Nationwide Seroprevalence of SARS-CoV-2 in Saudi Arabia

Abstract

BackgroundEstimated seroprevalence of Coronavirus Infectious Disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) is a critical evidence for a better evaluation of the virus spread and monitoring the progress of the COVID-19 pandemic in a population. In the Kingdom of Saudi Arabia (KSA), SARS-CoV-2 seroprevalence has been reported in specific regions, but an extensive nationwide study has not been reported. Here, we report a nationwide study to determine the prevalence of SARS-CoV-2 in the population of KSA during the pandemic, using serum samples from healthy blood donors, non-COVID patients and healthcare workers (HCWs) in six different regions of the kingdom, with addition samples from COVID-19 patients.MethodsA total of 11703 serum samples were collected from different regions of the KSA including; 5395 samples from residual healthy blood donors (D); 5877 samples from non-COVID patients collected through residual sera at clinical biochemistry labs from non-COVID patients (P); and 400 samples from consented HCWs. To determine the seroprevalence of SARS-CoV-2, all serum samples, in addition to positive control sera from RT-PCR confirmed COVID-19 patients, were subjected to in-house ELISA with a sample pooling strategy, which was further validated by testing individual samples that make up some of the pools, with a statistical estimation method to report seroprevalence estimatesResultsOverall (combining D and P groups) seroprevalence estimate was around 11% in Saudi Arabia; and was 5.1% (Riyadh), 1.5% (Jazan), 18.4% (Qassim), 20.8% (Hail), 14.7% (ER; Alahsa), and 18.8% in Makkah. Makkah samples were only D group and had a rate of 24.4% and 12.8% in the cities of Makkah and Jeddah, respectively. The seroprevalence in Saudi Arabia across the sampled areas would be 12 times the COVID-19 infection rate. Among HCWs, 7.5% (4.95-10.16 CI 95%) had reactive antibodies to SARS-CoV-2 without reporting any previously confirmed infection. This was higher in HCWs with hypertension. The study also presents the demographics and prevalence of co-morbidities in HCWs and subset of non-COVID-19 population.ConclusionOur study estimates the overall national serological prevalence of COVID-19 in Saudi Arabia to be 11%, with an apparent disparity between regions.

SARS-CoV-2 infections in 165 countries over time

“…To assess the accuracy of the above approach, the estimated cumulative infection fractions were compared to 22 previously published nationwide seroprevalence surveys across 14 countries (Supplemental Table S1) (Alharbi et al, 2021;Anand et al, 2020;Bogogiannidou et al, 2020;Espenhain et al, 2021;Hallal et al, 2020;Le Vu et al, 2021;Merkely et al, 2020;Murhekar et al, , 2021Nah et al, 2021;Poljak et al, 2021;Pollán et al, 2020;Reicher et al, 2021;Snoeck et al, 2020;Ward et al, 2020). Only surveys attempting to estimate nationwide seroprevalence in the general population (in particular, either using geographically or demographically stratified sampling or adjusting for sample demographics) were included.…”

Estimation of immune response (IgG) to SARS-COV2 (COVID-19) after the third COVID-19 wave in Egypt, A cross-sectional Study

“…When evaluating the risk of acquiring COVID-19 infection, we noticed neither precaution measures nor comorbid diseases had a role in this risk in our participants (Table 6). 7 To the best of our knowledge, our study was the only one that evaluated the COVID-19 seroprevalence in Egypt in 2021 after the third wave. However, three studies evaluated COVID-19 seroprevalence in Egypt in 2020.…”

“…3 The continuing increase in the number of COVID-19 is putting a strain on healthcare systems 6 So, it is essential to evaluate the extent of the exposure to the SARS-CoV-2 virus especially with the occurrence of a large number of asymptomatic infections. 7 Assessing the disease prevalence is critical in both screening and monitoring disease status. 8 There is an under-estimate in the diagnosis of COVID-19 cases using the polymerase chain reaction (PCR) worldwide because the mild and asymptomatic infections often go undetected.…”

“…9,16 However, more seroprevalence studies are needed to offer information that takes into account the diversity of specific populations, time of the sample, location, and kind of detected immune responses. 7 Several COVID-19-related comorbid diseases impair immune system function, which has an impact on COVID-19 responsiveness. 17 So, we evaluated the immune response to SARS-CoV-2 after the third wave of COVID-19 and assessed the effect of comorbid diseases on this immune response.…”

Comprehensive Survey of Using Machine Learning in the COVID-19 Pandemic

“…The situation has remained stable from 2004 till the appearance of another dangerous virus in 2102, known as the Middle East respiratory syndrome coronavirus (MERS-CoV) [ 6 ]. The MERS-CoV appeared firstly in patients with acute pneumonia in the Kingdom of Saudi Arabia (KSA) [ 7 , 8 ]. Although MERS-CoV has a lower spread rate than SARS, the rate of mortality among MERS-CoV patients was higher [ 9 ].…”