A Dual-Antigen Enzyme-Linked Immunosorbent Assay Allows the Assessment of Severe Acute Respiratory Syndrome Coronavirus 2 Antibody Seroprevalence in a Low-Transmission Setting

Hicks, Sarah M.; Pohl, Kai; Neeman, Teresa; McNamara, Hayley A.; Parsons, Kate M; He, Jin-Shu; Ali, Sidra Asad; Nazir, Samina; Rowntree, Louise C.; Nguyen, Thi H. O.; Kedzierska, Katherine; Doolan, Denise L.; Vinuesa, Carola G.; Cook, Matthew; Coatsworth, Nicholas; Myles, Paul S.; Kurth, Florian; Sander, Leif Erik; Mann, Graham J.; Gruen, Russell L.; George, Amee J.; Gardiner, Elizabeth E.; Cockburn, Ian A.

doi:10.1093/infdis/jiaa623

Cited by 18 publications

(16 citation statements)

References 15 publications

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“…We noted however, that the 13 participants in this study previously diagnosed with COVID-19 represented 21% of known EH HCW infections, whereas only seven percent of the overall workforce participated in our study. Our work mirrors a previous a sero-surveillance study of the general population in Australia and international studies which indicate that a significant proportion of infections are being missed by symptomatic or directed testing ( 7 , 13 , 14 ). Despite this, our study only identified three HCW with positive serology who had not previously been diagnosed by PCR testing.…”

Section: Discussionsupporting

confidence: 86%

“…Based on this sample, we determined the seroprevalence of SARS-CoV-2 antibodies in healthcare workers at Eastern Health to be 2.17%. This was higher than previous estimates of seroprevalence in the Australian community, which ranged from 0.15% to 0.79% ( 7 , 8 ), however, these figures, calculated from samples collected prior to the second wave of infections, likely underestimate community seroprevalence.…”

Section: Discussioncontrasting

confidence: 80%

“…We estimated that we would need a sample size of 768 to detect a difference of 2% between seroprevalence of high risk workers vs low risk workers with a power of 0.8, alpha of 0.05 and beta of 0.2. This was based on an estimated background seroprevalence in Australia of 1%( 7 , 8 ). The survey was hosted by the secure online database platform REDcap ( 9 , 10 ) and collected demographic details, including work site, and role within the organisation, questions about PCR proven infection and contact with a positive COVID-19 case.…”

Section: Methodsmentioning

confidence: 99%

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SARS-CoV-2 seroprevalence in healthcare workers in a tertiary healthcare network in Victoria, Australia

Lau

Buntine

Price

et al. 2021

Infection, Disease & Health

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Background Healthcare workers (HCW) are exposed to an increased risk of COVID-19 through direct contact with patients and patient environments. We calculated the; seroprevalence of SARS-CoV-2 in HCW at Eastern Health, a tertiary healthcare network in Victoria, and assessed associations with demographics, work location and role. Methods A cross-sectional cohort study of HCW at Eastern Health was conducted. Serum was analysed for the presence of antibodies to SARS-CoV-2, and all participants completed; an online survey collecting information on demographics, place of work, role, and exposures; to COVID-19. Seroprevalence was calculated as the proportion participants with SARS-CoV-2; antibodies out of all tested individuals. Results The crude seroprevalence of SARS-CoV-2 antibodies in this study was 2.17% (16/736). Thirteen of the 16 (81.2%) positive cases had previously been diagnosed with COVID-19 by PCR: the seroprevalence in the group not previously diagnosed with COVID by PCR was 0.42% (3/720). Having direct contact with COVID-19 patients did not increase the likelihood of having positive serology. A prior history of symptoms consistent with COVID-19 was associated with a higher likelihood of having positive serology (OR 17.2, p=0.006, 95%CI: 2.25-131.55). Conclusion Our calculated seroprevalence of 2.17% is higher than estimated in the general Australian population, but lower than that reported in HCW internationally. The; majority of those with positive serology in our study had previously been diagnosed with COVID-19 by PCR based testing. Seropositivity was not associated with interaction with COVID-19 positive patients, highlighting effective infection prevention and control practices within the workplace.

