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Vaughan A, Duffell E, Freidl GS, Lemos DS, Nardone A, Valenciano M, Subissi L, Bergeri I, K Broberg E, Penttinen P, Pebody R, Keramarou M. Systematic review of seroprevalence of SARS-CoV-2 antibodies and appraisal of evidence, prior to the widespread introduction of vaccine programmes in the WHO European Region, January-December 2020. BMJ Open 2023; 13:e064240. [PMID: 37931969 PMCID: PMC10632881 DOI: 10.1136/bmjopen-2022-064240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 09/04/2023] [Indexed: 11/08/2023] Open
Abstract
OBJECTIVES Systematic review of SARS-CoV-2 seroprevalence studies undertaken in the WHO European Region to measure pre-existing and cumulative seropositivity prior to the roll out of vaccination programmes. DESIGN A systematic review of the literature. DATA SOURCES We searched MEDLINE, EMBASE and the preprint servers MedRxiv and BioRxiv in the WHO 'COVID-19 Global literature on coronavirus disease' database using a predefined search strategy. Articles were supplemented with unpublished WHO-supported Unity-aligned seroprevalence studies and other studies reported directly to WHO Regional Office for Europe and European Centre for Disease Prevention and Control. ELIGIBILITY CRITERIA Studies published before the widespread implementation of COVID-19 vaccination programmes in January 2021 among the general population and blood donors, at national and regional levels. DATA EXTRACTION AND SYNTHESIS At least two independent researchers extracted the eligible studies; a third researcher resolved any disagreements. Study risk of bias was assessed using a quality scoring system based on sample size, sampling and testing methodologies. RESULTS In total, 111 studies from 26 countries published or conducted between 1 January 2020 and 31 December 2020 across the WHO European Region were included. A significant heterogeneity in implementation was noted across the studies, with a paucity of studies from the east of the Region. Sixty-four (58%) studies were assessed to be of medium to high risk of bias. Overall, SARS-CoV-2 seropositivity prior to widespread community circulation was very low. National seroprevalence estimates after circulation started ranged from 0% to 51.3% (median 2.2% (IQR 0.7-5.2%); n=124), while subnational estimates ranged from 0% to 52% (median 5.8% (IQR 2.3%-12%); n=101), with the highest estimates in areas following widespread local transmission. CONCLUSIONS The low levels of SARS-CoV-2 antibody in most populations prior to the start of vaccine programmes underlines the critical importance of targeted vaccination of priority groups at risk of severe disease, while maintaining reduced levels of transmission to minimise population morbidity and mortality.
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Affiliation(s)
- Aisling Vaughan
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Erika Duffell
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Gudrun S Freidl
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Diogo Simão Lemos
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | | | | | | | | | - Eeva K Broberg
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Pasi Penttinen
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Richard Pebody
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Maria Keramarou
- European Centre for Disease Prevention and Control, Solna, Sweden
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Fox T, Geppert J, Dinnes J, Scandrett K, Bigio J, Sulis G, Hettiarachchi D, Mathangasinghe Y, Weeratunga P, Wickramasinghe D, Bergman H, Buckley BS, Probyn K, Sguassero Y, Davenport C, Cunningham J, Dittrich S, Emperador D, Hooft L, Leeflang MM, McInnes MD, Spijker R, Struyf T, Van den Bruel A, Verbakel JY, Takwoingi Y, Taylor-Phillips S, Deeks JJ. Antibody tests for identification of current and past infection with SARS-CoV-2. Cochrane Database Syst Rev 2022; 11:CD013652. [PMID: 36394900 PMCID: PMC9671206 DOI: 10.1002/14651858.cd013652.pub2] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The diagnostic challenges associated with the COVID-19 pandemic resulted in rapid development of diagnostic test methods for detecting SARS-CoV-2 infection. Serology tests to detect the presence of antibodies to SARS-CoV-2 enable detection of past infection and may detect cases of SARS-CoV-2 infection that were missed by earlier diagnostic tests. Understanding the diagnostic accuracy of serology tests for SARS-CoV-2 infection may enable development of effective diagnostic and management pathways, inform public health management decisions and understanding of SARS-CoV-2 epidemiology. OBJECTIVES To assess the accuracy of antibody tests, firstly, to determine if a person presenting in the community, or in primary or secondary care has current SARS-CoV-2 infection according to time after onset of infection and, secondly, to determine if a person has previously been infected with SARS-CoV-2. Sources of heterogeneity investigated included: timing of test, test method, SARS-CoV-2 antigen used, test brand, and reference standard for non-SARS-CoV-2 cases. SEARCH METHODS The COVID-19 Open Access Project living evidence database from the University of Bern (which includes daily updates from PubMed and Embase and preprints from medRxiv and bioRxiv) was searched on 30 September 2020. We included additional publications from the Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre) 'COVID-19: Living map of the evidence' and the Norwegian Institute of Public Health 'NIPH systematic and living map on COVID-19 evidence'. We did not apply language restrictions. SELECTION CRITERIA We included test accuracy