1
|
Sticchi Damiani A, Zizza A, Banchelli F, Gigante M, De Feo ML, Ostuni A, Marinelli V, Quagnano S, Negro P, Di Renzo N, Guido M. Association between ABO blood groups and SARS-CoV-2 infection in blood donors of Puglia region. Ann Hematol 2023; 102:2923-2931. [PMID: 37442822 PMCID: PMC10492875 DOI: 10.1007/s00277-023-05331-1] [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: 03/09/2023] [Accepted: 06/17/2023] [Indexed: 07/15/2023]
Abstract
This is an observational multicentric cross-sectional study aiming at assessing the association between ABO blood groups and SARS-CoV-2 seroprevalence among the blood donors in Puglia region. Data on ABO and Rh blood groups and demographic characteristics were obtained from Blood Bank Information System. All donors were screened for SARS-CoV-2 IgG antibodies. Comparison of seroprevalence among blood groups and the association between the recorded variables and seroprevalence were evaluated. A total of 35,709 donors from 22 centers were included, with a seroprevalence of 6.8%. The distribution of ABO phenotypes was blood type O (46.8%), A (34.0%), B (14.7%), and AB (4.5%). Among the 2416 donors reactive for SARS-CoV-2 IgG, the prevalent phenotype was blood type O (43.1%), followed by A (37.7%), B (14.2%), and AB (5%). The seroprevalence of phenotype A and AB was 7.5%, followed by B (6.5%) and O (6.2%). According to the adjusted analysis, there was an increase in seroprevalence in groups A and AB, compared to group O, and an increase in males compared to females. A possible effect modification was observed after stratifying for sex (p = 0.0515). A significantly lower prevalence of blood type O was found compared to A and AB, whereas no association was observed between Rh factor and seroprevalence. We hypothesized that the A antigen present in blood type A and AB can play a role in the binding of SARS-CoV-2 to ACE2 receptors, resulting in an increased risk of infection. Furthermore, natural anti-A/anti-B antibodies produced in group O could block viral adhesion to cells and explain a lower risk of infection.
Collapse
Affiliation(s)
- Alessia Sticchi Damiani
- Immunohaematology and Transfusion Medicine Unit, Inter-Company Department of Transfusion Medicine (IDTM) of Local Health Unit (LHU) of Lecce, Vito Fazzi Hospital, 73100, Lecce, Italy.
| | - Antonella Zizza
- Institute of Clinical Physiology, National Research Council, Via Prov.Le Lecce-Monteroni, 73100, Lecce, Italy.
| | - Federico Banchelli
- Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Unit of Statistical and Methodological Support to Clinical Research, University Hospital of Modena, Modena, Italy
| | - Maddalena Gigante
- Immunohaematology and Transfusion Medicine Unit, Inter-Company Department of Transfusion Medicine (IDTM) of Local Health Unit (LHU) of Bari, S. Paolo Hospital, Bari, Italy
| | - Maria Lucia De Feo
- Immunohaematology and Transfusion Medicine Unit, Inter-Company Department of Transfusion Medicine (IDTM) of Local Health Unit (LHU) of Foggia, Ospedali Riuniti of Foggia, Foggia, Italy
| | - Angelo Ostuni
- Immunohaematology and Transfusion Medicine Unit, Policlinico of Bari, Bari, Italy
| | - Valerio Marinelli
- Immunohaematology and Transfusion Medicine Unit, Inter-Company Department of Transfusion Medicine (IDTM) of Local Health Unit (LHU) of Lecce, Vito Fazzi Hospital, 73100, Lecce, Italy
| | - Serena Quagnano
- Immunohaematology and Transfusion Medicine Unit, Inter-Company Department of Transfusion Medicine (IDTM) of Local Health Unit (LHU) of Lecce, Vito Fazzi Hospital, 73100, Lecce, Italy
| | - Pierpaolo Negro
- Immunohaematology and Transfusion Medicine Unit, Inter-Company Department of Transfusion Medicine (IDTM) of Local Health Unit (LHU) of Lecce, Vito Fazzi Hospital, 73100, Lecce, Italy
| | - Nicola Di Renzo
- Immunohaematology and Transfusion Medicine Unit, Inter-Company Department of Transfusion Medicine (IDTM) of Local Health Unit (LHU) of Lecce, Vito Fazzi Hospital, 73100, Lecce, Italy
| | - Marcello Guido
- Laboratory of Hygiene, Department of Biological and Environmental Sciences and Technologies, University of Salento, Lecce, Italy
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
Harker S, James SE, Murphy J, Davies B, Moore C, Tennant BP, Geen J, Thomas D. Serosurveillance of SARS-CoV-2 in Welsh Blood Donors: Establishment of the surveillance system and results up to November 2022. Euro Surveill 2023; 28:2200473. [PMID: 37166761 PMCID: PMC10176830 DOI: 10.2807/1560-7917.es.2023.28.19.2200473] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 02/10/2023] [Indexed: 05/12/2023] Open
Abstract
BackgroundIn 2020, Wales experienced some of the highest rates of confirmed COVID-19 cases in Europe. We set up a serosurveillance scheme using residual samples from blood donations to inform the pandemic response in Wales.AimTo identify changes in SARS-CoV-2 antibody seroprevalence in Wales by time, demography and location.MethodsResidual samples from blood donations made in Wales between 29 June 2020 and 20 November 2022 were tested for antibodies to the nucleocapsid antigen (anti-N) of SARS-CoV-2, resulting from natural infection. Donations made between 12 April 2021 and 20 November 2022 were also tested for antibodies to the spike antigen (anti-S) occurring as a result of natural infection and vaccination.ResultsAge-standardised seroprevalence of anti-N antibodies in donors remained stable (4.4-5.5%) until November 2020 before increasing to 16.7% by February 2021. Trends remained steady until November 2021 before increasing, peaking in November 2022 (80.2%). For anti-S, seroprevalence increased from 67.1% to 98.6% between May and September 2021, then remained above 99%. Anti-N seroprevalence was highest in younger donors and in donors living in urban South Wales. In contrast, seroprevalence of anti-S was highest in older donors and was similar across regions. No significant difference was observed by sex. Seroprevalence of anti-N antibodies was higher in Black, Asian and other minority ethnicities (self-reported) compared with White donors, with the converse observed for anti-S antibodies.ConclusionWe successfully set up long-term serological surveillance of SARS-CoV-2 using residual samples from blood donations, demonstrating variation based on age, ethnicity and location.
Collapse
Affiliation(s)
- Sophie Harker
- Communicable Diseases Surveillance Centre, Public Health Wales, Cardiff, United Kingdom
| | - Siân Elizabeth James
- Research Development and Innovation, Welsh Blood Service, Pontyclun, United Kingdom
| | - James Murphy
- Laboratory Medicine, Swansea Bay University Health Board, Swansea, United Kingdom
| | - Ben Davies
- Laboratory Medicine, Swansea Bay University Health Board, Swansea, United Kingdom
| | - Catherine Moore
- Wales Specialist Virology Centre, Public Health Wales, Cardiff, United Kingdom
| | - Brian P Tennant
- Clinical Biochemistry Service, Cwm Taf Morgannwg University Health Board, Llantrisant, United Kingdom
| | - John Geen
- Clinical Biochemistry Service, Cwm Taf Morgannwg University Health Board, Llantrisant, United Kingdom
| | - Daniel Thomas
- Communicable Diseases Surveillance Centre, Public Health Wales, Cardiff, United Kingdom
| |
Collapse
|
4
|
Metzger C, Leroy T, Bochnakian A, Jeulin H, Gegout-Petit A, Legrand K, Schvoerer E, Guillemin F. Seroprevalence and SARS-CoV-2 invasion in general populations: A scoping review over the first year of the pandemic. PLoS One 2023; 18:e0269104. [PMID: 37075077 PMCID: PMC10118383 DOI: 10.1371/journal.pone.0269104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 05/13/2022] [Indexed: 04/20/2023] Open
Abstract
Since the beginning of the COVID-19 pandemic, counting infected people has underestimated asymptomatic cases. This literature scoping review assessed the seroprevalence progression in general populations worldwide over the first year of the pandemic. Seroprevalence studies were searched in PubMed, Web of Science and medRxiv databases up to early April 2021. Inclusion criteria were a general population of all ages or blood donors as a proxy. All articles were screened for the title and abstract by two readers, and data were extracted from selected articles. Discrepancies were resolved with a third reader. From 139 articles (including 6 reviews), the seroprevalence estimated in 41 countries ranged from 0 to 69%, with a heterogenous increase over time and continents, unevenly distributed among countries (differences up to 69%) and sometimes among regions within a country (up to 10%). The seroprevalence of asymptomatic cases ranged from 0% to 31.5%. Seropositivity risk factors included low income, low education, low smoking frequency, deprived area residency, high number of children, densely populated centres, and presence of a case in a household. This review of seroprevalence studies over the first year of the pandemic documented the progression of this virus across the world in time and space and the risk factors that influenced its spread.
Collapse
Affiliation(s)
- Clémentine Metzger
- CHRU -Nancy, INSERM, Université de Lorraine, CIC Epidémiologie clinique,
F-54000, Nancy, France
| | - Taylor Leroy
- CHRU -Nancy, INSERM, Université de Lorraine, CIC Epidémiologie clinique,
F-54000, Nancy, France
| | - Agathe Bochnakian
- CHRU -Nancy, INSERM, Université de Lorraine, CIC Epidémiologie clinique,
F-54000, Nancy, France
| | - Hélène Jeulin
- Université de Lorraine, CNRS, LCPME, F‐54000, Nancy,
France
- Laboratoire de Virologie, CHRU de Nancy Brabois, F‐54500, Nancy,
France
| | | | - Karine Legrand
- CHRU -Nancy, INSERM, Université de Lorraine, CIC Epidémiologie clinique,
F-54000, Nancy, France
| | - Evelyne Schvoerer
- Université de Lorraine, CNRS, LCPME, F‐54000, Nancy,
France
- Laboratoire de Virologie, CHRU de Nancy Brabois, F‐54500, Nancy,
France
| | - Francis Guillemin
- CHRU -Nancy, INSERM, Université de Lorraine, CIC Epidémiologie clinique,
F-54000, Nancy, France
| |
Collapse
|
5
|
Amendola A, Canuti M, Bianchi S, Kumar S, Fappani C, Gori M, Colzani D, Kosakovsky Pond SL, Miura S, Baggieri M, Marchi A, Borghi E, Zuccotti G, Raviglione MC, Magurano F, Tanzi E. Molecular evidence for SARS-CoV-2 in samples collected from patients with morbilliform eruptions since late 2019 in Lombardy, northern Italy. ENVIRONMENTAL RESEARCH 2022; 215:113979. [PMID: 36029839 PMCID: PMC9404229 DOI: 10.1016/j.envres.2022.113979] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 07/07/2022] [Accepted: 07/21/2022] [Indexed: 05/12/2023]
Abstract
As a reference laboratory for measles and rubella surveillance in Lombardy, we evaluated the association between SARS-CoV-2 infection and measles-like syndromes, providing preliminary evidence for undetected early circulation of SARS-CoV-2. Overall, 435 samples from 156 cases were investigated. RNA from oropharyngeal swabs (N = 148) and urine (N = 141) was screened with four hemi-nested PCRs and molecular evidence for SARS-CoV-2 infection was found in 13 subjects. Two of the positive patients were from the pandemic period (2/12, 16.7%, March 2020-March 2021) and 11 were from the pre-pandemic period (11/44, 25%, August 2019-February 2020). Sera (N = 146) were tested for anti-SARS-CoV-2 IgG, IgM, and IgA antibodies. Five of the RNA-positive individuals also had detectable anti-SARS-CoV-2 antibodies. No strong evidence of infection was found in samples collected between August 2018 and July 2019 from 100 patients. The earliest sample with evidence of SARS-CoV-2 RNA was from September 12, 2019, and the positive patient was also positive for anti-SARS-CoV-2 antibodies (IgG and IgM). Mutations typical of B.1 strains previously reported to have emerged in January 2020 (C3037T, C14408T, and A23403G), were identified in samples collected as early as October 2019 in Lombardy. One of these mutations (C14408T) was also identified among sequences downloaded from public databases that were obtained by others from samples collected in Brazil in November 2019. We conclude that a SARS-CoV-2 progenitor capable of producing a measles-like syndrome may have emerged in late June-late July 2019 and that viruses with mutations characterizing B.1 strain may have been spreading globally before the first Wuhan outbreak. Our findings should be complemented by high-throughput sequencing to obtain additional sequence information. We highlight the importance of retrospective surveillance studies in understanding the early dynamics of COVID-19 spread and we encourage other groups to perform retrospective investigations to seek confirmatory proofs of early SARS-CoV-2 circulation.
Collapse
Affiliation(s)
- Antonella Amendola
- Department of Health Sciences, University of Milan, 20142, Milan, Italy; Coordinated Research Center "EpiSoMI", University of Milan, 20133, Milan, Italy.
| | - Marta Canuti
- Department of Health Sciences, University of Milan, 20142, Milan, Italy.
| | - Silvia Bianchi
- Department of Health Sciences, University of Milan, 20142, Milan, Italy; Coordinated Research Center "EpiSoMI", University of Milan, 20133, Milan, Italy.
| | - Sudhir Kumar
- Institute for Genomics and Evolutionary Medicine, Temple University, 19122, Philadelphia, USA; Department of Biology, Temple University, 19122, Philadelphia, USA; Center for Excellence in Genome Medicine and Research, King Abdulaziz University, 22252, Jeddah, Saudi Arabia.
| | - Clara Fappani
- Department of Health Sciences, University of Milan, 20142, Milan, Italy; Coordinated Research Center "EpiSoMI", University of Milan, 20133, Milan, Italy.
| | - Maria Gori
- Department of Health Sciences, University of Milan, 20142, Milan, Italy; Coordinated Research Center "EpiSoMI", University of Milan, 20133, Milan, Italy.
| | - Daniela Colzani
- Department of Health Sciences, University of Milan, 20142, Milan, Italy; Coordinated Research Center "EpiSoMI", University of Milan, 20133, Milan, Italy.
| | - Sergei L Kosakovsky Pond
- Institute for Genomics and Evolutionary Medicine, Temple University, 19122, Philadelphia, USA; Department of Biology, Temple University, 19122, Philadelphia, USA.
| | - Sayaka Miura
- Institute for Genomics and Evolutionary Medicine, Temple University, 19122, Philadelphia, USA; Department of Biology, Temple University, 19122, Philadelphia, USA.
| | - Melissa Baggieri
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161, Rome, Italy.
| | - Antonella Marchi
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161, Rome, Italy.
| | - Elisa Borghi
- Department of Health Sciences, University of Milan, 20142, Milan, Italy; Coordinated Research Center "EpiSoMI", University of Milan, 20133, Milan, Italy.
| | - Gianvincenzo Zuccotti
- Department of Paediatrics, Children Hospital V. Buzzi, University of Milan, 20154, Milan, Italy; Romeo and Enrica Invernizzi Pediatric Research Center, University of Milan, 20154, Milan, Italy.
| | - Mario C Raviglione
- Centre for Multidisciplinary Research in Health Science, University of Milan, 20122, Milan, Italy.
| | - Fabio Magurano
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161, Rome, Italy.
| | - Elisabetta Tanzi
- Department of Health Sciences, University of Milan, 20142, Milan, Italy; Coordinated Research Center "EpiSoMI", University of Milan, 20133, Milan, Italy.
| |
Collapse
|
6
|
SARS-CoV-2 seroprevalence in blood donors before and after the first wave in Catalonia (Spain). BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2022; 20:353-361. [PMID: 35175189 PMCID: PMC9480965 DOI: 10.2450/2022.0232-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 12/29/2021] [Indexed: 01/24/2023]
Abstract
BACKGROUND Due to the COVID-19 pandemic, a national lockdown was applied in Spain from March to May 2020. It is uncertain when SARS-CoV-2 started to circulate in Catalonia, and only a few cases were diagnosed in this period. We assessed the SARS-CoV-2 seroprevalence in blood donors before and after the first wave and compared it with public health service (PHS) data. MATERIALS AND METHODS Retrospective archive or prospective fresh blood samples were obtained from blood donors aged 18 to 70 and anonymized after demographic data had been recorded (gender, age, place of residence, blood collection date). Two CE-marked enzyme-linked immunosorbent assays were used to test for anti-SARS-CoV-2. A SARS-CoV-2 IgM test was additionally performed in positive samples. Individuals aged 18 to 70 from among the general population diagnosed as having SARS-CoV-2 by the PHS were included for comparison with blood donor results. RESULTS A total of 10,170 blood donations were included in the first period, between 24 February and 9 March 2020, and 6,829 in the second period, between 16 May and 17 June 2020. The observed SARS-CoV-2 seroprevalence among blood donors rose from 0.27% (95% CI: 0.18-0.39) before the first wave to 5.55% (95% CI: 5.03-6.12) after it, and was even higher (6.90% [95% CI: 5.64-8.41]) among blood donors aged 18 to 29. The seroprevalence among blood donors was higher in more populated areas (Barcelona: 7.69%). A comparison of blood donor data with officially diagnosed cases showed a global 87.44% underestimation of SARS-CoV-2 in June 2020. DISCUSSION We analyzed the explosive 3-month increase in blood donor SARS-CoV-2 seroprevalence (from 0.27% to 5.55%) and show that more than 87% of cases went undiagnosed, despite the unprecedented deployment of testing measures. SARS-CoV-2 IgM results suggest that the virus was circulating among blood donors in February 2020. Blood donors are definitively proven to be a valuable resource for emerging disease surveillance studies.
