Population-based prevalence surveys during the COVID-19 pandemic: a systematic review

Abstract

Population-based prevalence surveys of COVID-19 contribute to establish the burden and epidemiology 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, their reliability, and biases. The available data described 37 surveys from 19 countries, mostly from Europe and America and using antibody testing. They reached highly heterogeneous sample sizes and prevalence estimates. Disproportional prevalence was observed in minority communities. 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, blood samples and prevalence >1%. Low risk of bias was related to Asian studies, RT-PCR tests and prevalence <1%.

Community prevalence of SARS-CoV-2 in England from April to November, 2020: results from the ONS Coronavirus Infection Survey

“…According to findings of a systematic review of population-based prevalence surveys from 19 countries, 20 during the COVID-19 pandemic, two-thirds of studies (n=25 [68%]) reported only antibody testing, with many of those studies having a high risk of bias. The few PCR-based surveys (such as ours) were generally found to have a low risk of bias and, importantly, provide information about people currently infected and potentially able to transmit SARS-CoV-2.…”

“…The few PCR-based surveys (such as ours) were generally found to have a low risk of bias and, importantly, provide information about people currently infected and potentially able to transmit SARS-CoV-2. 20 …”

Serological evidence of human infection with SARS-CoV-2: a systematic review and meta-analysis

“…Several systematic reviews and meta-analyses of SARS-CoV-2 seroprevalence were identified but had limited scope and did not investigate important differences between subpopulations, quantitatively assess study quality, or estimate the infection-to-case ratio. [8][9][10][11][12] We did a systematic review and meta-analysis to summarise serological surveys for SARS-CoV-2 infections in humans; to comprehensively evaluate the study designs, laboratory methods, and outcome interpretations for each included serological study; and to estimate the risk of infections by populations with different presumed levels of exposure to SARS-CoV-2. We aim for these results to help inform decision makers and researchers as plans are made for the next phases of the global pandemic.…”

Population-based seroprevalence of SARS-CoV-2 antibodies in a high-altitude setting in Peru

“…However, a great proportion of individuals infected by the COVID-19 remains, especially in resource-constrained settings, as it is usually asymptomatic, 2 and there is a lack of appropriate access to diagnosis in the health care system, both generating a gap in the information for appropriate decisions. 3,4 To deal with these issues, multiple population-based surveys have been conducted around the world, 5-7 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 first wave.…”

“…Few studies have been carried out in low- and middle-income countries, including Latin American countries, 5-7 where because different social determinants (e.g. poverty levels, inequities, overcrowding, and a weak health system), a higher COVID-19 prevalence could be expected.…”