studies of any design that evaluated commercially produced serology tests, targeting IgG, IgM, IgA alone, or in combination. Studies must have provided data for sensitivity, that could be allocated to a predefined time period after onset of symptoms, or after a positive RT-PCR test. Small studies with fewer than 25 SARS-CoV-2 infection cases were excluded. We included any reference standard to define the presence or absence of SARS-CoV-2 (including reverse transcription polymerase chain reaction tests (RT-PCR), clinical diagnostic criteria, and pre-pandemic samples). DATA COLLECTION AND ANALYSIS We use standard screening procedures with three reviewers. Quality assessment (using the QUADAS-2 tool) and numeric study results were extracted independently by two people. Other study characteristics were extracted by one reviewer and checked by a second. We present sensitivity and specificity with 95% confidence intervals (CIs) for each test and, for meta-analysis, we fitted univariate random-effects logistic regression models for sensitivity by eligible time period and for specificity by reference standard group. Heterogeneity was investigated by including indicator variables in the random-effects logistic regression models. We tabulated results by test manufacturer and summarised results for tests that were evaluated in 200 or more samples and that met a modification of UK Medicines and Healthcare products Regulatory Agency (MHRA) target performance criteria. MAIN RESULTS We included 178 separate studies (described in 177 study reports, with 45 as pre-prints) providing 527 test evaluations. The studies included 64,688 samples including 25,724 from people with confirmed SARS-CoV-2; most compared the accuracy of two or more assays (102/178, 57%). Participants with confirmed SARS-CoV-2 infection were most commonly hospital inpatients (78/178, 44%), and pre-pandemic samples were used by 45% (81/178) to estimate specificity. Over two-thirds of studies recruited participants based on known SARS-CoV-2 infection status (123/178, 69%). All studies were conducted prior to the introduction of SARS-CoV-2 vaccines and present data for naturally acquired antibody responses. Seventy-nine percent (141/178) of studies reported sensitivity by week after symptom onset and 66% (117/178) for convalescent phase infection. Studies evaluated enzyme-linked immunosorbent assays (ELISA) (165/527; 31%), chemiluminescent assays (CLIA) (167/527; 32%) or lateral flow assays (LFA) (188/527; 36%). Risk of bias was high because of participant selection (172, 97%); application and interpretation of the index test (35, 20%); weaknesses in the reference standard (38, 21%); and issues related to participant flow and timing (148, 82%). We judged that there were high concerns about the applicability of the evidence related to participants in 170 (96%) studies, and about the applicability of the reference standard in 162 (91%) studies. Average sensitivities for current SARS-CoV-2 infection increased by week after onset for all target antibodies. Average sensitivity for the combination of either IgG or IgM was 41.1% in week one (95% CI 38.1 to 44.2; 103 evaluations; 3881 samples, 1593 cases), 74.9% in week two (95% CI 72.4 to 77.3; 96 evaluations, 3948 samples, 2904 cases) and 88.0% by week three after onset of symptoms (95% CI 86.3 to 89.5; 103 evaluations, 2929 samples, 2571 cases). Average sensitivity during the convalescent phase of infection (up to a maximum of 100 days since onset of symptoms, where reported) was 89.8% for IgG (95% CI 88.5 to 90.9; 253 evaluations, 16,846 samples, 14,183 cases), 92.9% for IgG or IgM combined (95% CI 91.0 to 94.4; 108 evaluations, 3571 samples, 3206 cases) and 94.3% for total antibodies (95% CI 92.8 to 95.5; 58 evaluations, 7063 samples, 6652 cases). Average sensitivities for IgM alone followed a similar pattern but were of a lower test accuracy in every time slot. Average specificities were consistently high and precise, particularly for pre-pandemic samples which provide the least biased estimates of specificity (ranging from 98.6% for IgM to 99.8% for total antibodies). Subgroup analyses suggested small differences in sensitivity and specificity by test technology however heterogeneity in study results, timing of sample collection, and smaller sample numbers in some groups made comparisons difficult. For IgG, CLIAs were the most sensitive (convalescent-phase infection) and specific (pre-pandemic samples) compared to both ELISAs and LFAs (P < 0.001 for differences across test methods). The antigen(s) used (whether from the Spike-protein or nucleocapsid) appeared to have some effect on average sensitivity in the first weeks after onset but there was no clear evidence of an effect during convalescent-phase infection. Investigations of test performance by brand showed considerable variation in sensitivity between tests, and in results between studies evaluating the same test. For tests that were evaluated in 200 or more samples, the lower bound of the 95% CI for sensitivity was 90% or more for only a small number of tests (IgG, n = 5; IgG or IgM, n = 1; total antibodies, n = 4). More test brands met the MHRA minimum criteria for specificity of 98% or above (IgG, n = 16; IgG or IgM, n = 5; total antibodies, n = 7). Seven assays met the specified criteria for both sensitivity and specificity. In a low-prevalence (2%) setting, where antibody testing is used to diagnose COVID-19 in people with symptoms but who have had a negative PCR test, we would anticipate that 1 (1 to 2) case would be missed and 8 (5 to 15) would be falsely positive in 1000 people undergoing IgG or IgM testing in week three after onset of