'Orleans, Orleans, France
| | - Ammar Amirouche
- Hopital Paul Brousse, Villejuif, France
- Université Paris-Saclay, Gif-sur-Yvette, France
| | - Vernay Olivier
- Communauté de Communes Terres du Val de Loire, Orléans, France
| | - Amine Benyamina
- Hopital Paul Brousse, Villejuif, France
- Université Paris-Saclay, Gif-sur-Yvette, France
| | - Raphaël Serreau
- Unite de recherche clinique PARADICT-O, Orléans, France
- Hopital Paul Brousse, Villejuif, France
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Domen J, Verbakel JYJ, Adriaenssens N, Scholtes B, Peeters B, Bruyndonckx R, De Sutter A, Heytens S, Van den Bruel A, Desombere I, Van Damme P, Goossens H, Buret L, Duysburgh E, Coenen S. Validation of a rapid SARS-CoV-2 antibody test in general practice. BMJ Open 2023; 13:e069997. [PMID: 37130685 PMCID: PMC10163333 DOI: 10.1136/bmjopen-2022-069997] [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: 05/04/2023] Open
Abstract
OBJECTIVES To validate a rapid serological test (RST) for SARS-CoV-2 antibodies used in seroprevalence studies in healthcare providers, including primary healthcare providers (PHCPs) in Belgium. DESIGN A phase III validation study of the RST (OrientGene) within a prospective cohort study. SETTING Primary care in Belgium. PARTICIPANTS Any general practitioner (GP) working in primary care in Belgium and any other PHCP from the same GP practice who physically manages patients were eligible in the seroprevalence study. For the validation study, all participants who tested positive (376) on the RST at the first testing timepoint (T1) and a random sample of those who tested negative (790) and unclear (24) were included. INTERVENTION At T2, 4 weeks later, PHCPs performed the RST with fingerprick blood (index test) immediately after providing a serum sample to be analysed for the presence of SARS-CoV-2 immunoglobulin G antibodies using a two-out-of-three assay (reference test). PRIMARY AND SECONDARY OUTCOME MEASURES The RST accuracy was estimated using inverse probability weighting to correct for missing reference test data, and considering unclear RST results as negative for the sensitivity and positive for the specificity. Using these conservative estimates, the true seroprevalence was estimated both for T2 and RST-based prevalence values found in a cohort study with PHCPs in Belgium. RESULTS 1073 paired tests (403 positive on the reference test) were included. A sensitivity of 73% (a specificity of 92%) was found considering unclear RST results as negative (positive). For an RST-based prevalence at T1 (13.9), T2 (24.9) and T7 (70.21), the true prevalence was estimated to be 9.1%, 25.9% and 95.7%, respectively. CONCLUSION The RST sensitivity (73%) and specificity (92%) make an RST-based seroprevalence below (above) 23% overestimate (underestimate) the true seroprevalence. TRIAL REGISTRATION NUMBER NCT04779424.
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Affiliation(s)
- Julie Domen
- Department of Family Medicine and Population Health (FAMPOP), Centre for General Practice, University of Antwerp, Antwerpen, Belgium
| | - Jan Yvan Jos Verbakel
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- Department of Public Health and Primary Care, EPI-Centre, KU Leuven, Leuven, Belgium
| | - Niels Adriaenssens
- Department of Family Medicine and Population Health (FAMPOP), Centre for General Practice, University of Antwerp, Antwerpen, Belgium
| | - Beatrice Scholtes
- General Practice Department-Primary Care and Health Research Unit, Liege University, Liege, Belgium
| | - Bart Peeters
- Department of Laboratory Medicine, University Hospital Antwerp, Edegem, Belgium
| | - Robin Bruyndonckx
- Department of Family Medicine and Population Health (FAMPOP), Centre for General Practice, University of Antwerp, Antwerpen, Belgium
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics (I-BioStat), Data Science Institute, Hasselt University, Hasselt, Belgium
- Epidemiology & Pharmavigilance, P95, Leuven, Belgium
| | - An De Sutter
- Department of Public Health and Primary Care, University of Ghent, Gent, Belgium
| | - Stefan Heytens
- Department of Public Health and Primary Care, University of Ghent, Gent, Belgium
| | - Ann Van den Bruel
- Department of Public Health and Primary Care, EPI-Centre, KU Leuven, Leuven, Belgium
| | - Isabelle Desombere
- Department of Infectious Diseases in Humans, Sciensano, Brussels, Belgium
| | - Pierre Van Damme
- Vaccine & Infectious Disease Institute, Centre for the Evaluation of Vaccination, University of Antwerp Faculty of Medicine and Health Sciences, Antwerpen (Wilrijk, Belgium
