Comparison of seroprevalence of SARS-CoV-2 infections with cumulative and imputed COVID-19 cases: Systematic review

Byambasuren, Oyungerel; Dobler, Claudia C.; Bell, Katy J.L.; Rojas, Diana Patricia; Clark, Justin; McLaws, Mary Louise; Glasziou, Paul

doi:10.1371/journal.pone.0248946

Cited by 84 publications

(97 citation statements)

References 38 publications

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“…This level of under-ascertainment suggests that confirmed SARS-CoV-2 infections are a poor indicator of the extent of infection spread, even in high-income countries where testing has been more widely available. The broad range of ratios mirrors estimates from other published evidence on case under-ascertainment, which suggests a range of 0.56 to 717 [49,50].…”

Section: Plos Onesupporting

confidence: 75%

Global seroprevalence of SARS-CoV-2 antibodies: A systematic review and meta-analysis

et al. 2021

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Background Many studies report the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies. We aimed to synthesize seroprevalence data to better estimate the level and distribution of SARS-CoV-2 infection, identify high-risk groups, and inform public health decision making. Methods In this systematic review and meta-analysis, we searched publication databases, preprint servers, and grey literature sources for seroepidemiological study reports, from January 1, 2020 to December 31, 2020. We included studies that reported a sample size, study date, location, and seroprevalence estimate. We corrected estimates for imperfect test accuracy with Bayesian measurement error models, conducted meta-analysis to identify demographic differences in the prevalence of SARS-CoV-2 antibodies, and meta-regression to identify study-level factors associated with seroprevalence. We compared region-specific seroprevalence data to confirmed cumulative incidence. PROSPERO: CRD42020183634. Results We identified 968 seroprevalence studies including 9.3 million participants in 74 countries. There were 472 studies (49%) at low or moderate risk of bias. Seroprevalence was low in the general population (median 4.5%, IQR 2.4–8.4%); however, it varied widely in specific populations from low (0.6% perinatal) to high (59% persons in assisted living and long-term care facilities). Median seroprevalence also varied by Global Burden of Disease region, from 0.6% in Southeast Asia, East Asia and Oceania to 19.5% in Sub-Saharan Africa (p<0.001). National studies had lower seroprevalence estimates than regional and local studies (p<0.001). Compared to Caucasian persons, Black persons (prevalence ratio [RR] 3.37, 95% CI 2.64–4.29), Asian persons (RR 2.47, 95% CI 1.96–3.11), Indigenous persons (RR 5.47, 95% CI 1.01–32.6), and multi-racial persons (RR 1.89, 95% CI 1.60–2.24) were more likely to be seropositive. Seroprevalence was higher among people ages 18–64 compared to 65 and over (RR 1.27, 95% CI 1.11–1.45). Health care workers in contact with infected persons had a 2.10 times (95% CI 1.28–3.44) higher risk compared to health care workers without known contact. There was no difference in seroprevalence between sex groups. Seroprevalence estimates from national studies were a median 18.1 times (IQR 5.9–38.7) higher than the corresponding SARS-CoV-2 cumulative incidence, but there was large variation between Global Burden of Disease regions from 6.7 in South Asia to 602.5 in Sub-Saharan Africa. Notable methodological limitations of serosurveys included absent reporting of test information, no statistical correction for demographics or test sensitivity and specificity, use of non-probability sampling and use of non-representative sample frames. Discussion Most of the population remains susceptible to SARS-CoV-2 infection. Public health measures must be improved to protect disproportionately affected groups, including racial and ethnic minorities, until vaccine-derived herd immunity is achieved. Improvements in serosurvey design and reporting are needed for ongoing monitoring of infection prevalence and the pandemic response.