Collapse
|
7
|
Seroprevalence of Anti-SARS-CoV-2 Antibodies in High-Risk Occupational and Low-Risk Groups in Southwestern Iran. Jundishapur J Microbiol 2022. [DOI: 10.5812/jjm-126975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background: Monitoring the spread of SARS-CoV-2 has been considered by the World Health Organization (WHO). We examined the prevalence of anti-SARS-CoV-2 immunoglobulin antibodies in southwestern Iran in spring 2020. The circulation of SARS-CoV-2 is high in the general population, especially among health care workers (HCWs) who are in close contact with patients. Objectives: The aim of this study was to determine the prevalence of anti-SARS-CoV-2 antigen in high-risk occupational and low-risk groups to investigate risk factors for serum positivity in Shiraz, southwestern Iran. Methods: A cross-sectional survey was performed on 366 participants (204 from high-risk and 162 from low-risk subjects). IgG and IgM antibodies were detected using Pishtaz Teb COVID-19 ELISA Kits to evaluate SARS-CoV-2-antigen in serum samples. After enzyme-linked immunosorbent assay (ELISA), serum prevalence, as well as IgG/IgM positive factors, was determined using logistic regression. Results: From July to September 2020 (a few months after reporting the first case of COVID-19 cases in Iran), out of 366 survived people, 72 (40.9%) were IgG positive, and 50 (27.5%) were IgM positive. The frequency of positive serology for IgG and IgM antibodies in individuals aged < 30 years was higher in the low-risk group than in the high-risk group. Multivariate logistic regression showed that headache (OR 0.312 [95% CI: 0.136 - 0.717]) and cough (OR 0.427 [95% CI: 0.182 - 1.004]) factors were associated with IgG or IgM positive serology. Conclusions: Between July and September 2020, the prevalence of anti-SARS-CoV-2 antigen was high in Shiraz. The prevalence of SARS-CoV-2 IgG/IgM antibodies in the high-risk group and their family as low risk was shown to increase viral infection due to close contact with COVID 19 patients than in the general population. Several factors were found to be related to the prevalence of anti-SARS-CoV-2 antigen that needs to be considered by policymakers to determine what to do about the SARS-CoV-2 pandemic.
Collapse
|
8
|
Zhang R, Wang Y, Lv Z, Pei S. Evaluating the impact of stay-at-home and quarantine measures on COVID-19 spread. BMC Infect Dis 2022; 22:648. [PMID: 35896977 PMCID: PMC9326419 DOI: 10.1186/s12879-022-07636-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 07/19/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND During the early stage of the COVID-19 pandemic, many countries implemented non-pharmaceutical interventions (NPIs) to control the transmission of SARS-CoV-2, the causative pathogen of COVID-19. Among those NPIs, stay-at-home and quarantine measures were widely adopted and enforced. Understanding the effectiveness of stay-at-home and quarantine measures can inform decision-making and control planning during the ongoing COVID-19 pandemic and for future disease outbreaks. METHODS In this study, we use mathematical models to evaluate the impact of stay-at-home and quarantine measures on COVID-19 spread in four cities that experienced large-scale outbreaks in the spring of 2020: Wuhan, New York, Milan, and London. We develop a susceptible-exposed-infected-removed (SEIR)-type model with components of self-isolation and quarantine and couple this disease transmission model with a data assimilation method. By calibrating the model to case data, we estimate key epidemiological parameters before lockdown in each city. We further examine the impact of stay-at-home and quarantine rates on COVID-19 spread after lockdown using counterfactual model simulations. RESULTS Results indicate that self-isolation of susceptible population is necessary to contain the outbreak. At a given rate, self-isolation of susceptible population induced by stay-at-home orders is more effective than quarantine of SARS-CoV-2 contacts in reducing effective reproductive numbers [Formula: see text]. Variation in self-isolation and quarantine rates can also considerably affect the duration of outbreaks, attack rates and peak timing. We generate counterfactual simulations to estimate effectiveness of stay-at-home and quarantine measures. Without these two measures, the cumulative confirmed cases could be much higher than reported numbers within 40 days after lockdown in Wuhan, New York, Milan, and London. CONCLUSIONS Our findings underscore the essential role of stay-at-home orders and quarantine of SARS-CoV-2 contacts during the early phase of the pandemic.
Collapse
Affiliation(s)
- Renquan Zhang
- School of Mathematical Sciences, Dalian University of Technology, 116024 Dalian, China
| | - Yu Wang
- School of Mathematical Sciences, Dalian University of Technology, 116024 Dalian, China
| | - Zheng Lv
- School of Control Science and Engineering, Dalian University of Technology, 116024 Dalian, China
| | - Sen Pei
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 10032 New York, USA
| |
Collapse
|
9
|
Nourmohammadi H, Dehkordi AH, Adibi A, Amin Hashemipour SM, Abdan M, Fakhri M, Abdan Z, Sarokhani D. Seroprevalence of COVID-19 in Blood Donors: A Systematic Review and Meta-Analysis. Adv Virol 2022; 2022:9342680. [PMID: 35910542 PMCID: PMC9334089 DOI: 10.1155/2022/9342680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 05/20/2022] [Accepted: 05/26/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction Determining the prevalence of SARS-CoV-2 in blood donors makes the control of virus circulation possible in healthy people and helps implement strategies to reduce virus transmission. The purpose of the study was to examine the seroprevalence of COVID-19 in blood donors using systematic review and meta-analysis. Materials and Methods The electronic databases PubMed, Scopus, Web of Science, and the Google Scholar search engine were searched using standard keywords up to 2022-04-26. The variance of each study was calculated according to the binomial distribution. Studies were combined according to the sample size and variance. Q Cochrane test and I2 index were used to examine the heterogeneity of the studies. Data analysis was performed in STATA 14 software, and the significance level of the tests was P < 0.05. Results In the 28 papers examined with 227894 samples, the seroprevalence of COVID-19 in blood donors was 10% (95% CI: 9%, 11%), estimated 5% (95% CI: 4%, 7%) among men and 6% (95% CI: 4%, 7%) among women. This rate in different blood groups was as follows: A 12% (95% CI: 10%-14%), B 12% (95% CI: 10%-15%), AB 9% (95% CI: 7%-12%), and O 13% (95% CI: 11%-16%). The seroprevalence of COVID-19 in blood donors in North America 10%, Europe 7%, Asia 23%, South America 5%, and Africa was 4%; Moreover, the seroprevalence of IgG antibodies was estimated to be 23% (95% CI: 18%-29%) and IgM 29% (95% CI: 9%-49%). Conclusion The highest prevalence of COVID-19 serum in women blood donors was among blood group O and Asia. The seroprevalence of IgG and IgM antibodies was high too.
Collapse
Affiliation(s)
| | - Ali Hasanpour Dehkordi
- Social Determinants of Health Research Center, School of Allied Medical Sciences, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Amir Adibi
- Department of Child and Adolescent Psychiatry, Ilam University of Medical Sciences, Ilam, Iran
| | | | - Mohsen Abdan
- Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Moloud Fakhri
- Traditional and Complementary Medicine Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zahra Abdan
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Diana Sarokhani
- Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| |
Collapse
|
10
|
Fazio M, Pluchino A, Inturri G, Le Pira M, Giuffrida N, Ignaccolo M. Exploring the impact of mobility restrictions on the COVID-19 spreading through an agent-based approach. JOURNAL OF TRANSPORT & HEALTH 2022; 25:101373. [PMID: 35495092 PMCID: PMC9042024 DOI: 10.1016/j.jth.2022.101373] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 04/07/2022] [Accepted: 04/11/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND The recent health emergency caused by the COVID-19 pandemic forced people to change their mobility habits, with the reduction of non-essential travels and the promotion online activities. During the first phase of the emergency in 2020, governments considered several mobility restrictions to avoid the pandemic diffusion. However, it is difficult to quantify the actual effects of these restrictions on the virus spreading, especially due to the biased data available. Notwithstanding the big role of data analysis to understand the pandemic phenomenon, it is also important to have more general models capable of predicting the impact of different policy scenarios, including territorial parameters, independently from the available infection data. In this respect, this paper proposes an agent-based model to simulate the impact of mobility restrictions on the spreading of the COVID-19 at a large scale level, by considering different factors that can be attributed to the diffusion and lethality of the virus and population mobility patterns. METHODS The first step of the method includes a zonation of the study area, according to administrative boundaries. A risk index is calculated for each zone considering indicators which can influence the virus spreading and people lethality: mean winter temperature, housing concentration, healthcare density, population mobility, air pollution and the percentage of population over 60 years old. The agent-based model associates the risk index to the agents and determines their "status" ("susceptible", "infected", "isolated", "recovered" or "dead") by combining the risk index with the mean infection duration, using a SIR-based approach (i.e. susceptible-infective-removed). RESULTS The study is applied to Italy. Several scenarios based on different mobility restrictions have been simulated, including the one based on the official data (status quo). The main results show that characterizing zones with a risk index allows to adopt local policies with almost the same effectiveness as in the case of restrictions extended to the full study area; scenario simulations return an increase in terms of infected (+20%) and deaths (+25%) with respect to the status quo. These results underline the importance of finding a trade-off between socio-economic benefits and health impact. CONCLUSIONS The reproducibility of the proposed methodology and its scalability allow to apply it to different contexts and at a different administrative level, from the urban scale to a national one. Moreover, the model is able to provide a decision-support tool for the design of strategic plans to contrast pandemics based on respiratory diseases.
Collapse
Affiliation(s)
- Martina Fazio
- Department of Physics and Astronomy, University of Catania, Catania, Italy
| | - Alessandro Pluchino
- Department of Physics and Astronomy, University of Catania, Catania, Italy
- INFN Section of Catania, Catania, Italy
| | - Giuseppe Inturri
- Department of Electrical, Electronic and Computer Engineering, University of Catania, Catania, Italy
| | - Michela Le Pira
- Department of Civil Engineering and Architecture, University of Catania, Catania, Italy
| | - Nadia Giuffrida
- Spatial Dynamics Lab, University College Dublin, UCD Richview Campus, D04 V1W8, Belfield, Dublin, Ireland
| | - Matteo Ignaccolo
- Department of Civil Engineering and Architecture, University of Catania, Catania, Italy
| |
Collapse
|
11
|
Seroprevalence of SARS-CoV-2 antibodies and knowledge, attitude and practice toward COVID-19 in the Republic of Srpska-Bosnia & Herzegovina: A population-based study. PLoS One 2022; 17:e0262738. [PMID: 35089944 PMCID: PMC8797215 DOI: 10.1371/journal.pone.0262738] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 01/05/2022] [Indexed: 12/11/2022] Open
Abstract
The aim of the study was to assess the seroprevalence of SARS-CoV-2 in the Republic of Srpska, Bosnia and Herzegovina, and to analyse the knowledge, attitudes and practices of the population toward COVID-19. This population-based study was conducted in a group of 1,855 randomly selected individuals from all municipalities from 1 December 2020 to 15 January 2021. All individuals were asked to sign a consent form and to fill in a questionnaire, following which a blood samples were collected. Total anti-SARS-CoV-2 antibodies were determined in serum specimens using the total Ab ELISA assay. The overall seroprevalence rate was 40.3%. Subjects aged <65 years were 2.06 times more likely to be seropositive than those aged ≥65, and 30% of seropositive individuals presented no COVID-19 symptoms. The household members of seropositive individuals were 2.24 times more likely to develop COVID-19 symptoms than the household members of seronegative individuals. More than 95% of respondents believe that preventive measures are very important to control the infection transmission. Majority of respondents wear the masks properly, maintain the required physical distance whenever possible and wash hands with soap. Nearly 50% of individuals were of the opinion that the vaccine could prevent the infection. This study showed that an overall SARS-CoV-2 seropositivity rate by the middle of January 2021 was very high. Attitudes and practices regarding the COVID-19 indicate that additional efforts should be taken in order to improve the health education with a focus on preventive measures and vaccination.
Collapse
|
12
|
Kale P, Patel N, Gupta E, Bajpai M. SARS-Coronavirus-2 seroprevalence in asymptomatic healthy blood donors: Indicator of community spread. Transfus Apher Sci 2022; 61:103293. [PMID: 34686444 PMCID: PMC8516133 DOI: 10.1016/j.transci.2021.103293] [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: 07/21/2021] [Revised: 10/08/2021] [Accepted: 10/11/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND The Corona virus disease 2019 (COVID-19) pandemic caused by SARS -Corona virus-2 (SARS-CoV-2) has been a major concern the world over. Serological surveillance is an important tool to assess the spread of infection in the community. This study attempted to assess the prevalence of antibodies to SARS-CoV-2 among blood donors in Delhi, India during the pre-vaccination period. METHODS Seroprevalence of SARS-CoV2-2 IgG antibodies were determined in blood donors reporting to the Department of Transfusion medicine at a tertiary care hepatobiliary center, in India from September to October 2020. The SARS-CoV-2 IgG antibodies against spike subunit 1 protein were measured using the enhanced chemiluminescence method. RESULTS A total of 1066 blood donors were screened. The overall seropositivity for SARS-CoV-2 IgG antibodies was 27.57 % (294/1066). The highest seropositivity was seen in the age group 26-35 years, 46.6 % (137/492), followed by 18-25 years, 28.2 % (83/260), 36-45 years, 19.4 % (57/244), and more than 45 years, 5.8 % (17/70). The seropositivity in the donors who had donated blood previously was 26.1 % (189/723). There was no statistically significant difference amongst seroprevalence in the blood groups, AB blood group (32.6 %, 95 % CI 23.02-43.3), group B (27.2 %, 95 % CI 22.8-32.09 %), group A (27.1 %, 95 % CI 21.8-32.9 %), and group O (27.02 %, 95 % CI 22.3-32.1 %) (p 0.539). CONCLUSIONS There was significantly higher seropositivity for SARS-CoV-2 antibodies in the voluntary healthy blood donors indicating community spread and large number of asymptomatic cases in Delhi. Higher seroprevalence in younger adults indicated increased exposure to the virus and lack of COVID appropriate behaviour.