SARS-CoV-2 infection. In a seroprevalence survey, where prevalence of prior infection is 50%, we would anticipate that 51 (46 to 58) cases would be missed and 6 (5 to 7) would be falsely positive in 1000 people having IgG tests during the convalescent phase (21 to 100 days post-symptom onset or post-positive PCR) of SARS-CoV-2 infection. AUTHORS' CONCLUSIONS Some antibody tests could be a useful diagnostic tool for those in whom molecular- or antigen-based tests have failed to detect the SARS-CoV-2 virus, including in those with ongoing symptoms of acute infection (from week three onwards) or those presenting with post-acute sequelae of COVID-19. However, antibody tests have an increasing likelihood of detecting an immune response to infection as time since onset of infection progresses and have demonstrated adequate performance for detection of prior infection for sero-epidemiological purposes. The applicability of results for detection of vaccination-induced antibodies is uncertain.
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Affiliation(s)
- Tilly Fox
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Julia Geppert
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Jacqueline Dinnes
- Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
| | - Katie Scandrett
- Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Jacob Bigio
- Research Institute of the McGill University Health Centre, Montreal, Canada
- McGill International TB Centre, Montreal, Canada
| | - Giorgia Sulis
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - Dineshani Hettiarachchi
- Department of Anatomy Genetics and Biomedical Informatics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Yasith Mathangasinghe
- Department of Anatomy Genetics and Biomedical Informatics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
- Australian Regenerative Medicine Institute, Monash University, Clayton, Australia
| | - Praveen Weeratunga
- Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | | | - Brian S Buckley
- Cochrane Response, Cochrane, London, UK
- Department of Surgery, University of the Philippines, Manila, Philippines
| | | | | | - Clare Davenport
- Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
| | - Jane Cunningham
- Global Malaria Programme, World Health Organization, Geneva, Switzerland
| | | | | | - Lotty Hooft
- Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht , Netherlands
| | - Mariska Mg Leeflang
- Epidemiology and Data Science, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health, Amsterdam, Netherlands
| | | | - René Spijker
- Medical Library, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health, Amsterdam, Netherlands
- Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Thomas Struyf
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Ann Van den Bruel
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Jan Y Verbakel
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Yemisi Takwoingi
- Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
| | - Sian Taylor-Phillips
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
- Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Jonathan J Deeks
- Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
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3
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Zhang R, Wang Y, Lv Z, Pei S. Evaluating the impact of stay-at-home and quarantine measures on COVID-19 spread. BMC Infect Dis 2022; 22:648. [PMID: 35896977 PMCID: PMC9326419 DOI: 10.1186/s12879-022-07636-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 07/19/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND During the early stage of the COVID-19 pandemic, many countries implemented non-pharmaceutical interventions (NPIs) to control the transmission of SARS-CoV-2, the causative pathogen of COVID-19. Among those NPIs, stay-at-home and quarantine measures were widely adopted and enforced. Understanding the effectiveness of stay-at-home and quarantine measures can inform decision-making and control planning during the ongoing COVID-19 pandemic and for future disease outbreaks. METHODS In this study, we use mathematical models to evaluate the impact of stay-at-home and quarantine measures on COVID-19 spread in four cities that experienced large-scale outbreaks in the spring of 2020: Wuhan, New York, Milan, and London. We develop a susceptible-exposed-infected-removed (SEIR)-type model with components of self-isolation and quarantine and couple this disease transmission model with a data assimilation method. By calibrating the model to case data, we estimate key epidemiological parameters before lockdown in each city. We further examine the impact of stay-at-home and quarantine rates on COVID-19 spread after lockdown using counterfactual model simulations. RESULTS Results indicate that self-isolation of susceptible population is necessary to contain the outbreak. At a given rate, self-isolation of susceptible population induced by stay-at-home orders is more effective than quarantine of SARS-CoV-2 contacts in reducing effective reproductive numbers [Formula: see text]. Variation in self-isolation and quarantine rates can also considerably affect the duration of outbreaks, attack rates and peak timing. We generate counterfactual simulations to estimate effectiveness of stay-at-home and quarantine measures. Without these two measures, the cumulative confirmed cases could be much higher than reported numbers within 40 days after lockdown in Wuhan, New York, Milan, and London. CONCLUSIONS Our findings underscore the essential role of stay-at-home orders and quarantine of SARS-CoV-2 contacts during the early phase of the pandemic.