| | - Herman Goossens
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerpen, Belgium
| | - Laetitia Buret
- General Practice Department-Primary Care and Health Research Unit, Liege University, Liege, Belgium
| | - Els Duysburgh
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Samuel Coenen
- Department of Family Medicine and Population Health (FAMPOP), Centre for General Practice, University of Antwerp, Antwerpen, Belgium
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerpen, Belgium
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Adriaenssens N, Scholtes B, Bruyndonckx R, Van Ngoc P, Verbakel JYJ, De Sutter A, Heytens S, Van Den Bruel A, Desombere I, Van Damme P, Goossens H, Buret L, Duysburgh E, Coenen S. Prevalence, incidence and longevity of antibodies against SARS-CoV-2 among primary healthcare providers in Belgium: a prospective cohort study with 12 months of follow-up. BMJ Open 2022; 12:e065897. [PMID: 36123069 PMCID: PMC9485641 DOI: 10.1136/bmjopen-2022-065897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To estimate the prevalence, incidence and longevity of antibodies against SARS-CoV-2 among primary healthcare providers (PHCPs). DESIGN Prospective cohort study with 12 months of follow-up. SETTING Primary care in Belgium. PARTICIPANTS Any general practitioner (GP) working in primary care in Belgium and any other PHCP from the same GP practice who physically manages (examines, tests, treats) patients were eligible. A convenience sample of 3648 eligible PHCPs from 2001 GP practices registered for this study (3044 and 604 to start in December 2020 and January 2021, respectively). 3390 PHCPs (92,9%) participated in their first testing time point (2820 and 565, respectively) and 2557 PHCPs (70,1%) in the last testing time point (December 2021). INTERVENTIONS Participants were asked to perform a rapid serological test targeting IgM and IgG against the receptor binding domain of SARS-CoV-2 and to complete an online questionnaire at each of maximum eight testing time points. PRIMARY AND SECONDARY OUTCOME MEASURES The prevalence, incidence and longevity of antibodies against SARS-CoV-2 both after natural infection and after vaccination. RESULTS Among all participants, 67% were women and 77% GPs. Median age was 43 years. The seroprevalence in December 2020 (before vaccination availability) was 15.1% (95% CI 13.5% to 16.6%), increased to 84.2% (95% CI 82.9% to 85.5%) in March 2021 (after vaccination availability) and reached 93.9% (95% CI 92.9% to 94.9%) in December 2021 (during booster vaccination availability and fourth (delta variant dominant) COVID-19 wave). Among not (yet) vaccinated participants the first monthly incidence of antibodies against SARS-CoV-2 was estimated to be 2.91% (95% CI 1.80% to 4.01%). The longevity of antibodies is higher in PHCPs with self-reported COVID-19 infection. CONCLUSIONS This study confirms that occupational health measures provided sufficient protection when managing patients. High uptake of vaccination resulted in high seroprevalence of SARS-CoV-2 antibodies in PHCPs in Belgium. Longevity of antibodies was supported by booster vaccination and virus circulation. TRIAL REGISTRATION NUMBER NCT04779424.
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Affiliation(s)
- Niels Adriaenssens
- Family Medicine & Population Health, Centre for General Practice, University of Antwerp Faculty of Medicine and Health Sciences, Antwerp (Wilrijk), Belgium
| | - Beatrice Scholtes
- General Practice Department, Primary Care and Health Research Unit, Liege University, Liege, Belgium
| | - Robin Bruyndonckx
- Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BIOSTAT), Hasselt University, Hasselt, Limburg, Belgium
- Epidemiology & Pharmacovigilance, P95, Leuven, Belgium
- Vaccine & Infectious Disease Institute, Laboratory of Medical Microbiology, University of Antwerp, Antwerp (Wilrijk), Belgium
| | - Pauline Van Ngoc
- General Practice Department, Primary Care and Health Research Unit, Liege University, Liege, Belgium
| | - Jan Yvan Jos Verbakel
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- Department of Public Health and Primary Care, KU Leuven, Leuven, Flanders, Belgium
| | - An De Sutter
- Department of Public Health and Primary Care, Ghent University, Gent, Belgium
| | - Stefan Heytens
- Department of Public Health and Primary Care, Ghent University, Gent, Belgium
| | - Ann Van Den Bruel
- Department of Public Health and Primary Care, KU Leuven, Leuven, Flanders, Belgium
| | - Isabelle Desombere
- Department of Infectious Diseases in Humans, Sciensano, Brussels, Belgium
| | - Pierre Van Damme