Collapse
Affiliation(s)
- Pratibha Kale
- Clinical Microbiology, Institute of Liver and Biliary Sciences, India
| | - Niharika Patel
- Clinical Microbiology, Institute of Liver and Biliary Sciences, India
| | - Ekta Gupta
- Clinical Virology, Institute of Liver and Biliary Sciences, India
| | - Meenu Bajpai
- Transfusion Medicine, Institute of Liver and Biliary Sciences, India.
| |
Collapse
|
13
|
Ibrahimagić A, Huseinagić S, Sarajlić-Spahić S, Bašić F, Durmišević J. Detection of anti-SARS-CoV-2 antibodies and its seroprevalence in Zavidovići municipality of Zenica-Doboj Canton, Bosnia and Herzegovina. Int J Health Sci (Qassim) 2022; 16:3-8. [PMID: 36101851 PMCID: PMC9441649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Improved serological detection of specific antibodies against SARS-CoV-2 could help estimate the true number of infections. METHODS A total of 443 serum samples provided by unvaccinated patients of all ages with unknown COVID-19 status that were originally submitted for routine screening or clinical management from outpatient laboratory during the March-April 2021 (third wave) were collected. Seroprevalence of IgM/IgG antibodies was determined by lateral flow immunoassay (Tigsun, Beijing, China). RESULTS Among 443 serum samples, 186 (42.0%) were positive (incidence of 5.2/1000) with slight predominace of females, 104 (55.9%), highest seropositivity in 25-50 and 51-64 years age groups, 61 (32.8%) and 57 (30.6%), respectively (P < 0.05); rural population was more prevalent, 101 (54.3%) (P < 0.05) and active workers, 86 (41.1%). Almost equal number of patients was with or without symptoms, 48.4% and 51.6%, respectively. For the comparison, in the same period it was registered 296 (out of 855; 34.6%) PCR SARS-CoV-19 positive persons (incidence of 8.2/1000) with the higher gender (females) and the highest age prevalence in 51-64 years age group (36.8%). In the period March 2020-June 2021, it was registered 804 (out of 3323; 24.2%) (incidence of 22.3/1000) PCR SARS-CoV-19 positive persons with no significant gender and significant age difference (25-50 and 51-64 years group, respectively). CONCLUSION In the regions with high prevalence/incidence of SARS-CoV-2 in the general population (Bosnia and Herzegovina is on the World top on the number of deaths) seroprevalence measuring can help tracking the spread of disease.
Collapse
Affiliation(s)
- Amir Ibrahimagić
- Department for Chemical Diagnostics, Institute for Health and Food Safety, Fra Ivana Jukića 2, 72 000 Zenica, Bosnia and Herzegovina,Address for correspondence: Amir Ibrahimagić, Institute for Health and Food Safety, Fra Ivana Jukića 2, 72000 Zenica, Bosnia and Herzegovina. Phone: 0038732/448-470. Fax: 0038732/448-000. E-mail:
| | - Senad Huseinagić
- Management of Institute for Health and Food Safety, Fra Ivana Jukića 2, 72 000 Zenica, Bosnia and Herzegovina
| | - Selvedina Sarajlić-Spahić
- Department for Promotion and Quality in Health, Institute for Health and Food Safety, Fra Ivana Jukića 2, 72 000 Zenica, Bosnia and Herzegovina
| | - Fatima Bašić
- Department for Epidemiology and Ecology, Institute for Health and Food Safety, Fra Ivana Jukića 2, 72 000 Zenica, Bosnia and Herzegovina
| | - Jasmin Durmišević
- Section for Health Ecology and Hygiene, Institute for Health and Food Safety, Fra Ivana Jukića 2, 72 000 Zenica, Bosnia and Herzegovina
| |
Collapse
|
14
|
Banerjee A, Chen S, Pasea L, Lai AG, Katsoulis M, Denaxas S, Nafilyan V, Williams B, Wong WK, Bakhai A, Khunti K, Pillay D, Noursadeghi M, Wu H, Pareek N, Bromage D, McDonagh TA, Byrne J, Teo JTH, Shah AM, Humberstone B, Tang LV, Shah ASV, Rubboli A, Guo Y, Hu Y, Sudlow CLM, Lip GYH, Hemingway H. Excess deaths in people with cardiovascular diseases during the COVID-19 pandemic. Eur J Prev Cardiol 2021; 28:1599-1609. [PMID: 33611594 PMCID: PMC7928969 DOI: 10.1093/eurjpc/zwaa155] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 11/26/2020] [Accepted: 12/10/2020] [Indexed: 12/21/2022]
Abstract
AIMS Cardiovascular diseases (CVDs) increase mortality risk from coronavirus infection (COVID-19). There are also concerns that the pandemic has affected supply and demand of acute cardiovascular care. We estimated excess mortality in specific CVDs, both 'direct', through infection, and 'indirect', through changes in healthcare. METHODS AND RESULTS We used (i) national mortality data for England and Wales to investigate trends in non-COVID-19 and CVD excess deaths; (ii) routine data from hospitals in England (n = 2), Italy (n = 1), and China (n = 5) to assess indirect pandemic effects on referral, diagnosis, and treatment services for CVD; and (iii) population-based electronic health records from 3 862 012 individuals in England to investigate pre- and post-COVID-19 mortality for people with incident and prevalent CVD. We incorporated pre-COVID-19 risk (by age, sex, and comorbidities), estimated population COVID-19 prevalence, and estimated relative risk (RR) of mortality in those with CVD and COVID-19 compared with CVD and non-infected (RR: 1.2, 1.5, 2.0, and 3.0).Mortality data suggest indirect effects on CVD will be delayed rather than contemporaneous (peak RR 1.14). CVD service activity decreased by 60-100% compared with pre-pandemic levels in eight hospitals across China, Italy, and England. In China, activity remained below pre-COVID-19 levels for 2-3 months even after easing lockdown and is still reduced in Italy and England. For total CVD (incident and prevalent), at 10% COVID-19 prevalence, we estimated direct impact of 31 205 and 62 410 excess deaths in England (RR 1.5 and 2.0, respectively), and indirect effect of 49 932 to 99 865 deaths. CONCLUSION Supply and demand for CVD services have dramatically reduced across countries with potential for substantial, but avoidable, excess mortality during and after the pandemic.
Collapse
Affiliation(s)
- Amitava Banerjee
- Institute of Health Informatics, University College London, 222 Euston Road, London, UK, NW1 1DA
- Health Data Research UK, Gibbs Building, 215 Euston Road, London, UK, NW1 2BE
- Department of Cardiology, Barts Health NHS Trust, Royal London Hospital, Whitechapel Road, London, UK, E1 1BB
- University College London Hospitals NHS Trust, 235 Euston Road, London, UK, NW1 2BU
| | - Suliang Chen
- Institute of Health Informatics, University College London, 222 Euston Road, London, UK, NW1 1DA
- Health Data Research UK, Gibbs Building, 215 Euston Road, London, UK, NW1 2BE
| | - Laura Pasea
- Institute of Health Informatics, University College London, 222 Euston Road, London, UK, NW1 1DA
- Health Data Research UK, Gibbs Building, 215 Euston Road, London, UK, NW1 2BE
| | - Alvina G Lai
- Institute of Health Informatics, University College London, 222 Euston Road, London, UK, NW1 1DA
- Health Data Research UK, Gibbs Building, 215 Euston Road, London, UK, NW1 2BE
| | - Michail Katsoulis
- Institute of Health Informatics, University College London, 222 Euston Road, London, UK, NW1 1DA
- Health Data Research UK, Gibbs Building, 215 Euston Road, London, UK, NW1 2BE
| | - Spiros Denaxas
- Institute of Health Informatics, University College London, 222 Euston Road, London, UK, NW1 1DA
- Health Data Research UK, Gibbs Building, 215 Euston Road, London, UK, NW1 2BE
| | - Vahe Nafilyan
- Office for National Statistics. 1 Drummond Gate, Pimlico, London, UK, SW1V 2QQ
| | - Bryan Williams
- University College London Hospitals NHS Trust, 235 Euston Road, London, UK, NW1 2BU
- Institute of Cardiovascular Science, University College London, London, UK, WC1E 6BT
- University College London Hospitals NIHR Biomedical Research Centre, Maple House, 1st Floor, 149 Tottenham Court Road, London, UK, W1T 7DN
| | - Wai Keong Wong
- Institute of Health Informatics, University College London, 222 Euston Road, London, UK, NW1 1DA
- University College London Hospitals NHS Trust, 235 Euston Road, London, UK, NW1 2BU
| | - Ameet Bakhai
- Department of Cardiology, Royal Free Hospital, Pond Street, London, UK, NW3 2QG
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Gwendolen Rd, Leicester, UK, LE5 4PW
| | - Deenan Pillay
- Division of Infection and Immunity, UCL Cruciform Building, University College London, Gower Street, London, UK, WC1E 6BT
| | - Mahdad Noursadeghi
- University College London Hospitals NHS Trust, 235 Euston Road, London, UK, NW1 2BU
- Division of Infection and Immunity, UCL Cruciform Building, University College London, Gower Street, London, UK, WC1E 6BT
| | - Honghan Wu
- Institute of Health Informatics, University College London, 222 Euston Road, London, UK, NW1 1DA
- Health Data Research UK, Gibbs Building, 215 Euston Road, London, UK, NW1 2BE
- School of Computer and Software, Najing University of Information Science and Technology, Ningliu Road, Nanjing, Jiangsu Province, P.R.C. 210044, China
| | - Nilesh Pareek
- Kings College Hospital NHS Foundation Trust, Denmark Hill, Brixton, London, UK, SE5 9RS
| | - Daniel Bromage
- Kings College Hospital NHS Foundation Trust, Denmark Hill, Brixton, London, UK, SE5 9RS
- Kings College London British Heart Foundation Centre, School of Cardiovascular Medicine & Sciences, London, Strand, London WC2R 2LS. UK
| | - Theresa A McDonagh
- Kings College Hospital NHS Foundation Trust, Denmark Hill, Brixton, London, UK, SE5 9RS
- Kings College London British Heart Foundation Centre, School of Cardiovascular Medicine & Sciences, London, Strand, London WC2R 2LS. UK
| | - Jonathan Byrne
- Kings College Hospital NHS Foundation Trust, Denmark Hill, Brixton, London, UK, SE5 9RS
| | - James T H Teo
- Kings College Hospital NHS Foundation Trust, Denmark Hill, Brixton, London, UK, SE5 9RS
| | - Ajay M Shah
- Kings College Hospital NHS Foundation Trust, Denmark Hill, Brixton, London, UK, SE5 9RS
- Kings College London British Heart Foundation Centre, School of Cardiovascular Medicine & Sciences, London, Strand, London WC2R 2LS. UK
| | - Ben Humberstone
- Office for National Statistics. 1 Drummond Gate, Pimlico, London, UK, SW1V 2QQ
| | - Liang V Tang
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Anoop S V Shah
- Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent Edinburgh, UK. EH16 4TJ
| | - Andrea Rubboli
- Division of Cardiology, Ospedale S. Maria delle Croci, Viale Randi 5, 48121, Ravenna. Italy
| | - Yutao Guo
- PLA General Hospital, 28 Fuxing Road, Beijing, Haidian District, Beijing, China
| | - Yu Hu
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Cathie L M Sudlow
- Health Data Research UK, Gibbs Building, 215 Euston Road, London, UK, NW1 2BE
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, 9 Little France Road, Edinburgh BioQuarter City, Edinburgh, UK, EH16 4UX
- BHF Data Science Centre, Health Data Research, 215 Euston Road, London, UK, NW1 2BE
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool,William Henry Duncan Building, 6 W Derby Street, Liverpool, UK, L7 8TX
- Liverpool Heart & Chest Hospital, Thomas Drive, Liverpool, UK, L14 3PE
- Department of Clinical Medicine, Aalborg Thrombosis Research Unit, Aalborg University, Søndre Skovvej 15, Forskningens Hus 9000, Aalborg, Denmark
| | - Harry Hemingway
- Institute of Health Informatics, University College London, 222 Euston Road, London, UK, NW1 1DA
- Health Data Research UK, Gibbs Building, 215 Euston Road, London, UK, NW1 2BE
| |
Collapse
|
15
|
Crocchiolo R, Alfarano F, Volpato E, Pugliano M, Cuppari I, Mazza AM, Bellio L, Fanti D, Vismara C, Scaglione F, Sacchi N, Pollichieni S, Mele L, Diral E, Grillo G, Rossini S. SARS-COV-2 SCREENING IN ALLOGENEIC HEMATOPOIETIC STEM CELL DONORS: IMPLICATIONS FOR THE EVALUATION PROCESS AND ELIGIBILITY. Hematol Transfus Cell Ther 2021; 44:13-16. [PMID: 34901751 PMCID: PMC8648663 DOI: 10.1016/j.htct.2021.09.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/20/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction Soon after the onset of the SARS-CoV-2 pandemic, viral screening by nasopharyngeal swab became mandatory for allogeneic hematopoietic stem cell (HSC) donor eligibility. Methods We described our monocenter experience with allogeneic HSC donors from February 1 to the October 31, 2020 to verify whether the introduction of SARS-CoV-2 screening altered the donor eligibility and/or entailed a prolongation of the evaluation process. Results A total of 21 allogeneic HSC donors were screened during the above-mentioned period upon request by the local transplant physicians or by the Italian Bone Marrow Donor Registry; among the HSC donors (n = 17) who completed the eligibility process and further received the nasopharyngeal swab, all but one were negative for the presence of SARS-CoV-2. The positive donor remained asymptomatic for the whole duration of the infection, which lasted six weeks. However, he was temporarily excluded from donation. The median duration of the evaluation process was not significantly different, compared to the same period of 2019 (p-value = 0.11). Conclusion The mandatory SARS-CoV-2 screening in allogeneic HSC donors allowed for the detection of 6% positivity in this monocenter series over a 9-month period. Despite the inconvenience of this unexpected non-eligibility, the exclusion of a SARS-CoV-2 positive donor represented an important safety measure for the donor, with respect to a new and still partially unknown virus. The screening did not alter the length of the donor evaluation and thus, did not cause a delay in the eligibility process.
Collapse
Affiliation(s)
| | | | | | | | - Irene Cuppari
- ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | | | - Laura Bellio
- ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Diana Fanti
- ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Chiara Vismara
- ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | | | - Nicoletta Sacchi
- Italian Bone Marrow Donor Registry, Ospedale Galliera, Genova, Italy
| | | | - Lia Mele
- HLA Laboratory, A.O. SS Antonio e Biagio e C. Arrigo, Alessandria, Italy
| | - Elisa Diral
- ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | | | | |
Collapse
|
16
|
Sebastião CS, Galangue M, Gaston C, Van-Dunen R, Quivinja J, Lunbungululo E, Alfredo D, Sozinho A, Teixeira A, Manico E, Machado D, Mateus A, David Z, Paixão J, Neto Z, de Vasconcelos JN, Morais J. Seroprevalence of anti-SARS-CoV-2 antibodies and risk factors among healthy blood donors in Luanda, Angola. BMC Infect Dis 2021; 21:1131. [PMID: 34727874 PMCID: PMC8562364 DOI: 10.1186/s12879-021-06814-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 10/25/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND SARS-CoV-2 emerged in China and spread throughout the world due to its rapid transmission. The exposure rate in the healthy population is unknown, mainly in resource-limited countries. Herein, we estimated the seroprevalence of anti-SARS-CoV-2 antibodies and risk factors among blood donors in Luanda, the capital city of Angola. METHODS This was a retrospective study conducted with 343 blood donors. Chi-square and logistic regression were calculated to predict the independent variable for SARS-CoV-2 infection and deemed significant when p < 0.05. RESULTS Seroprevalence of anti-SARS-CoV-2 was 4.7%. Positivity rates varied to age groups (3.5-14.3%), gender (0-5%), area of residence (3.1-.6%), educational level (5.1-10.2%), occupation (4.4-7.7%), and the blood donor category (2.0-5.1%). Past and recent infections were detected in 3.2% and 1.5%, respectively. Blood donors under the age of 20 years (OR: 4.58, p = 0.241) and from non-urbanized areas (OR: 1.86, p = 0.293) presented a high risk related to infection. The infection was higher in blood group A and lower in blood group O. The risk of SARS-CoV-2 infection has increased from January 2020 (OR: 0.03, p = 0.001) to August 2020 (OR: 0.57, p = 0.426). CONCLUSIONS We provide an estimate of the exposure of healthy blood donors in Luanda. Also, we detected anti-SARS-CoV-2 in January 2020, indicating that the SARS-CoV-2 could have been imported during the first month of 2020. Further studies should be performed to assess the exposure rate in different groups from Angola.
Collapse
Affiliation(s)
- Cruz S Sebastião
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola
- Centro de Investigação em Saúde de Angola (CISA), Caxito, Angola
- Instituto Superior de Ciências da Saúde (ISCISA), Universidade Agostinho Neto (UAN), Luanda, Angola
| | - Manuela Galangue
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola
| | - Celestina Gaston
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola
| | - Rui Van-Dunen
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola
| | - Joltim Quivinja
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola
| | | | | | - Alberto Sozinho
- Instituto Nacional de Sangue, Ministry of Health, Luanda, Angola
| | | | - Eunice Manico
- Instituto Nacional de Sangue, Ministry of Health, Luanda, Angola
| | - Deodete Machado
- Instituto Nacional de Sangue, Ministry of Health, Luanda, Angola
| | - António Mateus
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola
| | - Zinga David
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola
| | - Joana Paixão
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola
| | - Zoraima Neto
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola
| | - Jocelyne Neto de Vasconcelos
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola
- Centro de Investigação em Saúde de Angola (CISA), Caxito, Angola
| | - Joana Morais
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola.