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Affiliation(s)
- Renquan Zhang
- School of Mathematical Sciences, Dalian University of Technology, 116024 Dalian, China
| | - Yu Wang
- School of Mathematical Sciences, Dalian University of Technology, 116024 Dalian, China
| | - Zheng Lv
- School of Control Science and Engineering, Dalian University of Technology, 116024 Dalian, China
| | - Sen Pei
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 10032 New York, USA
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Lai A, Tambuzzi S, Bergna A, Battistini A, Della Ventura C, Galli M, Zoja R, Zehender G, Cattaneo C. Evidence of SARS-CoV-2 Antibodies and RNA on Autopsy Cases in the Pre-Pandemic Period in Milan (Italy). Front Microbiol 2022; 13:886317. [PMID: 35783409 PMCID: PMC9240701 DOI: 10.3389/fmicb.2022.886317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 05/17/2022] [Indexed: 12/31/2022] Open
Abstract
In this study, we analyzed blood samples obtained from 169 cadavers subjected to an autopsy from 1 October 2019 to 27 March 2020. The presence of anti-severe acute respiratory syndrome coronavirus 2 (anti-SARS-CoV-2) antibodies was searched by lateral flow immunochromatographic assay (LFIA) and ELISA tests and the SARS-CoV-2 RNA was tested in blood and available lung tissues by real-time PCR (RT-PCR) and droplet digital PCR (ddPCR). Five cases resulted in positives at the serological screening for anti-SARS-CoV-2. Three results were weakly positive for IgM while only one showed strong reactivity for IgG antibodies. The fifth subject (who died in December 2019) resulted positive for the ELISA test. The detection of SARS-CoV-2 RNA resulted in positive only in the blood and lung tissues of such cases. These data suggest that cadaveric blood may be a suitable substrate for the assessment of SARS-CoV-2 infection; moreover, they extend the observations of sporadic cases of SARS-CoV-2 infection in North Italy prior to the first confirmed cases.
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Affiliation(s)
- Alessia Lai
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
- *Correspondence: Alessia Lai
| | - Stefano Tambuzzi
- Department of Biomedical Sciences for Health, Institute of Forensic Medicine, University of Milan, Milan, Italy
| | - Annalisa Bergna
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Alessio Battistini
- Department of Biomedical Sciences for Health, Institute of Forensic Medicine, University of Milan, Milan, Italy
| | - Carla Della Ventura
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Massimo Galli
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Riccardo Zoja
- Department of Biomedical Sciences for Health, Institute of Forensic Medicine, University of Milan, Milan, Italy
| | | | - Cristina Cattaneo
- Department of Biomedical Sciences for Health, Institute of Forensic Medicine, University of Milan, Milan, Italy
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Azami M, Moradi Y, Moradkhani A, Aghaei A. SARS-CoV-2 seroprevalence around the world: an updated systematic review and meta-analysis. Eur J Med Res 2022; 27:81. [PMID: 35655237 PMCID: PMC9160514 DOI: 10.1186/s40001-022-00710-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/16/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Covid-19 has been one of the major concerns around the world in the last 2 years. One of the challenges of this disease has been to determine its prevalence. Conflicting results of the serology test in Covid explored the need for an updated meta-analysis on this issue. Thus, this systematic review aimed to estimate the prevalence of global SARS-CoV-2 serology in different populations and geographical areas. METHODS To identify studies evaluating the seroprevalence of SARS-CoV-2, a comprehensive literature search was performed from international databases, including Medline (PubMed), Web of Sciences, Scopus, EMBASE, and CINHAL. RESULTS In this meta-analysis, the results showed that SARS-CoV-2 seroprevalence is between 3 and 15% worldwide. In Eastern Mediterranean, the pooled estimate of seroprevalence SARS-CoV-2 was 15% (CI 95% 5-29%), and in Africa, the pooled estimate was 6% (CI 95% 1-13%). In America, the pooled estimate was 8% (CI 95% 6-11%), and in Europe, the pooled estimate was 5% (CI 95% 4-6%). Also the last region, Western Pacific, the pooled estimate was 3% (CI 95% 2-4%). Besides, we analyzed three of these areas separately. This analysis estimated the prevalence in subgroups such as study population, diagnostic methods, sampling methods, time, perspective, and type of the study. CONCLUSION The present meta-analysis showed that the seroprevalence of SARS-CoV-2 has been between 3 and 15% worldwide. Even considering the low estimate of this rate and the increasing vaccination in the world, many people are still susceptible to SARS-CoV-2.
