Resurgence of COVID-19 in Manaus, Brazil, despite high seroprevalence

Sabino, Ester C.; Buss, Lewis; Carvalho, Maria P S S; Prete, Carlos A.; Crispim, Myuki A. E.; Fraiji, Nelson Abrahim; Pereira, Rafael Henrique Moraes; Parag, Kris V; Peixoto, Pedro S.; Kraemer, Moritz U. G.; Oikawa, Márcio K.; Salomon, Tassila; Cucunubá, Zulma M.; Castro, Márcia C.; Santos, Andreza Aruska de Souza; Nascimento, Vítor H.; Pereira, Henrique; Ferguson, Neil; Pybus, Oliver G.; Kucharski, Adam J.; Busch, Michael P.; Dye, Christopher; Faria, Nuno Rodrigues

doi:10.1016/s0140-6736(21)00183-5

Cited by 789 publications

(786 citation statements)

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“…It is important to note that the high seroprevalence in December in Tirana was not followed by any decrease in infection rates, in January 2021. A similar phenomenon is observed in other populations with very high infection rate such as Manaus, Brazil (36). A number of factors, including newly discovered variants of SARS-COV-2, can influence the infection rate during 2021.…”

Section: Discussionsupporting

confidence: 85%

Rapid increase of SARS-CoV-2 seroprevalence during the 2020 pandemic year in the population of the city of Tirana, Albania

Sulçebe

Ylli

Cenko

et al. 2021

Preprint

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Introduction: While the identification of anti SARS-CoV-2 antibodies has been used to measure the hidden circulation of the COVID-19 in communities, there are few publications on the dynamics of SARS-CoV-2 seroprevalence during both waves of 2020. This study provides original data about the change in proportion of individuals showing immune response to COVID-19 between beginning of July and end of December 2020. Methods: The study was conducted in two rounds, 27 June -3 July, and 21-28 December 2020, using two independently selected samples of individuals 20-70 years old. Study participants were randomly selected from lists of the inhabitants of the catchment communities of four primary health care centers in Tirana City. Serological testing was performed by an ELISA method which determines IgG class antibodies anti S1 protein of SARS-CoV-2 virus. The validity of the method was tested in a sample of blood donors sera of 2018. Results: The proportion of individuals classified as seropositive during the first round, in early July was 7.5% (95% CI: 4.3% - 10.7%). The proportion rose sharply in the second round, by late December 2020, reaching 48.2% (95% CI: 44.8% - 51.7%). The same increasing pattern was observed in all studied categories. No statistical significance was found between men and women and between age categories. The prevalence of seropositive individuals was always significantly higher among those who reported symptoms and those who had done the molecular test. Conclusion: The ratio of total infected cases over confirmed cases was estimated to be higher than 10 to 1 in Albania. The rapid increase in SARS-CoV-2 seroprevalence observed in Tirana City may have been facilitated by a number of factors, including the very low infection exposure during the period March - May 2020, and the consecutive high susceptibility in population. Despite the observed high seroprevalence, one month after the study, COVID-19 incidence continued to increase in Tirana.

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Section: Discussionsupporting

confidence: 85%

Rapid increase of SARS-CoV-2 seroprevalence during the 2020 pandemic year in the population of the city of Tirana, Albania

Sulçebe

Ylli

Cenko

et al. 2021

Preprint

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“…It must, however, be noted that the concept of herd immunity has recently been challenged by resurgence of COVID-19 in Manaus, Brazil, a region in which seroprevalence data suggested that about 76% of the population had been infected with SARS-CoV-2 by October 2020. 28 It is unknown whether there was an error with over-estimation of the first wave seroprevalence, or the resurgence can be explained by the advent of a new strain (P1) that has a high propensity for re-infection. Careful monitoring for new strains and for their ability to evade existing natural immune responses and vaccine-induced immunity is needed.…”

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 re-infection risk in Austria