- Faculdade de Medicina, Universidade Agostinho Neto (UAN), Luanda, Angola.
| |
Collapse
|
17
|
Vaselli NM, Hungerford D, Shenton B, Khashkhusha A, Cunliffe NA, French N. The seroprevalence of SARS-CoV-2 during the first wave in Europe 2020: A systematic review. PLoS One 2021; 16:e0250541. [PMID: 34727115 PMCID: PMC8562786 DOI: 10.1371/journal.pone.0250541] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 09/23/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND A year following the onset of the COVID-19 pandemic, new infections and deaths continue to increase in Europe. Serological studies, through providing evidence of past infection, can aid understanding of the population dynamics of SARS-CoV-2 infection. OBJECTIVES This systematic review of SARS-CoV-2 seroprevalence studies in Europe was undertaken to inform public health strategies including vaccination, that aim to accelerate population immunity. METHODS We searched the databases Web of Science, MEDLINE, EMBASE, SCOPUS, Cochrane Database of Systematic Reviews and grey literature sources for studies reporting seroprevalence of SARS-CoV-2 antibodies in Europe published between 01/12/2019-30/09/20. We provide a narrative synthesis of included studies. Studies were categorized into subgroups including healthcare workers (HCWs), community, outbreaks, pregnancy and children/school. Due to heterogeneity in other subgroups, we only performed a random effects meta-analysis of the seroprevalence amongst HCWs stratified by their country. RESULTS 115 studies were included spanning 17 European countries, that estimated the seroprevalence of SARS-CoV-2 from samples obtained between November 2019 -August 2020. A total of 54/115 studies included HCWs with a reported seroprevalence among HCWs ranging from 0.7% to 45.3%, which did not differ significantly by country. In community studies significant heterogeneity was reported in the seroprevalence between different age groups and the majority of studies reported there was no significant difference by gender. CONCLUSION This review demonstrates a wide heterogeneity in reported seroprevalence of SARS-CoV-2 antibodies between populations. Continued evaluation of seroprevalence is required to understand the impact of public health measures and inform interventions including vaccination programmes.
Collapse
Affiliation(s)
- Natasha Marcella Vaselli
- Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Daniel Hungerford
- Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
- NIHR HPRU in Gastrointestinal Infections at the University of Liverpool, Liverpool, United Kingdom
- NIHR HPRU in Emerging and Zoonotic Infections at the University of Liverpool, Liverpool, United Kingdom
| | - Ben Shenton
- Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Arwa Khashkhusha
- School of Medicine, Faculty of Life Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Nigel A. Cunliffe
- Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
- NIHR HPRU in Gastrointestinal Infections at the University of Liverpool, Liverpool, United Kingdom
| | - Neil French
- Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
- NIHR HPRU in Emerging and Zoonotic Infections at the University of Liverpool, Liverpool, United Kingdom
| |
Collapse
|
18
|
High Seroprevalence of SARS-CoV-2 (COVID-19)-Specific Antibodies among Healthcare Workers: A Cross-Sectional Study in Guilan, Iran. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2021; 2021:9081491. [PMID: 34691195 PMCID: PMC8536443 DOI: 10.1155/2021/9081491] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/26/2021] [Accepted: 10/05/2021] [Indexed: 12/23/2022]
Abstract
Background This study was conducted to evaluate the anti‐SARS‐CoV‐2 IgM and IgG antibodies among healthcare workers in Guilan. Methods This cross-sectional study was conducted on 503 healthcare workers. Between April and May 2020, blood samples were collected from the healthcare workers of Razi Hospital in Rasht, Guilan, Iran. Enzyme-linked immunosorbent assay (ELISA) was used for the detection and quantitation of anti‐SARS‐CoV‐2 IgM/IgG antibodies by using kits made by Pishtaz Teb Company, Tehran, Iran. Results From a total of 503 participants, the result of the anti‐SARS‐CoV‐2 IgM antibody test was positive in 28 subjects (5.6%) and the anti‐SARS‐CoV‐2 IgG antibody test was positive in171 subjects (34%). Participants in the age group of 35–54 years were significantly more likely to have a positive anti‐SARS‐CoV‐2 antibody test than the age group of 20–34 years (odds ratio = 1.53, 95% CI: 1.04–2.25, P=0.029). Also, physicians were significantly more likely to have a positive antibody test than office workers (odds ratio = 1.92, 95% CI: 1.04–3.54, P=0.037). The wide range of symptoms was significantly associated with the positive anti‐SARS‐CoV‐2 antibody test. The most significant association was observed between fever and a positive anti‐SARS‐CoV‐2 antibody test (odds ratio = 3.03, 95% CI: 2.06–4.44, P < 0.001). Conclusion The results of the current study indicated that the seroprevalence of COVID-19 was high among healthcare workers of Guilan Province. It seems that this finding was due to the earlier exposure to COVID-19 and the lack of awareness and preparedness to deal with the pandemic in Iran, compared to other countries.
Collapse
|
19
|
Elnasser Z, Obeidat H, Amarin Z, Alrabadi N, Jaradat A, Alomarat D, BaniSalem M, Almomani R. Prevalence of COVID-19 among blood donors: The Jordan University of Science and Technology experience. Medicine (Baltimore) 2021; 100:e27537. [PMID: 34731151 PMCID: PMC8519210 DOI: 10.1097/md.0000000000027537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 09/29/2021] [Indexed: 01/05/2023] Open
Abstract
The corona virus disease-19 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, had health and economic results that profoundly affected communities worldwide. Investigating the seroprevalence of SARS-Cov-2 in blood donors is of a significant clinical and scientific value as it adds to knowledge about local herd immunity levels.To study the prevalence of SARS-Cov-2 infection among blood donors at a tertiary referral hospital in the north of Jordan.This is a prospective study that included all blood donors between September 2020 and March 2021. Donors' IgG antibodies were qualitatively immunoassayed to determine the antibody status against SARS-CoV-2. The Elecsys Anti-SARS-CoV-2 technique was utilized.One thousand samples were tested by total antibody against SARS-CoV-2. The median age was 29 years, 96.7% were males. The seroprevalence was 14.5%, and 80% of the positive participants did not report previous COVID-19 infection. The seroprevalence of COVID-19 antibodies was less among smokers and those with an O blood group and higher among donors with an AB blood group.The prevalence of COVID-19 among healthy young blood donors at a tertiary teaching health facility in the north of Jordan was 14.5%. Smokers and those with an O blood group were less likely to be seropositive, as opposed to donors with an AB blood group.
Collapse
Affiliation(s)
- Ziad Elnasser
- Department of Pathology and Microbiology, Jordan University of Science and Technology, PO Box 3030, Irbid, Jordan
| | - Haneen Obeidat
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, PO Box 3030, Irbid, Jordan
| | - Zouhair Amarin
- Department of Obstetrics and Gynecology, Jordan University of Science and Technology, PO Box 3030, Irbid, Jordan
| | - Nasr Alrabadi
- Department of Pharmacology, Jordan University of Science and Technology, PO Box 3030, Irbid, Jordan
| | - Abdullah Jaradat
- Department of Medicine, Jordan University of Science and Technology, PO Box 3030, Irbid, Jordan
| | - Du’a Alomarat
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, PO Box 3030, Irbid, Jordan
| | - Mo’ath BaniSalem
- Department of Medicine, Jordan University of Science and Technology, PO Box 3030, Irbid, Jordan
| | - Randa Almomani
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, PO Box 3030, Irbid, Jordan
| |
Collapse
|
20
|
Valenti L, Pelusi S, Cherubini A, Bianco C, Ronzoni L, Uceda Renteria S, Coluccio E, Berzuini A, Lombardi A, Terranova L, Malvestiti F, Lamorte G, Erba E, Oggioni M, Ceriotti F, Prati D. Trends and risk factors of SARS-CoV-2 infection in asymptomatic blood donors. Transfusion 2021; 61:3381-3389. [PMID: 34647620 PMCID: PMC8661834 DOI: 10.1111/trf.16693] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/16/2021] [Accepted: 09/18/2021] [Indexed: 12/21/2022]
Abstract
Background A large proportion of SARS‐CoV‐2‐infected individuals does not develop severe symptoms. Serological tests help in evaluating the spread of infection and disease immunization. The aim of this study was to prospectively examine the trends and risk factors of SARS‐CoV‐2 infection in blood donors. Study design and methods We screened 8798 asymptomatic donors presenting in Milan from July 2020 to February 2021 (10,680 presentations) before the vaccination campaign for anti‐nucleoprotein (NP) antibodies, and for anti‐spike receptor‐binding domain (RBD) antibodies and nasopharyngeal swab PCR in those who tested positive. Results The prevalence of anti‐NP+/RBD+ tests increased progressively with time up to ~15% (p < .0001), preceded by a peak of PCR+ tests. Anti‐RBD titers were higher in anti‐NP IgG+/IgM+ than in IgG+/IgM− individuals and in those with a history of infection (p < .0001); of these 197/630 (31.2%) displayed high titers (>80 AU/ml). Anti‐RBD titers declined during follow‐up, depending on baseline titers (p < .0001) and time (p = .025). Risk factors for seroconversion were a later presentation date and non‐O ABO blood group (p < .001). A positive PCR was detected in 0.7% of participants in the absence of SARS‐CoV‐2 viremia. Conclusions During the second wave of SARS‐CoV‐2 infection in Northern Italy, we detected an increase in seroprevalence in healthy blood donors from ~4% to ~15%, with a trend paralleling that observed in the general population. Seroconversion was more frequent in carriers of non‐O blood groups. The persistence of anti‐RBD antibodies was short‐lived.
Collapse
Affiliation(s)
- Luca Valenti
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milano, Italy.,Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milano, Italy
| | - Serena Pelusi
- Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milano, Italy
| | - Alessandro Cherubini
- Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milano, Italy
| | - Cristiana Bianco
- Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milano, Italy
| | - Luisa Ronzoni
- Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milano, Italy
| | - Sara Uceda Renteria
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milano, Italy
| | - Elena Coluccio
- Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milano, Italy
| | - Alessandra Berzuini
- Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milano, Italy
| | - Angela Lombardi
- Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milano, Italy
| | - Leonardo Terranova
- Respiratory Diseases, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milano, Italy
| | - Francesco Malvestiti
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milano, Italy
| | - Giuseppe Lamorte
- Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milano, Italy
| | - Elisa Erba
- Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milano, Italy
| | - Massimo Oggioni
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milano, Italy
| | - Ferruccio Ceriotti
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milano, Italy
| | - Daniele Prati
- Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milano, Italy
| |
Collapse
|
21
|
Differences in the Prevalence of SARS-CoV-2 Infection and Access to Care between Italians and Non-Italians in a Social-Housing Neighbourhood of Milan, Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010621. [PMID: 34682369 PMCID: PMC8535198 DOI: 10.3390/ijerph182010621] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/28/2021] [Accepted: 10/08/2021] [Indexed: 12/15/2022]
Abstract
The northern Italian region of Lombardy has been severely affected by the COVID-19 pandemic since its arrival in Europe. However, there are only a few published studies of the possible influence of social and cultural factors on its prevalence in the general population. This cross-sectional study of the San Siro social-housing neighbourhood of Milan, which was carried about between 23 December 2020 and 19 February 2021, found that the prevalence of anti-SARS-CoV-2 nucleocapsid antibodies in the population as a whole was 12.4% (253/2044 inhabitants), but there was a more than two-fold difference between non-Italians and Italians (23.3% vs. 9.1%). Multivariable analyses showed that being more than 50 years old, living in crowded accommodation, being a non-Italian, and having a low educational level were associated with higher odds of a positive SARS-CoV-2 test, whereas a higher level of education, retirement, and being a former or current cigarette smoker were inversely associated with SARS-CoV-2 infection. Our findings are in line with previous observations indicating that a lower socio-economic status may be a risk factor for COVID-19 and show that non-Italians are disproportionately affected by SARS-CoV-2 infection. This suggests that public health policies should focus more on disadvantaged populations.
Collapse
|
22
|
Tadesse EB, Endris AA, Solomon H, Alayu M, Kebede A, Eshetu K, Teka G, Seid BE, Ahmed J, Abayneh SA, Moges B, Gerawork H, Sugerman D, Assefa Z, Abayneh A, Abate E, Taddese L. Seroprevalence and risk factors for SARS-CoV-2 Infection in selected urban areas in Ethiopia: a cross-sectional evaluation during July 2020. Int J Infect Dis 2021; 111:179-185. [PMID: 34411720 PMCID: PMC8366039 DOI: 10.1016/j.ijid.2021.08.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 08/09/2021] [Accepted: 08/11/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Ethiopia reported the first case of COVID-19 on 13th March, 2020 with community transmission ensuing by mid-May. A national, population-based serosurvey against anti-SARS-CoV-2 IgG was conducted to measure the prevalence of prior COVID-19 infections and better approximate the burden across major towns in Ethiopia. METHODS We conducted a cross-sectional, population-based serosurvey from June 24 to July 8, 2020 in 14 major urban areas. Two-stage cluster sampling was used to randomly select enumeration areas and households. All persons aged ≥15 years were enrolled. Serum samples were tested by Abbott™ ARCHITECT™ assay for SARS-CoV-2 IgG antibodies. National COVID-19 surveillance data on the median date of the serosurvey is analyzed for comparison. FINDINGS Adjusted seroprevalence was 3.5% (95% CI: 3.2%-3.8%) after controlling for age, sex and test kit performance. Males (3.7%) and females (3.3%) were nearly equally infected, while middle-aged adults '40-65 years' had the highest (4.0%) prevalence. Gambella (7.5%), Dire Dawa (6.2%) and Jigjiga (6.1%) were the most affected towns. About 6.7% and 8.0% of seropositives had symptoms and chronic underlying illness, respectively. A surveillance system had identified 4,416 RT-PCR confirmed cases in Addis Ababa. INTERPRETATION This serosurvey shows that a majority of urban Ethiopians remain uninfected with SARS-CoV-2. Most anti-SARS-CoV-2 IgG positive cases were asymptomatic with no underlying illness, keeping case detection to a minimum.
Collapse
Affiliation(s)
| | | | - Henok Solomon
- Ethiopian Public Health Institute, P.O. Box 1242, Addis Ababa, Ethiopia
| | - Mikias Alayu
- Ethiopian Public Health Institute, P.O. Box 1242, Addis Ababa, Ethiopia
| | - Adisu Kebede
- Ethiopian Public Health Institute, P.O. Box 1242, Addis Ababa, Ethiopia
| | - Kirubel Eshetu
- Ethiopian Public Health Institute, P.O. Box 1242, Addis Ababa, Ethiopia
| | - Gizaw Teka
- Ethiopian Public Health Institute, P.O. Box 1242, Addis Ababa, Ethiopia
| | - Biniyam Eskinder Seid
- U.S. Centers for Disease Control and Prevention, P.O. Box 1014,Addis Ababa, Ethiopia
| | - Jelaludin Ahmed
- U.S. Centers for Disease Control and Prevention, P.O. Box 1014,Addis Ababa, Ethiopia
| | | | - Beyene Moges
- Federal Ministry of Health, P. O. Box 1234, Addis Ababa, Ethiopia
| | | | - David Sugerman
- U.S. Centers for Disease Control and Prevention, P.O. Box 1014,Addis Ababa, Ethiopia
| | - Zewdu Assefa
- Ethiopian Public Health Institute, P.O. Box 1242, Addis Ababa, Ethiopia
| | - Aschalew Abayneh
- Ethiopian Public Health Institute, P.O. Box 1242, Addis Ababa, Ethiopia
| | - Ebba Abate
- Ethiopian Public Health Institute, P.O. Box 1242, Addis Ababa, Ethiopia
| | - Lia Taddese
- Federal Ministry of Health, P. O. Box 1234, Addis Ababa, Ethiopia
| |
Collapse
|
23
|
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.
