Increasing rate of anti-SARS-CoV-2 antibodies between the first and second waves of COVID-19 in São Paulo, Brazil: A cross-sectional blood donors-based study

Vale, Nayara Moya Rios do; Latini, Flávia Roche Moreira; Arnoni, Carine Prisco; Parreira, Rafael Martins; Girão, Manoel João Batista Castelo; Cortez, Afonso José Pereira; Bonetti, T.C.

doi:10.1016/j.clinsp.2022.100016

Cited by 10 publications

(8 citation statements)

References 27 publications

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“…The overall seroprevalence we found in São Sebastião and the lack of difference between groups and strata differ from what studies in other Brazilian populations found (see [ 15 , 16 , 17 , 18 ] for examples). That discrepancy is likely related to the time at which the surveys were conducted, as well as to the characteristics of the populations under scrutiny and to those of the tests used.…”

Section: Discussioncontrasting

confidence: 99%

Seroprevalence of SARS-CoV-2 and Vaccination Coverage among Residents of a Lower-Middle-Class Population in the Federal District, Brazil

et al. 2023

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Estimating seroprevalence and vaccination coverage against COVID-19 is crucial to the development of well-targeted public health policies at the local level. Here, we estimated seroprevalence and vaccination coverage in a lower-middle-class population in Brazil. We conducted an observational, cross-sectional, population-based survey from 24 September to 19 December 2021. CMIA tests were used to detect anti-SARS-CoV-2 IgG against the N-protein. The overall seroprevalence was 24.15% (177/733), and vaccination coverage was 91.40% (670/733); 72.09% (483/670) were fully vaccinated. Among vaccinated participants, seroprevalence was 24.77% (95% CI 21.50–28.04; 166/670), with a prevalence ratio (PR) of 1.03 (95% CI 0.98–1.08; p-value 0.131). Among participants who received an mRNA vaccine with S-based epitope (485), seroprevalence was 16.29% (95% CI 13.04–19.85; 79/485). Among unvaccinated participants, seroprevalence was 17.46% (95% CI 10.04–28.62; 11/63). Finally, in spite of the political climate and other possible causes for vaccine hesitancy, the positive Brazilian culture towards vaccination might have curbed hesitancy.

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Section: Discussioncontrasting

confidence: 99%

Seroprevalence of SARS-CoV-2 and Vaccination Coverage among Residents of a Lower-Middle-Class Population in the Federal District, Brazil

et al. 2023

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“…In this community-based study conducted in the city of Salvador, Brazil, we found that nearly half of residents in an urban slum had evidence of SARS-CoV-2 infection after the first wave of the epidemic in 2020 and before the peak of the second wave. In contrast, cross-sectional surveys conducted among blood donors in the states of São Paulo and Rio Grande do Sul estimated 10% to 30% seroprevalence in February 2021, when our data collection ended [ 25 , 26 ]. This finding is consistent with studies in other settings that reported higher seroprevalence in slums than in non-slum settings [ 4 , 27 ], highlighting the increased vulnerability of socioeconomically deprived communities.…”

Section: Discussionmentioning

confidence: 99%

Structural factors associated with SARS-CoV-2 infection risk in an urban slum setting in Salvador, Brazil: A cross-sectional survey

