Seroprevalence of SARS-CoV-2-specific IgG antibodies in Kashmir, India, 7 months after the first reported local COVID-19 case: results of a population-based seroprevalence survey from October to November 2020

Khan, S. Muhammad Salim; Qurieshi, Mariya Amin; Haq, Inaamul; Majid, Sabhiya; Ahmad, Javeed; Ayub, Taha; Bhat, Ashfaq Ahmad; Fazili, Anjum; Ganai, A.M.; Jan, Yasmeen; Kaul, Rauf-ur-Rashid; Khan, Zahid Ali; Masoodi, Muneer Ahmad; Mushtaq, Bushra; Nazir, Fouzia; Nazir, Mudasir; Raja, Malik Waseem; Rasool, Mahbooba; Anjum, Asma; Ayoub, Shifana; Aziz, Munazza; Bhat, Arif Akbar; Chowdri, Iqra Nisar; Ismail, Shaista; Kawoosa, Misbah Ferooz; Khan, Mohammad Ashraf; Khan, Mosin Saleem; Kousar, Rafiya; Lone, Ab Aziz; Nabi, Syed Ashfaq; Obaid, Mohammad; Qazi, Tanzeela Bashir; Sabah, Iram; Sumji, Ishtiyaq Ahmad

doi:10.1136/bmjopen-2021-053791

Cited by 7 publications

(2 citation statements)

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“…In Jammu and Kashmir, the northernmost part of India, a total of 4,398 deaths and 323,499 confirmed cases of COVID-19 were reported by the end of the second wave since the beginning of the outbreak, with more than 60% of cases and around 50% of deaths occurring only from Kashmir division ( 1 , 4 ). In October-November 2020, the first pan-Kashmir serosurveillance study found a seroprevalence of 36.7% among the general population aged more than 18 years ( 5 ). Since the start of the pandemic, the lockdown was imposed in Kashmir with periodic systematic relaxations.…”

Section: Introductionmentioning

confidence: 99%

Seroprevalence of SARS-CoV-2-specific anti-spike IgM, IgG, and anti-nucleocapsid IgG antibodies during the second wave of the pandemic: A population-based cross-sectional survey across Kashmir, India

Lone

Khan

Qurieshi

et al. 2022

Front. Public Health

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BackgroundWithin Kashmir, which is one of the topographically distinct areas in the Himalayan belt of India, a total of 2,236 cumulative deaths occurred by the end of the second wave. We aimed to conduct this population-based study in the age group of 7 years and above to estimate the seropositivity and its attributes in Kashmir valley.MethodsWe conducted a community-based household-level cross-sectional study, with a multistage, population-stratified, probability-proportionate-to-size, cluster sampling method to select 400 participants from each of the 10 districts of Kashmir. We also selected a quota of healthcare workers, police personnel, and antenatal women from each of the districts. Households were selected from each cluster and all family members with age 7 years or more were invited to participate. Information was collected through a standardized questionnaire and entered into Epicollect 5 software. Trained healthcare personnel were assigned for collecting venous blood samples from each of the participants which were transferred and processed for immunological testing. Testing was done for the presence of SARS-CoV-2-specific anti-spike IgM, IgG antibodies, and anti-nucleocapsid IgG antibodies. Weighted seropositivity was estimated along with the adjustment done for the sensitivity and specificity of the test used.FindingsThe data were collected from a total of 4,229 participants from the general population within the 10 districts of Kashmir. Our results showed that 84.84% (95% CI 84.51–85.18%) of the participants were seropositive in the weighted imputed data among the general population. In multiple logistic regression, the variables significantly affecting the seroprevalence were the age group 45–59 years (odds ratio of 0.73; 95% CI 0.67–0.78), self-reported history of comorbidity (odds ratio of 1.47; 95% CI 1.33–1.61), and positive vaccination history (odds ratio of 0.85; 95% CI 0.79–0.90) for anti-nucleocapsid IgG antibodies. The entire assessed variables showed a significant role during multiple logistic regression analysis for affecting IgM anti-spike antibodies with an odds ratio of 1.45 (95% CI 1.32–1.57) for age more than 60 years, 1.21 (95% CI 1.15–1.27) for the female gender, 0.87 (95% CI 0.82–0.92) for urban residents, 0.86 (95% CI 0.76–0.92) for self-reported comorbidity, and an odds ratio of 1.16 (95% CI 1.08–1.24) for a positive history of vaccination. The estimated infection fatality ratio was 0.033% (95% CI: 0.034–0.032%) between 22 May and 31 July 2021 against the seropositivity for IgM antibodies.InterpretationDuring the second wave of the SARS-CoV-2 pandemic, 84.84% (95% CI 84.51–85.18%) of participants from this population-based cross-sectional sample were seropositive against SARS-CoV-2. Despite a comparatively lower number of cases reported and lower vaccination coverage in the region, our study found such high seropositivity across all age groups, which indicates the higher number of subclinical and less severe unnoticed caseload in the community.