Collapse
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
| |
Collapse
|
24
|
Ruggiero M, Somigliana E, Tassis B, Li Piani L, Uceda Renteria S, Barbara G, Lunghi G, Pietrasanta C, Ferrazzi E. Clinical relevance of SARS-CoV-2 infection in late pregnancy. BMC Pregnancy Childbirth 2021; 21:505. [PMID: 34253173 PMCID: PMC8273567 DOI: 10.1186/s12884-021-03985-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 07/07/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Evidence on the outcome of SARS-CoV-2 infection in pregnancy is generally reassuring but yet not definitive. METHODS To specifically assess the impact of SARS-CoV-2 infection in late pregnancy, we prospectively recruited 315 consecutive women delivering in a referral hospital located in Lombardy, Italy in the early phase of the epidemic. Restriction of the recruitment to this peculiar historical time period allowed to exclude infections occurring early in pregnancy and to limit the recall bias. All recruited subjects underwent a nasopharyngeal swab to assess the presence of Sars-Cov-2 using Real-time PCR. In addition, two different types of antibodies for the virus were evaluated in peripheral blood, those against the spike proteins S1 and S2 of the envelope and those against the nucleoprotein of the nucleocapsid. Women were considered to have had SARS-CoV-2 infection in pregnancy if at least one of the three assessments was positive. RESULTS Overall, 28 women had a diagnosis of SARS-CoV-2 infection in pregnancy (8.9%). Women diagnosed with the infection were more likely to report one or more episodes of symptoms suggestive for Covid-19 (n = 11, 39.3%) compared to unaffected women (n = 39, 13.6%). The corresponding OR was 4.11 (95%CI: 1.79-9.44). Symptoms significantly associated with Covid-19 in pregnancy included fever, cough, dyspnea and anosmia. Only one woman necessitated intensive care. Pregnancy outcome in women with and without SARS-CoV-2 infection did not also differ. CONCLUSIONS SARS-CoV-2 infection is asymptomatic in three out of five women in late pregnancy and is rarely severe. In addition, pregnancy outcome may not be markedly affected.
Collapse
Affiliation(s)
- Marta Ruggiero
- Department of Woman, New-Born and Child, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Mangiagalli Centre, Via M. Fanti, 6, 20122, Milan, Italy
- Department of Clinical Sciences and Community Health, Università Degli Studi Di Milano, Milan, Italy
| | - Edgardo Somigliana
- Department of Woman, New-Born and Child, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Mangiagalli Centre, Via M. Fanti, 6, 20122, Milan, Italy.
- Department of Clinical Sciences and Community Health, Università Degli Studi Di Milano, Milan, Italy.
| | - Beatrice Tassis
- Department of Woman, New-Born and Child, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Mangiagalli Centre, Via M. Fanti, 6, 20122, Milan, Italy
| | - Letizia Li Piani
- Department of Woman, New-Born and Child, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Mangiagalli Centre, Via M. Fanti, 6, 20122, Milan, Italy
- Department of Clinical Sciences and Community Health, Università Degli Studi Di Milano, Milan, Italy
| | - Sara Uceda Renteria
- Virology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Mangiagalli Centre, Milan, Italy
| | - Giussy Barbara
- Department of Woman, New-Born and Child, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Mangiagalli Centre, Via M. Fanti, 6, 20122, Milan, Italy
| | - Giovanna Lunghi
- Virology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Mangiagalli Centre, Milan, Italy
| | - Carlo Pietrasanta
- Department of Clinical Sciences and Community Health, Università Degli Studi Di Milano, Milan, Italy
- Neonatal Intensive Care Unit (NICU), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Mangiagalli Centre, Milan, Italy
| | - Enrico Ferrazzi
- Department of Woman, New-Born and Child, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Mangiagalli Centre, Via M. Fanti, 6, 20122, Milan, Italy
- Department of Clinical Sciences and Community Health, Università Degli Studi Di Milano, Milan, Italy
| |
Collapse
|
25
|
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.
Collapse
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
| |
Collapse
|
26
|
Tran Kiem C, Crépey P, Bosetti P, Levy Bruhl D, Yazdanpanah Y, Salje H, Boëlle PY, Cauchemez S. Lockdown as a last resort option in case of COVID-19 epidemic rebound: a modelling study. ACTA ACUST UNITED AC 2021; 26. [PMID: 34085634 PMCID: PMC8176673 DOI: 10.2807/1560-7917.es.2021.26.22.2001536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Given its high economic and societal cost, policymakers might be reluctant to implement a large-scale lockdown in case of coronavirus disease (COVID-19) epidemic rebound. They may consider it as a last resort option if alternative control measures fail to reduce transmission. Aim We developed a modelling framework to ascertain the use of lockdown to ensure intensive care unit (ICU) capacity does not exceed a peak target defined by policymakers. Methods We used a deterministic compartmental model describing transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the trajectories of COVID-19 patients in healthcare settings, accounting for age-specific mixing patterns and an increasing probability of severe outcomes with age. The framework is illustrated in the context of metropolitan France. Results The daily incidence of ICU admissions and the number of occupied ICU beds are the most robust indicators to decide when a lockdown should be triggered. When the doubling time of hospitalisations estimated before lockdown is between 8 and 20 days, lockdown should be enforced when ICU admissions reach 3.0–3.7 and 7.8–9.5 per million for peak targets of 62 and 154 ICU beds per million (4,000 and 10,000 beds for metropolitan France), respectively. When implemented earlier, the lockdown duration required to get back below a desired level is also shorter. Conclusions We provide simple indicators and triggers to decide if and when a last-resort lockdown should be implemented to avoid saturation of ICU. These metrics can support the planning and real-time management of successive COVID-19 pandemic waves.
Collapse
Affiliation(s)
- Cécile Tran Kiem
- Collège Doctoral, Sorbonne Université, Paris, France.,Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, CNRS, Paris, France
| | - Pascal Crépey
- Univ Rennes, EHESP, REPERES « Recherche en Pharmaco-Epidémiologie et Recours aux Soins » - EA 7449, Rennes, France
| | - Paolo Bosetti
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, CNRS, Paris, France
| | - Daniel Levy Bruhl
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Yazdan Yazdanpanah
- Infections Antimicrobials Modelling Evolution (IAME), UMR1137, INSERM, University of Paris, Paris, France
| | - Henrik Salje
- Department of Genetics, University of Cambridge, Cambridge, United Kingdom.,Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, CNRS, Paris, France
| | - Pierre-Yves Boëlle
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, INSERM, Paris, France
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, CNRS, Paris, France
| |
Collapse
|
27
|
De Nicolò A, Avataneo V, Cusato J, Palermiti A, Mula J, De Vivo E, Antonucci M, Bonora S, Calcagno A, Di Perri G, De Rosa FG, D’Avolio A. Analytical Validation and Clinical Application of Rapid Serological Tests for SARS-CoV-2 Suitable for Large-Scale Screening. Diagnostics (Basel) 2021; 11:869. [PMID: 34065954 PMCID: PMC8151461 DOI: 10.3390/diagnostics11050869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/06/2021] [Accepted: 05/10/2021] [Indexed: 11/18/2022] Open
Abstract
Recently, large-scale screening for COVID-19 has presented a major challenge, limiting timely countermeasures. Therefore, the application of suitable rapid serological tests could provide useful information, however, little evidence regarding their robustness is currently available. In this work, we evaluated and compared the analytical performance of a rapid lateral-flow test (LFA) and a fast semiquantitative fluorescent immunoassay (FIA) for anti-nucleocapsid (anti-NC) antibodies, with the reverse transcriptase real-time PCR assay as the reference. In 222 patients, LFA showed poor sensitivity (55.9%) within two weeks from PCR, while later testing was more reliable (sensitivity of 85.7% and specificity of 93.1%). Moreover, in a subset of 100 patients, FIA showed high sensitivity (89.1%) and specificity (94.1%) after two weeks from PCR. The coupled application for the screening of 183 patients showed satisfactory concordance (K = 0.858). In conclusion, rapid serological tests were largely not useful for early diagnosis, but they showed good performance in later stages of infection. These could be useful for back-tracing and/or to identify potentially immune subjects.
Collapse
Affiliation(s)
- Amedeo De Nicolò
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.A.); (J.C.); (A.P.); (J.M.); (E.D.V.); (M.A.); (S.B.); (A.C.); (G.D.P.); (F.G.D.R.); (A.D.)
| | - Valeria Avataneo
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.A.); (J.C.); (A.P.); (J.M.); (E.D.V.); (M.A.); (S.B.); (A.C.); (G.D.P.); (F.G.D.R.); (A.D.)
| | - Jessica Cusato
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.A.); (J.C.); (A.P.); (J.M.); (E.D.V.); (M.A.); (S.B.); (A.C.); (G.D.P.); (F.G.D.R.); (A.D.)
| | - Alice Palermiti
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.A.); (J.C.); (A.P.); (J.M.); (E.D.V.); (M.A.); (S.B.); (A.C.); (G.D.P.); (F.G.D.R.); (A.D.)
| | - Jacopo Mula
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.A.); (J.C.); (A.P.); (J.M.); (E.D.V.); (M.A.); (S.B.); (A.C.); (G.D.P.); (F.G.D.R.); (A.D.)
| | - Elisa De Vivo
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.A.); (J.C.); (A.P.); (J.M.); (E.D.V.); (M.A.); (S.B.); (A.C.); (G.D.P.); (F.G.D.R.); (A.D.)
| | - Miriam Antonucci
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.A.); (J.C.); (A.P.); (J.M.); (E.D.V.); (M.A.); (S.B.); (A.C.); (G.D.P.); (F.G.D.R.); (A.D.)
| | - Stefano Bonora
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.A.); (J.C.); (A.P.); (J.M.); (E.D.V.); (M.A.); (S.B.); (A.C.); (G.D.P.); (F.G.D.R.); (A.D.)
| | - Andrea Calcagno
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.A.); (J.C.); (A.P.); (J.M.); (E.D.V.); (M.A.); (S.B.); (A.C.); (G.D.P.); (F.G.D.R.); (A.D.)
| | - Giovanni Di Perri
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.A.); (J.C.); (A.P.); (J.M.); (E.D.V.); (M.A.); (S.B.); (A.C.); (G.D.P.); (F.G.D.R.); (A.D.)
- CoQua Lab, 10147 Torino, Italy
| | - Francesco Giuseppe De Rosa
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.A.); (J.C.); (A.P.); (J.M.); (E.D.V.); (M.A.); (S.B.); (A.C.); (G.D.P.); (F.G.D.R.); (A.D.)
| | - Antonio D’Avolio
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.A.); (J.C.); (A.P.); (J.M.); (E.D.V.); (M.A.); (S.B.); (A.C.); (G.D.P.); (F.G.D.R.); (A.D.)
- CoQua Lab, 10147 Torino, Italy
| |
Collapse
|
28
|
Pillonetto G, Bisiacco M, Palù G, Cobelli C. Tracking the time course of reproduction number and lockdown's effect on human behaviour during SARS-CoV-2 epidemic: nonparametric estimation. Sci Rep 2021; 11:9772. [PMID: 33963235 PMCID: PMC8105401 DOI: 10.1038/s41598-021-89014-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 04/14/2021] [Indexed: 01/10/2023] Open
Abstract
Understanding the SARS-CoV-2 dynamics has been subject of intense research in the last months. In particular, accurate modeling of lockdown effects on human behaviour and epidemic evolution is a key issue in order e.g. to inform health-care decisions on emergency management. In this regard, the compartmental and spatial models so far proposed use parametric descriptions of the contact rate, often assuming a time-invariant effect of the lockdown. In this paper we show that these assumptions may lead to erroneous evaluations on the ongoing pandemic. Thus, we develop a new class of nonparametric compartmental models able to describe how the impact of the lockdown varies in time. Our estimation strategy does not require significant Bayes prior information and exploits regularization theory. Hospitalized data are mapped into an infinite-dimensional space, hence obtaining a function which takes into account also how social distancing measures and people's growing awareness of infection's risk evolves as time progresses. This also permits to reconstruct a continuous-time profile of SARS-CoV-2 reproduction number with a resolution never reached before in the literature. When applied to data collected in Lombardy, the most affected Italian region, our model illustrates how people behaviour changed during the restrictions and its importance to contain the epidemic. Results also indicate that, at the end of the lockdown, around [Formula: see text] of people in Lombardy and [Formula: see text] in Italy was affected by SARS-CoV-2, with the fatality rate being 1.14%. Then, we discuss how the situation evolved after the end of the lockdown showing that the reproduction number dangerously increased in the summer, due to holiday relax, reaching values larger than one on August 1, 2020. Finally, we also document how Italy faced the second wave of infection in the last part of 2020. Since several countries still observe a growing epidemic and others could be subject to other waves, the proposed reproduction number tracking methodology can be of great help to health care authorities to prevent SARS-CoV-2 diffusion or to assess the impact of lockdown restrictions on human behaviour to contain the spread.
Collapse
Affiliation(s)
- G Pillonetto
- Department of Information Engineering, University of Padova, Padova, Italy.
| | - M Bisiacco
- Department of Information Engineering, University of Padova, Padova, Italy
| | - G Palù
- Department of Molecular Medicine, Professor Emeritus, University of Padova, Padova, Italy
- Member of the Scientific Technical Committee, Italian Ministry of Health, Rome, Italy
| | - C Cobelli
- Member of Consiglio Superiore di Sanità, Italian Ministry of Health, Rome, Italy
- Dipartimento di Salute della Donna e del Bambino, Professor Emeritus, University of Padova, Padova, Italy
| |
Collapse
|
29
|
Di Stefano M, Sarno M, Faleo G, Farhan Mohamed AM, Lipsi MR, De Nittis R, Bruno SR, De Feo L, Granato T, Corso G, Arena F, Centra M, Lo Caputo S, Margaglione M, Santantonio TA, Fiore JR. Low Prevalence of Antibodies to SARS-CoV-2 and Undetectable Viral Load in Seropositive Blood Donors from South-Eastern Italy. Acta Haematol 2021; 144:580-584. [PMID: 33878755 PMCID: PMC8089405 DOI: 10.1159/000515258] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 02/15/2021] [Indexed: 01/08/2023]
Abstract
Recently, a significant cluster of pneumonia caused by a novel betacoronavirus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) was described initially in China and then spread throughout the world. Like other coronaviridae, the viral transmission occurs mainly through droplets. In addition, the virus has been detected in different clinical specimens, suggesting a potential transmission by other routes, including blood transfusion. However, the potential risk of transmission of SARS-CoV-2 via blood products is still unclear. The aim of our study was to investigate the prevalence of antibodies against SARS-CoV-2 among blood donors from South-Eastern Italy. Moreover, in the seropositive donors, we searched for the presence of the virus in nasopharyngeal swabs and in plasma samples. Overall, 1,797 blood donors from the Apulia region were tested for anti-SARS-CoV-2 antibodies, using a commercially available assay. Only 18/1,797 donors (1.0%) tested positive for anti-SARS-CoV-2 antibodies; in none of them SARS-CoV-2 viral RNA was detected in nasopharyngeal swabs and in plasma samples. Our results indicate that most of the blood donors in Apulia remained uninfected during this wave of the pandemic; further, none had detectable virus both in nasopharyngeal swabs and in blood samples. The risk to carry and transmit the virus by healthy and asymptomatic blood donors is probably very low.