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Section: Discussionsupporting

confidence: 86%

Section: Discussioncontrasting

confidence: 80%

Section: Methodsmentioning

confidence: 99%

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SARS-CoV-2 seroprevalence in healthcare workers in a tertiary healthcare network in Victoria, Australia

Lau

Buntine

Price

et al. 2021

Infection, Disease & Health

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“…However, even with robust testing many cases will be undiagnosed, especially asymptomatic cases, which could constitute half of all infections [30]. A recent seroprevalence study of elective surgery patients in four states [31] estimated that the number of true infections was around 5-10 times the number of reported cases, although the authors state that the study cohort may not reflect the general population (older individuals overrepresented). This prevalence ratio gives an approximate IFR for Australia of 0.1-0.3%.…”

Section: Discussionmentioning

confidence: 99%

Estimating the Case Fatality Ratio for COVID-19 using a Time-Shifted Distribution Analysis

Thomas

Marks

2020

Preprint

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Estimating the case fatality ratio (CFR) for COVID-19 is an important aspect of public health. However, calculating CFR accurately is problematic early in a novel disease outbreak, due to uncertainties regarding the time course of disease and difficulties in diagnosis and reporting of cases. In this work, we present a simple method for calculating the case fatality ratio using only public case and death data over time by exploiting the correspondence between the time distributions of cases and deaths. The time-shifted distribution (TSD) analysis generates two parameters of interest: the delay time between reporting of cases and deaths and the case fatality ratio. These parameters converge reliably over time once the exponential growth phase has finished. Analysis is performed for early COVID 19 outbreaks in many countries, and we discuss corrections to CFR values using excess-death and seroprevalence data to estimate the infection fatality ratio (IFR). While CFR values range from 0.2-20% in different countries, estimates for IFR are mostly around 0.5-0.8% for countries that experienced moderate outbreaks and 1-3% for severe outbreaks. The simplicity and transparency of TSD analysis enhance its usefulness in characterizing a new disease as well as the state of the health and reporting systems.

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“…However, even with robust testing, many cases will be undiagnosed, especially asymptomatic cases, which could constitute half of all infections [ 35 ]. A recent seroprevalence study of elective surgery patients in four states [ 36 ] estimated that the number of true infections was around 5–10 times the number of reported cases, although the authors state that the study cohort may not reflect the general population (older individuals overrepresented). This prevalence ratio gives an approximate IFR for Australia of 0.1–0.3%.…”

Section: Estimating the Infection Fatality Ratio From The Cfrmentioning

confidence: 99%

Estimating the case fatality ratio for COVID-19 using a time-shifted distribution analysis

Thomas

Marks

2021

Epidemiol. Infect.

View full text Add to dashboard Cite

Estimating the case fatality ratio (CFR) for COVID-19 is an important aspect of public health. However, calculating CFR accurately is problematic early in a novel disease outbreak, due to uncertainties regarding the time course of disease and difficulties in diagnosis and reporting of cases. In this work, we present a simple method for calculating the case fatality ratio using only public case and death data over time by exploiting the correspondence between the time distributions of cases and deaths. The time-shifted distribution (TSD) analysis generates two parameters of interest: the delay time between reporting of cases and deaths and the case fatality ratio. These parameters converge reliably over time once the exponential growth phase has finished. Analysis is performed for early COVID-19 outbreaks in many countries, and we discuss corrections to CFR values using excess-death and seroprevalence data to estimate the infection fatality ratio (IFR). While CFR values range from 0.2-20% in different countries, estimates for IFR are mostly around 0.5-0.8% for countries that experienced moderate outbreaks and 1-3% for severe outbreaks. The simplicity and transparency of TSD analysis enhance its usefulness in characterizing a new disease as well as the state of the health and reporting systems.

show abstract

A Dual-Antigen Enzyme-Linked Immunosorbent Assay Allows the Assessment of Severe Acute Respiratory Syndrome Coronavirus 2 Antibody Seroprevalence in a Low-Transmission Setting

Cited by 18 publications

References 15 publications

SARS-CoV-2 seroprevalence in healthcare workers in a tertiary healthcare network in Victoria, Australia

SARS-CoV-2 seroprevalence in healthcare workers in a tertiary healthcare network in Victoria, Australia

Estimating the Case Fatality Ratio for COVID-19 using a Time-Shifted Distribution Analysis

Estimating the case fatality ratio for COVID-19 using a time-shifted distribution analysis

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