Estimates of prevalence of anti-SARS-CoV-2 antibodies among blood donors in eight provinces of South Africa in November 2021

Cable, Russel; Coleman, Charl; Glatt, Tanya Nadia; Grebe, Eduard; Mhlanga, Laurette; Nyano, Cynthia; Pieterson, Nadia; Swanevelder, Ronél; Swarts, Avril; Sykes, Wendy; Berg, Karin van den; Vermeulen, Marion; Welte, Alex

doi:10.21203/rs.3.rs-1359658/v1

Cited by 12 publications

(13 citation statements)

References 5 publications

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“…Since the commencement of this study, other SARS-CoV-2 seroprevalence studies assessing infection-induced antibodies have been published. 20 , 21 However, these studies do not link data to national health registers or calculate IFRs.…”

Section: Discussionmentioning

confidence: 99%

Seroprevalence and infection fatality rate of the SARS-CoV-2 Omicron variant in Denmark: A nationwide serosurveillance study

Erikstrup¹,

Laksafoss²,

Gladov³

et al. 2022

The Lancet Regional Health - Europe

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Section: Discussionmentioning

confidence: 99%

Seroprevalence and infection fatality rate of the SARS-CoV-2 Omicron variant in Denmark: A nationwide serosurveillance study

Erikstrup¹,

Laksafoss²,

Gladov³

et al. 2022

The Lancet Regional Health - Europe

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“…The reduced mortality in the Omicron BA.4/BA.5 wave was more specifically presumed to be related to the high prevalence of humoral and cell-mediated immunity in South Africa. Studies of humoral immunity reported SARS-CoV-2 antibody sero-prevalence estimates of 71% (26) and 73% (3) before the Omicron BA.1/BA.2 wave, while estimates after the Omicron BA.1/BA.2 wave but just before the Omicron BA.4/BA.5 wave were 97% (27) and 91% (28). The latter serosurvey indicated that 61% of individuals had serological evidence of SARS-CoV-2 infection during the Omicron BA.1/BA.2 wave in South Africa (28).…”

Section: Discussionmentioning

confidence: 99%

Trends in Cases, Hospitalisation and Mortality Related to the Omicron BA.4/BA.5 Sub-Variants in South Africa

Jassat

Karim

Ozougwu

et al. 2022

Preprint

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Introduction: The Omicron BA.1/BA.2 wave in South Africa had lower hospitalisation and mortality than previous SARS-CoV-2 variants and was followed by an Omicron BA.4/BA.5 wave. This study compared admission incidence risk across waves, and the risk of mortality in the Omicron BA.4/BA.5 wave, to the Omicron BA.1/BA.2 and Delta waves. Methods: Data from South Africa's national hospital surveillance system, SARS-CoV-2 case linelist and Electronic Vaccine Data System were linked and analysed. Wave periods were defined when the country passed a weekly incidence of 30 cases/100,000 people. Mortality rates in the Delta, Omicron BA.1/BA.2 and Omicron BA.4/BA.5 wave periods were compared by post-imputation random effect multivariable logistic regression models. Results: In-hospital deaths declined 6-fold from 37,537 in the Delta wave to 6,074 in the Omicron BA.1/BA.2 wave and a further 7-fold to 837 in the Omicron BA.4/BA.5 wave. The case fatality ratio (CFR) was 25.9% (N=144,798), 10.9% (N=55,966) and 7.1% (N=11,860) in the Delta, Omicron BA.1/BA.2, and Omicron BA.4/BA.5 waves respectively. After adjusting for age, sex, race, comorbidities, health sector and province, compared to the Omicron BA.4/BA.5 wave, patients had higher risk of mortality in the Omicron BA.1/BA.2 wave (adjusted odds ratio [aOR] 1.43; 95% confidence interval [CI] 1.32-1.56) and Delta (aOR 3.22; 95% CI 2.98-3.49) wave. Being partially vaccinated (aOR 0.89, CI 0.86-0.93), fully vaccinated (aOR 0.63, CI 0.60-0.66) and boosted (aOR 0.31, CI 0.24-0.41); and prior laboratory-confirmed infection (aOR 0.38, CI 0.35-0.42) were associated with reduced risks of mortality. Conclusion: Overall, admission incidence risk and in-hospital mortality, which had increased progressively in South Africa's first three waves, decreased in the fourth Omicron BA.1/BA.2 wave and declined even further in the fifth Omicron BA.4/BA.5 wave. Mortality risk was lower in those with natural infection and vaccination, declining further as the number of vaccine doses increased.

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“…Increased testing in those with severe COVID-19 disease also likely attenuated the associations of mortality with the indicators of HIV control [27][28][29]. While we could not distinguish between deaths due to COVID-19 per se, and those where the SARS-CoV-2 diagnosis was incidental in a patient with an alternative primary cause of death, to mitigate against this, we restricted our primary analysis to the first three waves and an analysis of deaths in admitted patients showed that the vast majority of patients dying with SARS-COV-2 in this period did have COVID-19 pneumonia [18].…”

Section: Discussionmentioning

confidence: 99%

COVID-19 among adults living with HIV: Correlates of mortality in a general population in a resource-limited setting

Kassanjee

Davies

Ngwenya

et al. 2022

Preprint

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Introduction: While a large proportion of people with HIV (PWH) have experienced SARS-CoV-2 infections, there is uncertainty about the role of HIV disease severity on COVID-19 outcomes, especially in lower income settings. We studied the association between mortality and characteristics of HIV severity and management, and vaccination, among adult PWH. Methods: We analysed observational cohort data on all PWH aged ≥15 years experiencing a diagnosed SARS-CoV-2 infection (until March 2022), who accessed public sector healthcare in the Western Cape province of South Africa. Logistic regression was used to study the association of mortality with CD4 cell count, viral load, evidence of ART, time since first HIV evidence, and vaccination, adjusting for demographic characteristics, comorbidities, admission pressure, location and time period. Results: Mortality occurred in 5.7% (95% CI: 5.3,6.0) of 17 831 first diagnosed infections. Higher mortality was associated with lower recent CD4, no evidence of ART collection, high or unknown recent viral load (among those with ART evidence), and recent first HIV evidence, differentially by age. Vaccination was protective. The burden of comorbidities was high, and tuberculosis, chronic kidney disease, diabetes and hypertension were associated with higher mortality, more strongly in younger adults. Conclusions: Mortality was strongly associated with suboptimal HIV control, and prevalence of these risk factors increased in later COVID-19 waves. It remains a public health priority to ensure PWH are on suppressive ART and vaccinated, and manage any disruptions in care that occurred during the pandemic. The diagnosis and management of comorbidities, including for tuberculosis, should be optimised.

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Estimates of prevalence of anti-SARS-CoV-2 antibodies among blood donors in eight provinces of South Africa in November 2021

Cited by 12 publications

References 5 publications

Seroprevalence and infection fatality rate of the SARS-CoV-2 Omicron variant in Denmark: A nationwide serosurveillance study

Seroprevalence and infection fatality rate of the SARS-CoV-2 Omicron variant in Denmark: A nationwide serosurveillance study

Trends in Cases, Hospitalisation and Mortality Related to the Omicron BA.4/BA.5 Sub-Variants in South Africa

COVID-19 among adults living with HIV: Correlates of mortality in a general population in a resource-limited setting

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