Collapse
Affiliation(s)
- Mariantonietta Di Stefano
- Department of Clinical and Experimental Medicine, Infectious Diseases Unit, University of Foggia, Foggia, Italy
| | - Michelina Sarno
- Transfusion Medicine Center, AOU Policlinico Riuniti Foggia, Foggia, Italy
| | - Giuseppina Faleo
- Department of Clinical and Experimental Medicine, Infectious Diseases Unit, University of Foggia, Foggia, Italy
| | - Ahmed Mohamed Farhan Mohamed
- Department of General Courses, College of Applied Studies and Community Service, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | - Rosella De Nittis
- Microbiology and Virology Section, AOU Policlinico Riuniti, Foggia, Italy
| | - Serena Rita Bruno
- Department of Clinical and Experimental Medicine, Infectious Diseases Unit, University of Foggia, Foggia, Italy
| | - Lucia De Feo
- Transfusion Medicine Center, AOU Policlinico Riuniti Foggia, Foggia, Italy
| | - Tommaso Granato
- Transfusion Medicine Center, AOU Policlinico Riuniti Foggia, Foggia, Italy
| | - Gaetano Corso
- Department of Clinical and Experimental Medicine, Section of Clinical Biochemistry, University of Foggia, Foggia, Italy
| | - Fabio Arena
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Michele Centra
- Transfusion Medicine Center, AOU Policlinico Riuniti Foggia, Foggia, Italy
| | - Sergio Lo Caputo
- Department of Clinical and Experimental Medicine, Infectious Diseases Unit, University of Foggia, Foggia, Italy
| | - Maurizio Margaglione
- Department of Clinical and Experimental Medicine, Section of Genetics, University of Foggia, Foggia, Italy
| | - Teresa Antonia Santantonio
- Department of Clinical and Experimental Medicine, Infectious Diseases Unit, University of Foggia, Foggia, Italy
| | - Jose Ramon Fiore
- Department of Clinical and Experimental Medicine, Infectious Diseases Unit, University of Foggia, Foggia, Italy
| |
Collapse
|
30
|
Fochesato A, Simoni G, Reali F, Giordano G, Domenici E, Marchetti L. A Retrospective Analysis of the COVID-19 Pandemic Evolution in Italy. BIOLOGY 2021; 10:biology10040311. [PMID: 33917920 PMCID: PMC8068225 DOI: 10.3390/biology10040311] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/30/2021] [Accepted: 04/06/2021] [Indexed: 12/30/2022]
Abstract
Simple Summary Given the progress of the COVID-19 pandemic, it has become crucial to retrace the past epidemic trajectories to grasp non-trivial, qualitative features of viral dynamics that could contribute to the design of general guidelines for future outbreaks or epidemics. In this regard, we used a refinement of the SIDARTHE (Susceptible, Infected, Diagnosed, Ailing, Recognized, Threatened, Healed, Extinct) model to develop a retrospective computational analysis focused on an Italian case study. Our work aimed at evaluating the efficacy of adopted countermeasures (inferred from the resulting model parameters), and additionally providing an estimate of the undetected viral circulation as well as the day zero of the COVID-19 outbreak in Italy, which are not directly inferable from the data. Abstract Late 2019 saw the outbreak of COVID-19, a respiratory disease caused by the new coronavirus SARS-CoV-2, which rapidly turned into a pandemic, killing more than 2.77 million people and infecting more than 126 million as of late March 2021. Daily collected data on infection cases and hospitalizations informed decision makers on the ongoing pandemic emergency, enabling the design of diversified countermeasures, from behavioral policies to full lockdowns, to curb the virus spread. In this context, mechanistic models could represent valuable tools to optimize the timing and stringency of interventions, and to reveal non-trivial properties of the pandemic dynamics that could improve the design of suitable guidelines for future epidemics. We performed a retrospective analysis of the Italian epidemic evolution up to mid-December 2020 to gain insight into the main characteristics of the original strain of SARS-CoV-2, prior to the emergence of new mutations and the vaccination campaign. We defined a time-varying optimization procedure to calibrate a refined version of the SIDARTHE (Susceptible, Infected, Diagnosed, Ailing, Recognized, Threatened, Healed, Extinct) model and hence accurately reconstruct the epidemic trajectory. We then derived additional features of the COVID-19 pandemic in Italy not directly retrievable from reported data, such as the estimate of the day zero of infection in late November 2019 and the estimate of the spread of undetected infection. The present analysis contributes to a better understanding of the past pandemic waves, confirming the importance of epidemiological modeling to support an informed policy design against epidemics to come.
Collapse
Affiliation(s)
- Anna Fochesato
- Fondazione The Microsoft Research—University of Trento, Centre for Computational and Systems Biology (COSBI), 38068 Rovereto, Italy; (A.F.); (G.S.); (F.R.); (E.D.)
- Department of Mathematics, University of Trento, 38123 Trento, Italy
| | - Giulia Simoni
- Fondazione The Microsoft Research—University of Trento, Centre for Computational and Systems Biology (COSBI), 38068 Rovereto, Italy; (A.F.); (G.S.); (F.R.); (E.D.)
| | - Federico Reali
- Fondazione The Microsoft Research—University of Trento, Centre for Computational and Systems Biology (COSBI), 38068 Rovereto, Italy; (A.F.); (G.S.); (F.R.); (E.D.)
| | - Giulia Giordano
- Department of Industrial Engineering, University of Trento, 38122 Trento, Italy;
| | - Enrico Domenici
- Fondazione The Microsoft Research—University of Trento, Centre for Computational and Systems Biology (COSBI), 38068 Rovereto, Italy; (A.F.); (G.S.); (F.R.); (E.D.)
- Department of Cellular, Computational and Integrative Biology, University of Trento, 38123 Trento, Italy
| | - Luca Marchetti
- Fondazione The Microsoft Research—University of Trento, Centre for Computational and Systems Biology (COSBI), 38068 Rovereto, Italy; (A.F.); (G.S.); (F.R.); (E.D.)
- Correspondence:
| |
Collapse
|
31
|
Spada E, Vitale F, Bruno F, Castelli G, Reale S, Perego R, Baggiani L, Proverbio D. A pre- and during Pandemic Survey of Sars-Cov-2 Infection in Stray Colony and Shelter Cats from a High Endemic Area of Northern Italy. Viruses 2021; 13:618. [PMID: 33916759 PMCID: PMC8066308 DOI: 10.3390/v13040618] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/28/2021] [Accepted: 04/01/2021] [Indexed: 01/22/2023] Open
Abstract
Cats are susceptible to infection with severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). Whilst a number of studies have been performed worldwide on owned cats, limited data are available on stray, colony or shelter cats. We investigated SARS-CoV-2 infection in a stray cat population before and during human outbreaks of SARS-CoV-2 in cities in the Lombardy region in northern Italy, a high endemic region for SARS-CoV-2, using serological and molecular methods. A cohort of different samples were collected from 241 cats, including frozen archived serum samples from 136 cats collected before the 2019 coronavirus disease (COVID-19) pandemic and serum, pharyngeal and rectal swab samples from 105 cats collected during the SARS-CoV-2 outbreak. All pre-pandemic samples tested seronegative for antibodies against the nucleocapsid of SARS-CoV-2 using indirect enzyme linked immunosorbent assay (ELISA) test, while one serum sample collected during the pandemic was seropositive. No serological cross-reactivity was detected between SARS-CoV-2 antibodies and antibodies against feline enteric (FECV) and infectious peritonitis coronavirus (FIPC), Feline Immunodeficiency Virus (FIV), Feline Calicivirus (FCV), Feline Herpesvirus-1 (FHV-1), Feline Parvovirus (FPV), Leishmania infantum, Anaplasma phagocytophilum, Rickettsia spp., Toxoplasma gondii or Chlamydophila felis. No pharyngeal or rectal swab tested positive for SARS-CoV-2 RNA on real time reverse transcription-polymerase chain reaction (rRT-PCR). Our data show that SARS-CoV-2 did infect stray cats in Lombardy during the COVID-19 pandemic, but with lower prevalence than found in owned cats. This should alleviate public concerns about stray cats acting as SARS-CoV-2 carriers.
Collapse
Affiliation(s)
- Eva Spada
- Laboratorio di Ricerca di Medicina Emotrasfusionale Veterinaria (REvLab), Dipartimento di Medicina Veterinaria (DIMEVET), Università degli Studi di Milano, 26900 Lodi, Italy; (L.B.); (D.P.)
| | - Fabrizio Vitale
- Centro di Referenza Nazionale per le Leishmaniosi (C.Re.Na.L), Istituto Zooprofilattico Sperimentale (IZS) della Sicilia A. Mirri, 90129 Palermo, Italy; (F.V.); (F.B.); (G.C.); (S.R.)
| | - Federica Bruno
- Centro di Referenza Nazionale per le Leishmaniosi (C.Re.Na.L), Istituto Zooprofilattico Sperimentale (IZS) della Sicilia A. Mirri, 90129 Palermo, Italy; (F.V.); (F.B.); (G.C.); (S.R.)
| | - Germano Castelli
- Centro di Referenza Nazionale per le Leishmaniosi (C.Re.Na.L), Istituto Zooprofilattico Sperimentale (IZS) della Sicilia A. Mirri, 90129 Palermo, Italy; (F.V.); (F.B.); (G.C.); (S.R.)
| | - Stefano Reale
- Centro di Referenza Nazionale per le Leishmaniosi (C.Re.Na.L), Istituto Zooprofilattico Sperimentale (IZS) della Sicilia A. Mirri, 90129 Palermo, Italy; (F.V.); (F.B.); (G.C.); (S.R.)
| | - Roberta Perego
- Laboratorio di Ricerca di Medicina Emotrasfusionale Veterinaria (REvLab), Dipartimento di Medicina Veterinaria (DIMEVET), Università degli Studi di Milano, 26900 Lodi, Italy; (L.B.); (D.P.)
| | - Luciana Baggiani
- Laboratorio di Ricerca di Medicina Emotrasfusionale Veterinaria (REvLab), Dipartimento di Medicina Veterinaria (DIMEVET), Università degli Studi di Milano, 26900 Lodi, Italy; (L.B.); (D.P.)
| | - Daniela Proverbio
- Laboratorio di Ricerca di Medicina Emotrasfusionale Veterinaria (REvLab), Dipartimento di Medicina Veterinaria (DIMEVET), Università degli Studi di Milano, 26900 Lodi, Italy; (L.B.); (D.P.)
| |
Collapse
|
32
|
Grant R, Dub T, Andrianou X, Nohynek H, Wilder-Smith A, Pezzotti P, Fontanet A. SARS-CoV-2 population-based seroprevalence studies in Europe: a scoping review. BMJ Open 2021; 11:e045425. [PMID: 33795310 PMCID: PMC8021754 DOI: 10.1136/bmjopen-2020-045425] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 02/09/2021] [Accepted: 02/25/2021] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES We aimed to review SARS-CoV-2 seroprevalence studies conducted in Europe to understand how they may be used to inform ongoing control strategies for COVID-19. DESIGN Scoping review of peer-reviewed publications and manuscripts on preprint servers from January 2020 to 15 September 2020. PRIMARY MEASURE Seroprevalence estimate (and lower and upper CIs). For studies conducted across a country or territory, we used the seroprevalence estimate and the upper and lower CIs and compared them to the total number of reported infections to calculate the ratio of reported to expected infections. RESULTS We identified 23 population-based seroprevalence studies conducted in Europe. Among 12 general population studies, seroprevalence ranged from 0.42% among residual clinical samples in Greece to 13.6% in an area of high transmission in Gangelt, Germany. Of the eight studies in blood donors, seroprevalence ranged from 0.91% in North-Western Germany to 23.3% in a high-transmission area in Lombardy region, Italy. In three studies which recruited individuals through employment, seroprevalence ranged from 0.5% among factory workers in Frankfurt, Germany, to 10.2% among university employees in Milan, Italy. In comparison to nationally reported cases, the extent of infection, as derived from these seroprevalence estimates, is manyfold higher and largely heterogeneous. CONCLUSION Exposure to the virus in Europe has not reached a level of infection that would prevent further circulation of the virus. Effective vaccine candidates are urgently required to deliver the level of immunity in the population.
Collapse
Affiliation(s)
- Rebecca Grant
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France
- Sorbonne Université, Paris, France
| | - Timothée Dub
- Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Xanthi Andrianou
- Department of Infectious Diseases, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Hanna Nohynek
- Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Annelies Wilder-Smith
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Arnaud Fontanet
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France
- PACRI Unit, Conservatoire National des Arts et Métiers, Paris, France
| |
Collapse
|
33
|
Larremore DB, Fosdick BK, Bubar KM, Zhang S, Kissler SM, Metcalf CJE, Buckee CO, Grad YH. Estimating SARS-CoV-2 seroprevalence and epidemiological parameters with uncertainty from serological surveys. eLife 2021; 10:e64206. [PMID: 33666169 PMCID: PMC7979159 DOI: 10.7554/elife.64206] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 03/04/2021] [Indexed: 12/24/2022] Open
Abstract
Establishing how many people have been infected by SARS-CoV-2 remains an urgent priority for controlling the COVID-19 pandemic. Serological tests that identify past infection can be used to estimate cumulative incidence, but the relative accuracy and robustness of various sampling strategies have been unclear. We developed a flexible framework that integrates uncertainty from test characteristics, sample size, and heterogeneity in seroprevalence across subpopulations to compare estimates from sampling schemes. Using the same framework and making the assumption that seropositivity indicates immune protection, we propagated estimates and uncertainty through dynamical models to assess uncertainty in the epidemiological parameters needed to evaluate public health interventions and found that sampling schemes informed by demographics and contact networks outperform uniform sampling. The framework can be adapted to optimize serosurvey design given test characteristics and capacity, population demography, sampling strategy, and modeling approach, and can be tailored to support decision-making around introducing or removing interventions.
Collapse
Affiliation(s)
- Daniel B Larremore
- Department of Computer Science, University of Colorado BoulderBoulderUnited States
- BioFrontiers Institute, University of Colorado BoulderBoulderUnited States
| | - Bailey K Fosdick
- Department of Statistics, Colorado State UniversityFort CollinsUnited States
| | - Kate M Bubar
- Department of Applied Mathematics, University of Colorado BoulderBoulderUnited States
- IQ Biology Program, University of Colorado BoulderBoulderUnited States
| | - Sam Zhang
- Department of Applied Mathematics, University of Colorado BoulderBoulderUnited States
| | - Stephen M Kissler
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public HealthBostonUnited States
| | - C Jessica E Metcalf
- Department of Ecology and Evolutionary Biology and the Woodrow Wilson School, Princeton UniversityPrincetonUnited States
| | - Caroline O Buckee
- Department of Epidemiology, Harvard T.H. Chan School of Public HealthBostonUnited States
- Center for Communicable Disease Dynamics, Harvard T.H. Chan School of Public HealthBostonUnited States
| | - Yonatan H Grad
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public HealthBostonUnited States
| |
Collapse
|
34
|
Banjar A, Al-Tawfiq JA, Alruwaily A, Alserehi H, Al-Qunaibet A, Alaswad R, Almutlaq H, Almudaiheem A, Khojah AT, Alsaif F, Almolad SK, Alqahtani S, AlJurayyan A, Alotaibi A, Almalki S, Abuhaimed Y, Alkhashan A, Alfaifi A, Alabdulkareem K, Jokhdar H, Assiri A, Almudarra S. Seroprevalence of antibodies to SARS-CoV-2 among blood donors in the early months of the pandemic in Saudi Arabia. Int J Infect Dis 2021; 104:452-457. [PMID: 33465488 PMCID: PMC7816871 DOI: 10.1016/j.ijid.2021.01.028] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/12/2021] [Accepted: 01/13/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Serologic testing provides better understanding of SARS-CoV-2 prevalence and its transmission. This study was an investigation of the prevalence of antibodies to SARS-CoV-2 among blood donors in Saudi Arabia. OBJECTIVE To estimate the seroprevalence of anti-SARS-CoV-2 antibodies among blood donors in Saudi Arabia during the early phase of the COVID-19 pandemic. METHODS Serology results and epidemiological data were analyzed for 837 adult blood donors, with no confirmed SARS-CoV-2 infection, in Saudi Arabia from 20th to 25th May 2020. Seroprevalence was determined using electrochemical immunoassay to detect anti-SARS-CoV-2 antibodies. RESULTS The overall seroprevalence of anti-SARS-CoV-2 antibodies was 1.4% (12/837). Non-citizens had higher seroprevalence compared with citizens (OR 13.6, p = 0.001). Secondary education was significantly associated with higher seroprevalence compared with higher education (OR 6.8, p = 0.005). The data showed that the highest seroprevalence was in Makkah (8.1%). Uisng Makkah seroprevalence as the reference, the seroprevalence in other areas was: Madinah 4.1% (OR 0.48, 95% CI 0.12-1.94), Jeddah 2.3% (OR 0.27, 95% CI 0.31-2.25), and Qassim 2.9 % (OR 0.34, 95% CI 0.04-2.89) and these were not statistically different from seroprevalence in the Makkah region. CONCLUSIONS At the early months of the COVID-19 pandemic in Saudi Arabia, the seroprevalence of antibodies to SARS-CoV-2 among blood donors was low, but was higher among non-citizens. These findings may indicate that non-citizens and less educated individuals may be less attentive to preventive measures. Monitoring seroprevalence trends over time require repeated sampling.