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Section: Introductionmentioning

confidence: 99%

Seroprevalence of SARS-CoV-2-specific anti-spike IgM, IgG, and anti-nucleocapsid IgG antibodies during the second wave of the pandemic: A population-based cross-sectional survey across Kashmir, India

Lone

Khan

Qurieshi

et al. 2022

Front. Public Health

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“…The asymptomatic transmission in the community coupled with the high exposure ratio questions the utility of contact tracing and surveillance measures. Therefore, mitigation strategies to target individuals with risk factors for severe disease, such as medical co-morbidities and the elderly, might be more pragmatic and effective (Khan et al, 2021).…”

Section: 2021)asmentioning

confidence: 99%

Community seroprevalence and risk factors for SARS-CoV-2 infection in different subpopulations in Vellore, India, and their implications for future prevention

Dayanand

Irudhayanathan

Kundu

et al. 2022

International Journal of Infectious Diseases

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Objectives To inform public health policy decisions through assessment of IgG antibody seroprevalence in the population and the risk factors for SARS-CoV-2 infection. Methods We estimated the seroprevalence of IgG antibodies among different subpopulations at the end of the first and second waves of the pandemic. We also assessed various risk factors associated with the seropositivity including socio demography, IgG antibodies against endemic human coronavirus and vaccination status. Results Of the 2433 consented participants, the overall estimated seroprevalence at the end of first and second waves were 28.5% (95% CI:22.3%-33.7%) and 71.5% (95% CI:62.8%-80.5%), respectively. The accrual of IgG positivity was heterogeneous, with highest seroprevalence among the urban slum population(75.1%). Vaccine uptake was varied among the subpopulations, with low rates (<10%) among the rural and urban slums. The majority of seropositive individuals (75%) were asymptomatic. Residence in urban slums (OR 2.02; 95% CI:1.57-2.6; p<0.001), middle socioeconomic status (OR 1.77; 95% CI:1.17-2.67; p=0.007), presence of diabetes (OR 1.721; 95% CI:1.148-2.581; p=0.009), and hypertension (OR 1.75; 95% CI:1.16-2.64; p=0.008) were associated with seropositivity on multivariable analyses. Conclusion Although considerable population immunity has been reached with more than two-thirds seropositivity, improved vaccination strategies among unreached subpopulations and high-risk individuals are suggested for better preparedness in future.

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Assessing the Burden of COVID-19 in Developing Countries: Systematic Review, Meta-Analysis, and Public Policy Implications

Owusu‐Boaitey

Pugh

Fosdick

et al. 2021

Preprint

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Introduction The infection fatality rate (IFR) of COVID-19 has been carefully measured and analyzed in high-income countries, whereas there has been no systematic analysis of age-specific seroprevalence or IFR for developing countries. Indeed, it has been suggested that the death rate in developing countries may be far lower than in high-income countries - an outcome that would be starkly different from the typical pattern for many other infectious diseases. Methods We systematically reviewed the literature to identify all serology studies in developing countries that were conducted using representative samples of specimens collected by early 2021. For each of the antibody assays used in these serology studies, we identified data on assay characteristics, including the extent of seroreversion over time. We analyzed the serology data using a Bayesian model that incorporates conventional sampling uncertainty as well as uncertainties about assay sensitivity and specificity. We then calculated IFRs using individual case reports or aggregated public health updates, including age-specific estimates whenever feasible. Results Seroprevalence in many developing country locations was markedly higher than in high-income countries but still far short of herd immunity. In most locations, seroprevalence among older adults was similar to that of younger age-groups. Age-specific IFRs were 1.3-2.5x higher than in high-income countries. The median value of population IFR was 0.5% among developing countries with satisfactory death reporting as of 2016, compared to a median of 0.05% for other developing countries. Conclusion The burden of COVID-19 is far higher in developing countries than in high-income countries, reflecting a combination of elevated transmission to middle-aged and older adults as well as limited access to adequate healthcare. These results underscore the critical need to accelerate the provision of vaccine doses to vulnerable populations in developing countries.

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Seroprevalence of SARS-CoV-2-specific IgG antibodies in Kashmir, India, 7 months after the first reported local COVID-19 case: results of a population-based seroprevalence survey from October to November 2020

Cited by 7 publications

References 38 publications

Seroprevalence of SARS-CoV-2-specific anti-spike IgM, IgG, and anti-nucleocapsid IgG antibodies during the second wave of the pandemic: A population-based cross-sectional survey across Kashmir, India

Seroprevalence of SARS-CoV-2-specific anti-spike IgM, IgG, and anti-nucleocapsid IgG antibodies during the second wave of the pandemic: A population-based cross-sectional survey across Kashmir, India

Community seroprevalence and risk factors for SARS-CoV-2 infection in different subpopulations in Vellore, India, and their implications for future prevention

Assessing the Burden of COVID-19 in Developing Countries: Systematic Review, Meta-Analysis, and Public Policy Implications

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