et al. 2022

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Background The structural environment of urban slums, including physical, demographic, and socioeconomic attributes, renders inhabitants more vulnerable to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. Yet, little is known about the specific determinants that contribute to high transmission within these communities. We therefore aimed to investigate SARS-CoV-2 seroprevalence in an urban slum in Brazil. Methods and findings We performed a cross-sectional serosurvey of an established cohort of 2,041 urban slum residents from the city of Salvador, Brazil between November 2020 and February 2021, following the first Coronavirus Disease 2019 (COVID-19) pandemic wave in the country and during the onset of the second wave. The median age in this population was 29 years (interquartile range [IQR] 16 to 44); most participants reported their ethnicity as Black (51.5%) or Brown (41.7%), and 58.5% were female. The median size of participating households was 3 (IQR 2 to 4), with a median daily per capita income of 2.32 (IQR 0.33–5.15) US Dollars. The main outcome measure was presence of IgG against the SARS-CoV-2 spike protein. We implemented multilevel models with random intercepts for each household to estimate seroprevalence and associated risk factors, adjusting for the sensitivity and specificity of the assay, and the age and gender distribution of our study population. We identified high seroprevalence (47.9%, 95% confidence interval [CI] 44.2% to 52.1%), particularly among female residents (50.3% [95% CI 46.3% to 54.8%] versus 44.6% [95% CI 40.1% to 49.4%] among male residents, p < 0.01) and among children (54.4% [95% CI 49.6% to 59.3%] versus 45.4% [95% CI 41.5% to 49.7%] among adults, p < 0.01). Adults residing in households with children were more likely to be seropositive (48.6% [95% CI 44.8% to 52.3%] versus 40.7% [95% CI 37.2% to 44.3%], p < 0.01). Women who were unemployed and living below the poverty threshold (daily per capita household income <$1.25) were more likely to be seropositive compared to men with the same employment and income status (53.9% [95% CI 47.0% to 60.6%] versus 32.9% [95% CI 23.2% to 44.3%], p < 0.01). Participation in the study was voluntary, which may limit the generalizability of our findings. Conclusions Prior to the peak of the second wave of the COVID-19 pandemic, cumulative incidence as assessed by serology approached 50% in a Brazilian urban slum population. In contrast to observations from industrialized countries, SARS-CoV-2 incidence was highest among children, as well as women living in extreme poverty. These findings emphasize the need for targeted interventions that provide safe environments for children and mitigate the structural risks posed by crowding and poverty for the most vulnerable residents of urban slum communities.

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“…We found suggestive evidence that healthcare workers vaccinated earlier were at higher risk of covid-19 and that infection of healthcare workers before vaccination may have led to overestimation of waning in this group. Our estimates in the older population, who also contributed most to the estimates of waning against severe disease, are likely less affected by bias owing to lower incidence in these age groups, as suggested by serologic data, 28 and better adherence to risk mitigation, as observed in other contexts. 29 30 …”

Section: Discussionmentioning

confidence: 79%

Change in covid-19 risk over time following vaccination with CoronaVac: test negative case-control study

Hitchings

Ranzani

Lind

et al. 2022

BMJ

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Objective To estimate the change in odds of covid-19 over time following primary series completion of the inactivated whole virus vaccine CoronaVac (Sinovac Biotech) in São Paulo State, Brazil. Design Test negative case-control study. Setting Community testing for covid-19 in São Paulo State, Brazil. Participants Adults aged ≥18 years who were residents of São Paulo state, had received two doses of CoronaVac, did not have a laboratory confirmed SARS-CoV-2 infection before vaccination, and underwent reverse transcription polymerase chain reaction (RT-PCR) testing for SARS-CoV-2 from 17 January to 14 December 2021. Cases were matched to test negative controls by age (in 5 year bands), municipality of residence, healthcare worker status, and epidemiological week of RT-PCR test. Main outcome measures RT-PCR confirmed symptomatic covid-19 and associated hospital admissions and deaths. Conditional logistic regression was adjusted for sex, number of covid-19 associated comorbidities, race, and previous acute respiratory illness. Results From 202 741 eligible people, 52 170 cases with symptomatic covid-19 and 69 115 test negative controls with covid-19 symptoms were formed into 43 257 matched sets. Adjusted odds ratios of symptomatic covid-19 increased with time since completion of the vaccination series. The increase in odds was greater in younger people and among healthcare workers, although sensitivity analyses suggested that this was in part due to bias. In addition, the adjusted odds ratios of covid-19 related hospital admission or death significantly increased with time compared with the odds 14-41 days after series completion: from 1.25 (95% confidence interval 1.04 to 1.51) at 70-97 days up to 1.94 (1.41 to 2.67) from 182 days onwards. Conclusions Significant increases in the risk of moderate and severe covid-19 outcomes occurred three months after primary vaccination with CoronaVac among people aged 65 and older. These findings provide supportive evidence for the implementation of vaccine boosters in these populations who received this inactivated vaccine. Studies of waning should include analyses designed to uncover common biases.

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Increasing rate of anti-SARS-CoV-2 antibodies between the first and second waves of COVID-19 in São Paulo, Brazil: A cross-sectional blood donors-based study

Cited by 10 publications

References 27 publications

Seroprevalence of SARS-CoV-2 and Vaccination Coverage among Residents of a Lower-Middle-Class Population in the Federal District, Brazil

Seroprevalence of SARS-CoV-2 and Vaccination Coverage among Residents of a Lower-Middle-Class Population in the Federal District, Brazil

Structural factors associated with SARS-CoV-2 infection risk in an urban slum setting in Salvador, Brazil: A cross-sectional survey

Change in covid-19 risk over time following vaccination with CoronaVac: test negative case-control study

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