Population‐based prevalence surveys during the Covid‐19 pandemic: A systematic review

Abstract

Summary Population‐based prevalence surveys of Covid‐19 contribute to establish the burden of infection, the role of asymptomatic and mild infections in transmission, and allow more precise decisions about reopen policies. We performed a systematic review to evaluate qualitative aspects of these studies, assessing their reliability and compiling practices that can influence the methodological quality. We searched MEDLINE, EMBASE, bioRxiv and medRxiv, and included cross‐sectional studies using molecular and/or serological tests to estimate the prevalence of Covid‐19 in the general population. Survey quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies. A correspondence analysis correlated methodological parameters of each study to identify patterns related to higher, intermediate and lower risks of bias. The available data described 37 surveys from 19 countries. The majority were from Europe and America, used antibody testing, and reached highly heterogeneous sample sizes and prevalence estimates. Minority communities were disproportionately affected by Covid‐19. Important risk of bias was detected in four domains: sample size, data analysis with sufficient coverage, measurements in standard way and response rate. The correspondence analysis showed few consistent patterns for high risk of bias. Intermediate risk of bias was related to American and European studies, municipal and regional initiatives, blood samples and prevalence >1%. Low risk of bias was related to Asian studies, nationwide initiatives, reverse‐transcriptase polymerase chain reaction tests and prevalence <1%. We identified methodological standards applied worldwide in Covid‐19 prevalence surveys, which may assist researchers with the planning, execution and reporting of future population‐based surveys.

Reconciling estimates of global spread and infection fatality rates of COVID‐19: An overview of systematic evaluations

“…Nine potentially eligible articles were retrieved [1][2][3][5][6][7][8][9][10] And four were rejected (Figure 1). [7][8][9][10] One more eligible report 4 was identified from communication with experts. The six eligible evaluations are named after their first authors or team throughout the manuscript.…”

SARS-CoV-2 seroprevalence in a high-altitude setting in Peru: adult population-based cross-sectional study

“…However, a great proportion of individuals infected by SARS-CoV-2 virus remains undetected, especially in resource-constrained settings, as they usually are asymptomatic (Gandhi, Yokoe & Havlir, 2020), and there is a lack of appropriate access to diagnosis in the health care system, generating a gap in the information for appropriate decisions (Byambasuren et al, 2020;Eckerle & Meyer, 2020). To deal with these issues, multiple population-based surveys have been conducted around the world (Franceschi et al, 2020;Lai, Wang & Hsueh, 2020;Rostami et al, 2020), with divergent results as countries are in different epidemiological scenarios, i.e., beginning or end of the first pandemic wave, urban/rural areas, national/regional representation, or different diagnostic test used (molecular, antibody, or antigen detection tests). Even so, reported prevalence has usually been lower than 20% after the end of the first wave (Rostami et al, 2020).…”

Estimating SARS-CoV-2 prevalence from large-scale wastewater surveillance: insights from combined analysis of 44 sites in England

“…Estimates of SARS-CoV-2 infection prevalence are essential to understand COVID-19 disease burden and the impact of public health interventions (Franceschi et al, 2020;Lancet, 2020) (Pouwels et al, 2021). The sensitivity of surveillance for COVID-19 varies for several epidemiological, administrative, political and financial reasons, meaning that reported cases are likely to be an underestimate of actual cases (Noushad & Al-Saqqaf, 2021;Richterich, 2020;F.…”