Pilz

Chakeri

Ioannidis

et al. 2021

Preprint

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Background: A key question concerning coronavirus disease 2019 (COVID-19) is how effective and long lasting immunity against this disease is in individuals who were previously infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to evaluate the risk of SARS-CoV-2 re-infections in the general population in Austria. Methods: This is a retrospective observational study using national SARS-CoV-2 infection data from the Austrian epidemiological reporting system. As the primary outcome, we aim to compare the odds of SARS-CoV-2 re-infections of COVID-19 survivors of the first wave (February to April 30, 2020) versus the odds of first infections in the remainder general population by tracking polymerase chain reaction (PCR)-confirmed infections of both groups during the second wave from September 1 to November 30, 2020. Re-infection counts are tentative, since it cannot be excluded that the positive PCR in the first and/or second wave might have been a false positive. Results: We recorded 40 tentative re-infections in 14,840 COVID-19 survivors of the first wave (0.27%) and 253,581 infections in 8,885,640 individuals of the remaining general population (2.85%) translating into an odds ratio (95% confidence interval) of 0.09 (0.07 to 0.13). Conclusions: We observed a relatively low re-infection rate of SARS-CoV-2 in Austria. Protection against SARS-CoV-2 after natural infection is comparable to the highest available estimates on vaccine efficacies. Further well-designed research on this issue is urgently needed for improving evidence-based decisions on public health measures and vaccination strategies.

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“…In mid-December 2020, the United Kingdom reported a SARS-CoV-2 variant termed B.1.1.7 (20I/501Y.V1) that exhibited a rapid increase in its range and incidence following its initial detection in November (Andrew Rambaut,Nick Loman,Oliver Pybus,Wendy Barclay,Jeff Barrett,Alesandro Carabelli,Tom Connor,Tom Peacock,David L Robertson,Erik Volz, Genomics Consortium UK (CoG-UK), 2020; Volz, Mishra, et al, 2021). Since then, additional "variants of concern" have emerged, namely lineages B.1.351 (20H/501Y.V2) from S Africa (Tegally et al, 2020) and P.1 (20J/501Y.V3) and P.2 from Brazil (Voloch et al, 2020;Faria et al, 2021;Naveca, da Costa, et al, 2021;Sabino et al, 2021). A key concern is that certain polymorphisms may enhance SARS-CoV-2 infectivity or transmission, akin to what was seen for Spike D614G (Korber et al, 2020;Volz, Hill, et al, 2021), which has overtaken the original D614 form of the virus that dominated at the outset of the pandemic.…”

Section: Introductionmentioning

confidence: 99%

Emergence in late 2020 of multiple lineages of SARS-CoV-2 Spike protein variants affecting amino acid position 677

Hodcroft

Domman

Snyder³

et al. 2021

Preprint

122

120

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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein (S) plays critical roles in host cell entry. Non-synonymous substitutions affecting S are not uncommon and have become fixed in a number of SARS-CoV-2 lineages. A subset of such mutations enable escape from neutralizing antibodies or are thought to enhance transmission through mechanisms such as increased affinity for the cell entry receptor, angiotensin-converting enzyme 2 (ACE2). Independent genomic surveillance programs based in New Mexico and Louisiana contemporaneously detected the rapid rise of numerous clade 20G (lineage B.1.2) infections carrying a Q677P substitution in S. The variant was first detected in the US on October 23, yet between 01 Dec 2020 and 19 Jan 2021 it rose to represent 27.8% and 11.3% of all SARS-CoV-2 genomes sequenced from Louisiana and New Mexico, respectively. Q677P cases have been detected predominantly in the south central and southwest United States; as of 03 Feb 2021, GISAID data show 499 viral sequences of this variant from the USA. Phylogenetic analyses revealed the independent evolution and spread of at least six distinct Q677H sub-lineages, with first collection dates ranging from mid-August to late November 2020. Four 677H clades from clade 20G (B.1.2), 20A (B.1.234), and 20B (B.1.1.220, and B.1.1.222) each contain roughly 100 or fewer sequenced cases, while a distinct pair of clade 20G clusters are represented by 754 and 298 cases, respectively. Although sampling bias and founder effects may have contributed to the rise of S:677 polymorphic variants, the proximity of this position to the polybasic cleavage site at the S1/S2 boundary are consistent with its potential functional relevance during cell entry, suggesting parallel evolution of a trait that may confer an advantage in spread or transmission. Taken together, our findings demonstrate simultaneous convergent evolution, thus providing an impetus to further evaluate S:677 polymorphisms for effects on proteolytic processing, cell tropism, and transmissibility.

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Resurgence of COVID-19 in Manaus, Brazil, despite high seroprevalence

Cited by 789 publications

References 14 publications

Rapid increase of SARS-CoV-2 seroprevalence during the 2020 pandemic year in the population of the city of Tirana, Albania

Rapid increase of SARS-CoV-2 seroprevalence during the 2020 pandemic year in the population of the city of Tirana, Albania

SARS-CoV-2 re-infection risk in Austria

Emergence in late 2020 of multiple lineages of SARS-CoV-2 Spike protein variants affecting amino acid position 677

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