Collapse
Affiliation(s)
- Ayman Banjar
- Deputy Ministry for Public Health, Ministry of Health, Riyadh, Saudi Arabia
| | - Jaffar A Al-Tawfiq
- Infectious Disease Unit, Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Infectious Disease Division, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
| | - Amaal Alruwaily
- Saudi Center for Disease Prevention and Control, Riyadh, Saudi Arabia
| | - Haleema Alserehi
- Saudi Center for Disease Prevention and Control, Riyadh, Saudi Arabia
| | - Ada Al-Qunaibet
- Saudi Center for Disease Prevention and Control, Riyadh, Saudi Arabia
| | - Rehab Alaswad
- Saudi Center for Disease Prevention and Control, Riyadh, Saudi Arabia
| | - Hind Almutlaq
- Saudi Center for Disease Prevention and Control, Riyadh, Saudi Arabia
| | | | - Abdullah T Khojah
- Faculty of Medicine, Al Imam Muhammad ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Faisal Alsaif
- Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Saeed Alqahtani
- Deputy Ministry for Laboratories and Blood Banks, Ministry of Health, Riyadh, Saudi Arabia
| | | | - Abdullah Alotaibi
- Dammam Regional Laboratory, Ministry of Health, Dammam, Saudi Arabia
| | - Safar Almalki
- Jeddah Regional Laboratory, Ministry of Health, Jeddah, Saudi Arabia
| | - Yousef Abuhaimed
- King Saud bin Abdulaziz University for Health Science, Riyadh, Saudi Arabia
| | - Abdullah Alkhashan
- Deputy Ministry for Laboratories and Blood Banks, Ministry of Health, Riyadh, Saudi Arabia
| | - Amal Alfaifi
- Deputy Ministry for Public Health, Ministry of Health, Riyadh, Saudi Arabia
| | - Khaled Alabdulkareem
- Deputy Ministry for Public Health, Ministry of Health, Riyadh, Saudi Arabia; Faculty of Medicine, Al Imam Muhammad ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Hani Jokhdar
- Deputy Ministry for Public Health, Ministry of Health, Riyadh, Saudi Arabia
| | - Abdullah Assiri
- Deputy Ministry for Public Health, Ministry of Health, Riyadh, Saudi Arabia
| | - Sami Almudarra
- Deputy Ministry for Public Health, Ministry of Health, Riyadh, Saudi Arabia; Saudi Center for Disease Prevention and Control, Riyadh, Saudi Arabia.
| |
Collapse
|
35
|
Sakalle S, Saroshe S, Shukla H, Mutha A, Vaze A, Arora A, Athotra A, Ramaswamy S, Jain A, Dhuria M, Patil AD, Rai A, Garg S, Jain SK, Bindal J, Singh SK. Seroprevalence of anti-SARS-CoV-2 antibodies in Indore, Madhya Pradesh: A community-based cross-sectional study, August 2020. J Family Med Prim Care 2021; 10:1479-1484. [PMID: 34041197 PMCID: PMC8140269 DOI: 10.4103/jfmpc.jfmpc_2015_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/02/2020] [Accepted: 12/16/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND In India, laboratory diagnosis of SARS - CoV-2 infection has been mostly based on real-time reverse transcriptase-polymerase chain reaction (RT-PCR). Studies have shown that Viral titres peak within the first week of symptoms but may decline later hampering RT-PCR-based diagnostic strategies. Exact estimate is difficult under high-risk screening strategy with evidences of having large number of asymptomatic cases. This has prompted a call for adoption of antibody testing as potential source of data. MATERIALS AND METHODS A cross-sectional study with a sample size of 7000 was conducted for 15 days including all the 85 wards under Indore Municipal Corporation. Stratified Random Sampling was used to collect the samples. Trained teams collected basic sociodemographic information and serum samples which were tested for the presence of specific antibodies to COVID-19 using ICMR-Kavach IgG ELISA kits. The data collected was compiled and analysed using appropriate statistical software. RESULTS Overall weighted seroprevalence of the study population was found to be 7.75%. The prevalence in males and females was comparable (7.91% vs 7.57%). Highest seropositivity (10.04%) was seen among individuals aged more than 60 years. Total number of infections in the population were estimated to be 2,03,160. Overall Case Infection Ratio was found to be 27.43. CONCLUSION The current seroprevalence study provides information on proportion of the population exposed, but the correlation between presence and absence of antibodies is not a marker of total or partial immunity. It must also be noted that more than 90 percent of the population is still susceptible for COVID-19 infection. Hence, non-pharmaceutical interventions like respiratory hygiene, physical distancing, hand sanitization, usage of personal protective equipment such as masks and implementation of public health measures need to be continued.
Collapse
Affiliation(s)
| | | | | | - Anita Mutha
- MGM Medical College, Indore, Madhya Pradesh, India
| | - Ameya Vaze
- Department of Health Service, Govt. of M.P., Madhya Pradesh, India
| | - Arpit Arora
- Indian Institute of Technology Bombay, Mumbai, Maharashtra, India
| | | | | | - Arania Jain
- Brain Above InfoSol Pvt. Ltd., Indore, Madhya Pradesh, India
| | - Meera Dhuria
- National Centre for Disease Control, New Delhi, India
| | - Anil D. Patil
- National Centre for Disease Control, New Delhi, India
| | - Arvind Rai
- National Centre for Disease Control, New Delhi, India
| | | | | | - Jyoti Bindal
- MGM Medical College, Indore, Madhya Pradesh, India
| | | |
Collapse
|
36
|
Latiano A, Tavano F, Panza A, Palmieri O, Niro GA, Andriulli N, Latiano T, Corritore G, Gioffreda D, Gentile A, Fontana R, Guerra M, Biscaglia G, Bossa F, Carella M, Miscio G, di Mauro L. False-positive results of SARS-CoV-2 IgM/IgG antibody tests in sera stored before the 2020 pandemic in Italy. Int J Infect Dis 2021; 104:159-163. [PMID: 33383223 PMCID: PMC7834192 DOI: 10.1016/j.ijid.2020.12.067] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 12/22/2020] [Accepted: 12/23/2020] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES Aside from the outbreak of the coronavirus disease 2019 (COVID-19), serological tests are not well known for their diagnostic value. We assessed the performance of serological tests using stored sera from patients with a variety of pathologic conditions, collected before the 2020 pandemic in Italy. METHODS Rapid lateral flow tests and Enzyme-Linked Immunosorbent Assays (ELISA) that detect Immunoglobulin M (IgM) and Immunoglobulin G (IgG) antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were carried out using 1150 stored human serum samples that had been collected in 2018 and 2019. The tests were also run using samples from 15 control patients who had positive or negative oral swab test results, as assessed using real-time reverse transcription-polymerase chain reaction (rRT-PCR). The urea dissociation test was employed to rule out false-positive reactivity in the two antibody detection methods. RESULTS The lateral flow tests revealed 21 positive samples from the stored sera: 12 for IgM, four for IgG, and five for IgM/IgG. Among the nine rRT-PCR- positive controls, six individuals presented IgG and three IgM/IgG positivity. Using the urea (6 mol/L) dissociation test, two of the twelve stored samples that had shown IgM positivity were confirmed to be positive. The ELISA test detected four IgM-positive and three IgG-positive specimens. After treatment with 4 mol/L urea, the IgM-positive samples became negative, whereas the IgG positivity persisted. All of the rRT-PCR-positive controls were found to retain IgM or IgG positivity following the urea treatment. CONCLUSIONS Our findings highlight the limited utility of serological testing for the SARS-CoV-2 virus based on the results of specimens collected before the outbreak of the infection.
Collapse
Affiliation(s)
- Anna Latiano
- Fondazione IRCCS Casa Sollievo della Sofferenza, Gastroenterology Unit, San Giovanni Rotondo, Foggia, Italy.
| | - Francesca Tavano
- Fondazione IRCCS Casa Sollievo della Sofferenza, Gastroenterology Unit, San Giovanni Rotondo, Foggia, Italy
| | - Anna Panza
- Fondazione IRCCS Casa Sollievo della Sofferenza, Gastroenterology Unit, San Giovanni Rotondo, Foggia, Italy
| | - Orazio Palmieri
- Fondazione IRCCS Casa Sollievo della Sofferenza, Gastroenterology Unit, San Giovanni Rotondo, Foggia, Italy
| | - Grazia A Niro
- Fondazione IRCCS Casa Sollievo della Sofferenza, Gastroenterology Unit, San Giovanni Rotondo, Foggia, Italy
| | | | - Tiziana Latiano
- Fondazione IRCCS Casa Sollievo della Sofferenza, Gastroenterology Unit, San Giovanni Rotondo, Foggia, Italy
| | - Giuseppe Corritore
- Fondazione IRCCS Casa Sollievo della Sofferenza, Gastroenterology Unit, San Giovanni Rotondo, Foggia, Italy
| | - Domenica Gioffreda
- Fondazione IRCCS Casa Sollievo della Sofferenza, Gastroenterology Unit, San Giovanni Rotondo, Foggia, Italy
| | - Annamaria Gentile
- Fondazione IRCCS Casa Sollievo della Sofferenza, Gastroenterology Unit, San Giovanni Rotondo, Foggia, Italy
| | - Rosanna Fontana
- Fondazione IRCCS Casa Sollievo della Sofferenza, Gastroenterology Unit, San Giovanni Rotondo, Foggia, Italy
| | - Maria Guerra
- Fondazione IRCCS Casa Sollievo della Sofferenza, Gastroenterology Unit, San Giovanni Rotondo, Foggia, Italy
| | - Giuseppe Biscaglia
- Fondazione IRCCS Casa Sollievo della Sofferenza, Gastroenterology Unit, San Giovanni Rotondo, Foggia, Italy
| | - Fabrizio Bossa
- Fondazione IRCCS Casa Sollievo della Sofferenza, Gastroenterology Unit, San Giovanni Rotondo, Foggia, Italy
| | - Massimo Carella
- Division of Medical Genetics, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Giuseppe Miscio
- Immunohematology and Transfusion Medicine Service, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Lazzaro di Mauro
- Immunohematology and Transfusion Medicine Service, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| |
Collapse
|
37
|
Comelli A, Focà E, Sansone E, Tomasi C, Albini E, Quiros-Roldan E, Tomasoni LR, Sala E, Bonfanti C, Caccuri F, Caruso A, De Palma G, Castelli F. Serological Response to SARS-CoV-2 in Health Care Workers Employed in a Large Tertiary Hospital in Lombardy, Northern Italy. Microorganisms 2021; 9:488. [PMID: 33669151 PMCID: PMC7996483 DOI: 10.3390/microorganisms9030488] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/21/2021] [Accepted: 02/22/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND COVID-19 pandemic is requesting unprecedented efforts by health-care workers (HCWs) in all countries, and especially in Italy during the first semester of 2020. METHODS This is a retrospective, observational study conducted at the Spedali Civili General Hospital, in Brescia, Northern Italy during the SARS CoV-2 pandemic in the first semester of 2020. Serum samples from HCWs were tested for SARS-CoV-2 spike protein-specific antibodies. An online survey was used to collect demographic, clinical, and epidemiological data. RESULTS Of the 1893 HCWs included, 433 (22.9%) were found seropositive for SARS-CoV-2 IgG. The cumulative prevalence of SARS-CoV-2 infection (antibodies production or past positive RT-PCR on nasal/throat swab) was 25.1% (475/1893). Fifty-six out of 433 (13%) seropositive participants declared to have been asymptomatic during the study period. The development of COVID-19 signs or symptoms is the main determinant of seropositivity (OR: 11.3, p < 0.0001) along with their duration and severity. 40/290 (14.5%) HCWs with documented positive RT-PCR during the study period did not show any detectable antibody response. IgG levels positively correlate with age, COVID-19-compatible signs and symptoms experienced and their duration. CONCLUSIONS In this study, carried out in one of the most affected areas in Europe, we demonstrate that most HCWs with COVID-19 related symptoms develop a spike protein-specific antibodies with potential neutralizing effect.
Collapse
Affiliation(s)
- Agnese Comelli
- University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, 25123 Brescia, Italy; (E.F.); (E.Q.-R.); (L.R.T.); (F.C.)
| | - Emanuele Focà
- University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, 25123 Brescia, Italy; (E.F.); (E.Q.-R.); (L.R.T.); (F.C.)
| | - Emanuele Sansone
- Postgraduate School of Occupational Health, DSMC, University of Brescia, 25123 Brescia, Italy;
| | | | - Elisa Albini
- Unit of Occupational Health, Hygiene, Toxicology and Occupational Prevention, ASST Spedali Civili, 25123 Brescia, Italy; (E.A.); (E.S.)
| | - Eugenia Quiros-Roldan
- University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, 25123 Brescia, Italy; (E.F.); (E.Q.-R.); (L.R.T.); (F.C.)
| | - Lina Rachele Tomasoni
- University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, 25123 Brescia, Italy; (E.F.); (E.Q.-R.); (L.R.T.); (F.C.)
| | - Emma Sala
- Unit of Occupational Health, Hygiene, Toxicology and Occupational Prevention, ASST Spedali Civili, 25123 Brescia, Italy; (E.A.); (E.S.)
| | - Carlo Bonfanti
- Department of Microbiology and Virology, Spedali Civili, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (C.B.); (F.C.); (A.C.)
| | - Francesca Caccuri
- Department of Microbiology and Virology, Spedali Civili, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (C.B.); (F.C.); (A.C.)
| | - Arnaldo Caruso
- Department of Microbiology and Virology, Spedali Civili, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (C.B.); (F.C.); (A.C.)
| | - Giuseppe De Palma
- University Department of Occupational Health and Industrial Hygiene, DSMC, University of Brescia and ASST Spedali Civili, 25123 Brescia, Italy;
| | - Francesco Castelli
- University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, 25123 Brescia, Italy; (E.F.); (E.Q.-R.); (L.R.T.); (F.C.)
| |
Collapse
|
38
|
Lombardi A, Mangioni D, Consonni D, Cariani L, Bono P, Cantù AP, Tiso B, Carugno M, Muscatello A, Lunghi G, Pesatori AC, Riboldi L, Ceriotti F, Bandera A, Gori A. Seroprevalence of anti-SARS-CoV-2 IgG among healthcare workers of a large university hospital in Milan, Lombardy, Italy: a cross-sectional study. BMJ Open 2021; 11:e047216. [PMID: 33619203 PMCID: PMC7902322 DOI: 10.1136/bmjopen-2020-047216] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES To assess the seroprevalence of anti-SARS-CoV-2 IgG among health careworkers (HCWs) in our university hospital and verify the risk of acquiring the infection according to work area. DESIGN Cross-sectional study. SETTING Monocentric, Italian, third-level university hospital. PARTICIPANTS All the employees of the hospital on a voluntary base, for a total of 4055 participants among 4572 HCWs (88.7%). PRIMARY AND SECONDARY OUTCOME MEASURES Number of anti-SARS-CoV-2 positive serology according to working area. Association of anti-SARS-CoV-2 positive serology to selected variables (age, gender, country of origin, body mass index, smoking, symptoms and contact with confirmed cases). RESULTS From 27 April 2020 to 12 June 2020, 4055 HCWs were tested and 309 (7.6%) had a serological positive test. No relevant difference was found between men and women (8.3% vs 7.3%, p=0.3), whereas a higher prevalence was observed among foreign-born workers (27/186, 14.5%, p<0.001), employees younger than 30 (64/668, 9.6%, p=0.02) or older than 60 years (38/383, 9.9%, p=0.02) and among healthcare assistants (40/320, 12.5%, p=0.06). Working as frontline HCWs was not associated with an increased frequency of positive serology (p=0.42). A positive association was found with presence and number of symptoms (p<0.001). The symptoms most frequently associated with a positive serology were taste and smell alterations (OR 4.62, 95% CI: 2.99 to 7.15) and fever (OR 4.37, 95% CI: 3.11 to 6.13). No symptoms were reported in 84/309 (27.2%) HCWs with positive IgG levels. Declared exposure to a suspected/confirmed case was more frequently associated (p<0.001) with positive serology when the contact was a family member (19/94, 20.2%) than a patient or colleague (78/888, 8.8%). CONCLUSIONS SARS-CoV-2 infection occurred undetected in a large fraction of HCWs and it was not associated with working in COVID-19 frontline areas. Beyond the hospital setting, exposure within the community represents an additional source of infection for HCWs.