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Section: Plos Onesupporting

confidence: 75%

Global seroprevalence of SARS-CoV-2 antibodies: A systematic review and meta-analysis

et al. 2021

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“…La carga de infectados o enfermos, incluye tanto los que fallecen como los que sobreviven, y no equivale a seroprevalencia (22,23).…”

Section: R E V F a C M E Dunclassified

Reflexiones críticas sobre el Índice de resiliencia epidemiológica municipal utilizado para la toma de decisiones de política pública en el control de la pandemia por COVID-19 en Colombia

et al. 2021

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El 2 de junio de 2021, el Ministerio de Salud y Protección Social de Colombia expidió la Resolución 777, mediante la cual se determinan las condiciones para el reinicio de todas las actividades económicas y sociales restringidas y se define el Índice de resiliencia epidemiológica municipal (IREM) como la herramienta para apoyar las decisiones relacionadas con esta reactivación económica, en medio del tercer pico epidémico de la COVID-19 en el país. El objetivo de este artículo es hacer un análisis crítico de los aspectos técnicos del IREM y explorar la conveniencia de su implementación como soporte del reinicio de las actividades económicas y sociales propuesto en la resolución. Dentro de este análisis crítico se destaca la falta de una clara definición de resiliencia epidemiológica que se ajuste a la literatura científica. Además, se cuestiona tanto la validez de apariencia, contenido y de constructo del índice global, como la validez del constructo de sus dimensiones y, por tanto, la pertinencia de usarlo como herramienta para definir dicho reinicio.

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“…Herd immunity is still not foreseeable in many countries of the world as seroprevalence population surveys reveal antibodies as low as 10–15% [ 20 ] and herd immunity cannot be predicted till more than half of the population gets the disease [ 21 ]. Herd immunity against a contagious disease like COVID-19 could be achieved when 70–90% of the population becomes immune due to mass scale vaccination or exposure to infection [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2: big seroprevalence data from Pakistan—is herd immunity at hand?

Haq

Rehman

Ahmad³

et al. 2021

Infection

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Purpose Seroprevalence surveys from different countries have reported SARS CoV-2 antibodies below 20% even in the most adversely affected areas and herd immunity cannot be predicted till more than half of the population gets the disease. The purpose of this survey was to estimate the magnitude of community-based spread of the infection, associated immunity, and the future prospects and proximity to a 'herd community'. Methods The study was undertaken as a cluster randomized, cross-sectional countrywide survey. This largest communitybased seroprevalence data of SARS-CoV-2 were collected between 15th and 31st July, 2020 from seven randomly selected cities belonging to the three most populous provinces of Pakistan. The FDA approved kit of ROCHE was used for detection of SARS-CoV-2 antibodies. Results Serum samples of 15,390 participants were tested for SARS CoV-2 antibodies with an overall seroprevalence of 42.4%. The seroprevalence ranged from 31.1% to 48.1% in different cities with the highest in Punjab province (44.5%). In univariable analysis, the odds of seropositivity was higher in men compared to women (OR: 1.10, 95% CI: 1.01-1.19, P < 0.05). In multivariable analysis, the risk of being seropositive was lower (OR 0.72, 95% CI: 0.60-0.87, P < 0.01) in younger group (≤ 20 years) than in those aged above 60 years. ConclusionThe study concluded that despite a reasonable seroprevalence, the country is yet to reach the base minimum of estimations for herd immunity. The durability of immunity though debated at the moment, has shown an evidenced informed shift towards longer side.

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Comparison of seroprevalence of SARS-CoV-2 infections with cumulative and imputed COVID-19 cases: Systematic review

Cited by 84 publications

References 38 publications

Global seroprevalence of SARS-CoV-2 antibodies: A systematic review and meta-analysis

Global seroprevalence of SARS-CoV-2 antibodies: A systematic review and meta-analysis

Reflexiones críticas sobre el Índice de resiliencia epidemiológica municipal utilizado para la toma de decisiones de política pública en el control de la pandemia por COVID-19 en Colombia

SARS-CoV-2: big seroprevalence data from Pakistan—is herd immunity at hand?

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