- Vaccine & Infectious Disease Institute, Centre for the Evaluation of Vaccination, University of Antwerp Faculty of Medicine and Health Sciences, Antwerp (Wilrijk), Belgium
| | - Herman Goossens
- Vaccine & Infectious Disease Institute, Laboratory of Medical Microbiology, University of Antwerp, Antwerp (Wilrijk), Belgium
| | - Laetitia Buret
- General Practice Department, Primary Care and Health Research Unit, Liege University, Liege, Belgium
| | - Els Duysburgh
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Samuel Coenen
- Family Medicine & Population Health, Centre for General Practice, University of Antwerp Faculty of Medicine and Health Sciences, Antwerp (Wilrijk), Belgium
- Vaccine & Infectious Disease Institute, Laboratory of Medical Microbiology, University of Antwerp, Antwerp (Wilrijk), Belgium
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Borro M, Salerno G, Montori A, Petrucca A, Anibaldi P, Marcolongo A, Bonfini R, Simmaco M, Santino I. SARS-CoV-2 Transmission Control Measures in the Emergency Department: The Role of Rapid Antigenic Testing in Asymptomatic Subjects. Healthcare (Basel) 2022; 10:healthcare10050790. [PMID: 35627926 PMCID: PMC9140606 DOI: 10.3390/healthcare10050790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 12/30/2022] Open
Abstract
Limiting transmission of SARS-CoV-2 from asymptomatic people assumes the paramount importance of keeping fragile subjects protected. We evaluated the utility of rapid SARS-CoV-2 antigen testing in asymptomatic subjects attending emergency departments in non-COVID-19 areas, using a single nasopharyngeal swab specimen collected in universal transport medium to perform both rapid antigen testing and rRT-PCR (used as reference standard) in a cohort of 899 patients. In the overall sample, the rapid antigen test had 43.9% sensitivity, 100% specificity, 100% positive predictive value, 93.6% negative predictive value. Considering subjects with rRT-PCR cycle threshold ≤30, the test had 80.4% sensitivity, 100% specificity, 100% positive predictive value, 98.8% negative predictive value. Considering subjects with rRT-PCR cycle threshold ≤25, the test had 94.7% sensitivity, 100% specificity, 100% positive predictive value and 99.7% negative predictive value. Despite low sensitivity, routine application of rapid antigen testing in the emergency department can lead to isolation in less than 30 min of about a half of asymptomatic COVID-19 subjects assigned to non-COVID-19 areas by clinical triage. The rapid test correctly identified 94.7% of asymptomatic patients with cycle threshold ≤ 25 that are supposed to be more infective; thus, it could be a useful measure to contain viral transmission in non-COVID-19 areas.
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Affiliation(s)
- Marina Borro
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Sapienza University, Via di Grottarossa 1035/1039, 00189 Rome, Italy; (M.S.); (I.S.)
- Laboratory of Clinical Biochemistry, Sant’Andrea University Hospital, Via di Grottarossa 1035, 00189 Rome, Italy;
- Correspondence: (M.B.); (G.S.)
| | - Gerardo Salerno
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Sapienza University, Via di Grottarossa 1035/1039, 00189 Rome, Italy; (M.S.); (I.S.)
- Laboratory of Clinical Biochemistry, Sant’Andrea University Hospital, Via di Grottarossa 1035, 00189 Rome, Italy;
- Correspondence: (M.B.); (G.S.)
| | - Andrea Montori
- Microbiology Unit, Sant’Andrea University Hospital, Via di Grottarossa 1035, 00189 Rome, Italy;
| | - Andrea Petrucca
- Laboratory of Clinical Biochemistry, Sant’Andrea University Hospital, Via di Grottarossa 1035, 00189 Rome, Italy;
| | - Paolo Anibaldi
- Medical Direction, Sant’Andrea University Hospital, Via di Grottarossa 1035, 00189 Rome, Italy;
| | - Adriano Marcolongo
- General Direction, Sant’Andrea University Hospital, Via di Grottarossa 1035, 00189 Rome, Italy;
| | - Rita Bonfini
- Emergency Department Unit, Sant’Andrea University Hospital, Via di Grottarossa 1035, 00189 Rome, Italy;
| | - Maurizio Simmaco
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Sapienza University, Via di Grottarossa 1035/1039, 00189 Rome, Italy; (M.S.); (I.S.)
- Laboratory of Clinical Biochemistry, Sant’Andrea University Hospital, Via di Grottarossa 1035, 00189 Rome, Italy;
| | - Iolanda Santino
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Sapienza University, Via di Grottarossa 1035/1039, 00189 Rome, Italy; (M.S.); (I.S.)
- Microbiology Unit, Sant’Andrea University Hospital, Via di Grottarossa 1035, 00189 Rome, Italy;
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