Collapse
Affiliation(s)
- Andrea Lombardi
- Infectious Diseases Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy
| | - Davide Mangioni
- Infectious Diseases Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Dario Consonni
- Epidemiology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Lisa Cariani
- Clinical Laboratory, Foundation IRCCS Ca' Granda Ospedale Maggiore, Milan, Italy
| | - Patrizia Bono
- Clinical Laboratory, Foundation IRCCS Ca' Granda Ospedale Maggiore, Milan, Italy
| | - Anna Paola Cantù
- Medical Direction, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Basilio Tiso
- Medical Direction, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Michele Carugno
- Epidemiology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milano, Milan, Italy
| | - Antonio Muscatello
- Infectious Diseases Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanna Lunghi
- Clinical Laboratory, Foundation IRCCS Ca' Granda Ospedale Maggiore, Milan, Italy
| | - Angela Cecilia Pesatori
- Epidemiology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milano, Milan, Italy
| | - Luciano Riboldi
- Occupational Health Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Ferruccio Ceriotti
- Clinical Laboratory, Foundation IRCCS Ca' Granda Ospedale Maggiore, Milan, Italy
| | - Alessandra Bandera
- Infectious Diseases Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy
- Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, Italy
| | - Andrea Gori
- Infectious Diseases Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy
- Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, Italy
| |
Collapse
|
39
|
Milazzo L, Lai A, Pezzati L, Oreni L, Bergna A, Conti F, Meroni C, Minisci D, Galli M, Corbellino M, Antinori S, Ridolfo AL. Dynamics of the seroprevalence of SARS-CoV-2 antibodies among healthcare workers at a COVID-19 referral hospital in Milan, Italy. Occup Environ Med 2021; 78:oemed-2020-107060. [PMID: 33542096 PMCID: PMC7868130 DOI: 10.1136/oemed-2020-107060] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/18/2020] [Accepted: 12/01/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Healthcare workers (HCWs) are at high risk of developing SARS-CoV-2 infection. The aim of this single-centre prospective study was to evaluate the trend of SARS-CoV-2 seroprevalence in HCWs working at the primary referral centre for infectious diseases and bioemergencies (eg, COVID-19) in Northern Italy and investigate the factors associated with seroconversion. METHODS Six hundred and seventy-nine HCW volunteers were tested for anti-SARS-CoV-2 antibodies three times between 4 March and 27 May 2020 and completed a questionnaire covering COVID-19 exposure, symptoms and personal protective equipment (PPE) training and confidence at each time. RESULTS SARS-CoV-2 seroprevalence rose from 3/679 to 26/608 (adjusted prevalence: 0.5%, 95% CI 0.1 to 1.7% and 5.4%, 95% CI 3.6 to 7.9, respectively) between the first two time points and then stabilised, in line with the curve of the COVID-19 epidemic in Milan. From the first time point, 61.6% of the HCWs had received training in the use of PPE and 17 (61.5%) of those who proved to be seropositive reported symptoms compatible with SARS-CoV-2 infection. Contacts with ill relatives or friends and self-reported symptoms were independently associated with an increased likelihood of seroconversion (p<0.0001 for both), whereas there was no significant association with professional exposure. CONCLUSION The seroprevalence of SARS-CoV-2 among the HCWs at our COVID-19 referral hospital was low at the time of the peak of the epidemic. The seroconversions were mainly attributable to extrahospital contacts, probably because the hospital readily adopted effective infection control measures. The relatively high number of asymptomatic seropositive HCWs highlights the need to promptly identify and isolate potentially infectious HCWs.
Collapse
Affiliation(s)
- Laura Milazzo
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Alessia Lai
- Luigi Sacco Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milano, Lombardia, Italy
| | - Laura Pezzati
- Luigi Sacco Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milano, Lombardia, Italy
| | - Letizia Oreni
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Annalisa Bergna
- Luigi Sacco Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milano, Lombardia, Italy
| | - Federico Conti
- Luigi Sacco Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milano, Lombardia, Italy
| | - Cristina Meroni
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Davide Minisci
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Massimo Galli
- Luigi Sacco Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milano, Lombardia, Italy
| | - Mario Corbellino
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Spinello Antinori
- Luigi Sacco Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milano, Lombardia, Italy
| | - Anna Lisa Ridolfo
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milano, Italy
| |
Collapse
|
40
|
Qutob N, Awartani F, Salah Z, Asia M, Abu Khader I, Herzallah K, Balqis N, Sallam H. Seroprevalence of SARS-CoV-2 in the West Bank region of Palestine: a cross-sectional seroepidemiological study. BMJ Open 2021; 11:e044552. [PMID: 33542045 PMCID: PMC7868131 DOI: 10.1136/bmjopen-2020-044552] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 01/06/2021] [Accepted: 01/07/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Seroprevalence rates are important indicators to the epidemiology of COVID-19 and the extent of the pandemic given the existence of asymptomatic cases. The purpose of this study is to assess the seroprevalence rate in the Palestinian population residing in the West Bank. SETTING The study involved 1355 participants from 11 governorates, including 112 localities in the West Bank and 1136 individuals visiting Palestinian medical laboratories. PARTICIPANTS Blood samples were collected between 15th June 2020 and 30th June 2020 from 1355 individuals from randomly selected households in the West Bank, in addition to 1136 individuals visiting Palestinian medical laboratories between the 1st May 2020 and 9th July 2020 for a routine check-up. PRIMARY AND SECONDARY OUTCOME MEASURES Out of the 2491 blood samples collected, serological tests for 2455 adequate serum samples were done using an immunoassay for qualitative detection of antibodies against SARS-CoV-2. Seroprevalence was estimated as the proportion of individuals who had a positive result in the total SARS-CoV-2 antibodies in the immunoassay. RESULTS The random sample of Palestinians living in the West Bank yielded 0% seroprevalence with 95% and an adjusted CI (0% to 0.0043%), while the lab referral samples yielded an estimated seroprevalence of 0.354% with 95% and an adjusted CI (0.001325% to 0.011566%). CONCLUSIONS Our results indicate that as of mid-June 2020, seroprevalence in Palestine persists low and is inadequate to provide herd immunity, emphasising the need to maintain health measures to keep the outbreak under control. Population-based seroprevalence studies are to be conducted periodically to monitor the SARS-CoV-2 seroprevalence in Palestine and inform policymakers about the efficacy of their surveillance system.
Collapse
Affiliation(s)
- Nouar Qutob
- Department of Health Sciences, Faculty of Graduate Studies, Arab American University, Ramallah, Palestine
| | - Faisal Awartani
- Department of Health Sciences, Faculty of Graduate Studies, Arab American University, Ramallah, Palestine
| | - Zaidoun Salah
- Department of Health Sciences, Faculty of Graduate Studies, Arab American University, Ramallah, Palestine
| | - Mohammad Asia
- Department of Health Sciences, Faculty of Graduate Studies, Arab American University, Ramallah, Palestine
| | - Imad Abu Khader
- Department of Health Sciences, Faculty of Graduate Studies, Arab American University, Ramallah, Palestine
| | - Khaled Herzallah
- Department of Health Sciences, Faculty of Graduate Studies, Arab American University, Ramallah, Palestine
| | - Nadeen Balqis
- Department of Health Sciences, Faculty of Graduate Studies, Arab American University, Ramallah, Palestine
| | - Husam Sallam
- Department of Health Sciences, Faculty of Graduate Studies, Arab American University, Ramallah, Palestine
| |
Collapse
|
41
|
Nelson SM, Ehnert S, Gromski PS, Child T, Trew G. SARS-Cov-2 viral and serological screening of staff in 31 European fertility units. Hum Reprod Open 2020; 2020:hoaa056. [PMID: 34056138 PMCID: PMC7799119 DOI: 10.1093/hropen/hoaa056] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/28/2020] [Indexed: 01/10/2023] Open
Abstract
STUDY QUESTION What is the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral presence and seroconversion in staff members in European fertility units prior to recommencement of clinical activity? SUMMARY ANSWER A large proportion of fertility clinic staff remain susceptible to SARS-CoV-2 with no evidence of seroconversion, indicating that continued comprehensive risk mitigation strategies are essential. WHAT IS KNOWN ALREADY In response to the coronavirus disease 2019 (COVID-19) pandemic, caused by SARS-CoV-2, routine fertility treatment was temporarily stopped in several European countries. The SARS-CoV-2 prevalence and seroconversion in fertility clinic staff, who are at potentially lower risk than routine healthcare workers, are unknown. STUDY DESIGN SIZE DURATION This cross-sectional study included 554 staff in 16 European IVF clinics, 13 ultrasound clinics, one diagnostic laboratory and one head office in four European countries (Austria, Denmark, Germany and the UK) between 15 April and 30 June 2020. PARTICIPANTS/MATERIALS SETTING METHODS There were 554 staff members returning for resumption of clinical activity. Paired nucleic acid amplification tests of oropharyngeal swabs for SARS-CoV-2 and serological testing for SARS-CoV-2 IgG were performed. MAIN RESULTS AND THE ROLE OF CHANCE Of the 554 staff members tested, 0.19% (95% CI 0.03, 1.10%) had evidence of SARS-CoV-2 as detected by RT-PCR. In contrast, 23 staff members, i.e. 4.15% (95% CI 2.78, 6.15%), had antibodies against SARS-CoV-2, with a wide range of antibody titres. There was no evidence of differences in seroconversion between countries with estimates ranging from 2.78% (95% CI 0.77, 9.58) in Austria to 6.75% (95% CI 4.46, 10.1) for the UK. There was no strong evidence of clustering within the clinics, with 21 of the 30 facilities having no staff members affected (prevalence estimates ranging from 0% to 35%), and one clinic having seven staff members affected (35% (95% CI 18.1%, 56.7%)). The single staff member who tested positive for SARS-CoV-2 virus was in the pre-symptomatic phase and was isolated, with no contacts having evidence of infection on repeat testing. LIMITATIONS REASONS FOR CAUTION This was a cross-sectional study prior to resumption of clinical activity, with repeat testing not undertaken. WIDER IMPLICATIONS OF THE FINDINGS The low prevalence of seroconversion of fertility clinic staff highlights the need for continued comprehensive risk mitigation strategies and engagement with national endeavours to identify and isolate new cases and their contacts as we embark on the resumption of fertility services. STUDY FUNDING/COMPETING INTERESTS The Fertility Partnership funded the study. S.M.N. reports personal fees from Access Fertility, personal fees from Merck, personal fees from Ferring, grants and personal fees from Roche Diagnostics, personal fees from The Fertility Partnership and personal fees from Modern Fertility, outside the submitted work. T.C. reports personal fees from Merck and personal fees from Ferring, outside the submitted work. G.T. reports personal fees from Merck, personal fees from Ferring and personal fees from Roche Diagnostics, outside the submitted work. S.E. and P.S.G. report no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
Collapse
Affiliation(s)
- Scott M Nelson
- School of Medicine, University of Glasgow, Glasgow, UK
- NIHR Bristol Biomedical Research Centre, Bristol, UK
- The Fertility Partnership, London, UK
| | | | | | - Tim Child
- The Fertility Partnership, London, UK
- Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, UK
| | - Geoffrey Trew
- Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, UK
| |
Collapse
|
42
|
Lombardi F, Belmonti S, Ricci R, Borghetti A, Fabbiani M, Ciccullo A, Cauda R, Di Giambenedetto S. No evidence of SARS-CoV-2 circulation in HIV-infected patients between December 2019 and February 2020 in Rome, Italy. Clin Microbiol Infect 2020; 27:S1198-743X(20)30722-9. [PMID: 33278571 PMCID: PMC7709603 DOI: 10.1016/j.cmi.2020.11.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/22/2020] [Accepted: 11/24/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Francesca Lombardi
- Università Cattolica del Sacro Cuore, Dipartimento di Sicurezza e Bioetica Sezione Malattie Infettive, Rome, Italy.
| | - Simone Belmonti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Area of Pathology, Department of Woman and Child Health and Public Health, Istituto di Anatomia Patologica, Rome, Italy
| | - Rosalba Ricci
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Institute of Microbiology and Virology, Rome, Italy
| | - Alberto Borghetti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Malattie Infettive, Rome, Italy
| | - Massimiliano Fabbiani
- Infectious and Tropical Diseases Unit, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
| | - Arturo Ciccullo
- Università Cattolica del Sacro Cuore, Dipartimento di Sicurezza e Bioetica Sezione Malattie Infettive, Rome, Italy
| | - Roberto Cauda
- Università Cattolica del Sacro Cuore, Dipartimento di Sicurezza e Bioetica Sezione Malattie Infettive, Rome, Italy; Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Malattie Infettive, Rome, Italy
| | - Simona Di Giambenedetto
- Università Cattolica del Sacro Cuore, Dipartimento di Sicurezza e Bioetica Sezione Malattie Infettive, Rome, Italy; Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Malattie Infettive, Rome, Italy
| |
Collapse
|
43
|
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.
Collapse
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.
| |
Collapse
|
44
|
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.
Collapse
Affiliation(s)
| | - Lea Merone
- James Cook University, Australia; Tropical Public Health Service, Cairns, Australia
| |
Collapse
|
45
|
Peirlinck M, Linka K, Costabal FS, Bhattacharya J, Bendavid E, Ioannidis JPA, Kuhl E. Visualizing the invisible: The effect of asymptomatic transmission on the outbreak dynamics of COVID-19. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.05.23.20111419. [PMID: 32869035 PMCID: PMC7457606 DOI: 10.1101/2020.05.23.20111419] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Understanding the outbreak dynamics of the COVID-19 pandemic has important implications for successful containment and mitigation strategies. Recent studies suggest that the population prevalence of SARS-CoV-2 antibodies, a proxy for the number of asymptomatic cases, could be an order of magnitude larger than expected from the number of reported symptomatic cases. Knowing the precise prevalence and contagiousness of asymptomatic transmission is critical to estimate the overall dimension and pandemic potential of COVID-19. However, at this stage, the effect of the asymptomatic population, its size, and its outbreak dynamics remain largely unknown. Here we use reported symptomatic case data in conjunction with antibody seroprevalence studies, a mathematical epidemiology model, and a Bayesian framework to infer the epidemiological characteristics of COVID-19. Our model computes, in real time, the time-varying contact rate of the outbreak, and projects the temporal evolution and credible intervals of the effective reproduction number and the symptomatic, asymptomatic, and recovered populations. Our study quantifies the sensitivity of the outbreak dynamics of COVID-19 to three parameters: the effective reproduction number, the ratio between the symptomatic and asymptomatic populations, and the infectious periods of both groups For nine distinct locations, our model estimates the fraction of the population that has been infected and recovered by Jun 15, 2020 to 24.15% (95% CI: 20.48%-28.14%) for Heinsberg (NRW, Germany), 2.40% (95% CI: 2.09%-2.76%) for Ada County (ID, USA), 46.19% (95% CI: 45.81%-46.60%) for New York City (NY, USA), 11.26% (95% CI: 7.21%-16.03%) for Santa Clara County (CA, USA), 3.09% (95% CI: 2.27%-4.03%) for Denmark, 12.35% (95% CI: 10.03%-15.18%) for Geneva Canton (Switzerland), 5.24% (95% CI: 4.84%-5.70%) for the Netherlands, 1.53% (95% CI: 0.76%-2.62%) for Rio Grande do Sul (Brazil), and 5.32% (95% CI: 4.77%-5.93%) for Belgium. Our method traces the initial outbreak date in Santa Clara County back to January 20, 2020 (95% CI: December 29, 2019 - February 13, 2020). Our results could significantly change our understanding and management of the COVID-19 pandemic: A large asymptomatic population will make isolation, containment, and tracing of individual cases challenging. Instead, managing community transmission through increasing population awareness, promoting physical distancing, and encouraging behavioral changes could become more relevant.
Collapse
Affiliation(s)
- Mathias Peirlinck
- Department of Mechanical Engineering, Stanford University School of Engineering, Stanford, California, United States
| | - Kevin Linka
- Department of Mechanical Engineering, Stanford University School of Engineering, Stanford, California, United States
| | - Francisco Sahli Costabal
- Department of Mechanical and Metallurgical Engineering and Institute for Biological and Medical Engineering, Schools of Engineering, Biology and Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Jay Bhattacharya
- Department of Medicine, Stanford University School of Medicine, Stanford, California, United States
| | - Eran Bendavid
- Department of Medicine, Stanford University School of Medicine, Stanford, California, United States
| | - John P A Ioannidis
- Department of Medicine, Stanford University School of Medicine, Stanford, California, United States
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, United States
| | - Ellen Kuhl
- Department of Mechanical Engineering, Stanford University School of Engineering, Stanford, California, United States
| |
Collapse
|
46
|
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.
Collapse
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
| |
Collapse
|