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Affiliation(s)
- Mobin Azami
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Yousef Moradi
- Department of Epidemiology and Biostatistics, Faculty of Medicine, Kurdistan University of Medical Science, Sanandaj, Iran
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Asra Moradkhani
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Abbas Aghaei
- Department of Epidemiology and Biostatistics, Faculty of Medicine, Kurdistan University of Medical Science, Sanandaj, Iran.
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
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Ruggiero M, Somigliana E, Tassis B, Li Piani L, Uceda Renteria S, Barbara G, Lunghi G, Pietrasanta C, Ferrazzi E. Clinical relevance of SARS-CoV-2 infection in late pregnancy. BMC Pregnancy Childbirth 2021; 21:505. [PMID: 34253173 PMCID: PMC8273567 DOI: 10.1186/s12884-021-03985-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 07/07/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Evidence on the outcome of SARS-CoV-2 infection in pregnancy is generally reassuring but yet not definitive. METHODS To specifically assess the impact of SARS-CoV-2 infection in late pregnancy, we prospectively recruited 315 consecutive women delivering in a referral hospital located in Lombardy, Italy in the early phase of the epidemic. Restriction of the recruitment to this peculiar historical time period allowed to exclude infections occurring early in pregnancy and to limit the recall bias. All recruited subjects underwent a nasopharyngeal swab to assess the presence of Sars-Cov-2 using Real-time PCR. In addition, two different types of antibodies for the virus were evaluated in peripheral blood, those against the spike proteins S1 and S2 of the envelope and those against the nucleoprotein of the nucleocapsid. Women were considered to have had SARS-CoV-2 infection in pregnancy if at least one of the three assessments was positive. RESULTS Overall, 28 women had a diagnosis of SARS-CoV-2 infection in pregnancy (8.9%). Women diagnosed with the infection were more likely to report one or more episodes of symptoms suggestive for Covid-19 (n = 11, 39.3%) compared to unaffected women (n = 39, 13.6%). The corresponding OR was 4.11 (95%CI: 1.79-9.44). Symptoms significantly associated with Covid-19 in pregnancy included fever, cough, dyspnea and anosmia. Only one woman necessitated intensive care. Pregnancy outcome in women with and without SARS-CoV-2 infection did not also differ. CONCLUSIONS SARS-CoV-2 infection is asymptomatic in three out of five women in late pregnancy and is rarely severe. In addition, pregnancy outcome may not be markedly affected.
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Affiliation(s)
- Marta Ruggiero
- Department of Woman, New-Born and Child, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Mangiagalli Centre, Via M. Fanti, 6, 20122, Milan, Italy
- Department of Clinical Sciences and Community Health, Università Degli Studi Di Milano, Milan, Italy
| | - Edgardo Somigliana
- Department of Woman, New-Born and Child, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Mangiagalli Centre, Via M. Fanti, 6, 20122, Milan, Italy.
- Department of Clinical Sciences and Community Health, Università Degli Studi Di Milano, Milan, Italy.
| | - Beatrice Tassis
- Department of Woman, New-Born and Child, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Mangiagalli Centre, Via M. Fanti, 6, 20122, Milan, Italy
| | - Letizia Li Piani
- Department of Woman, New-Born and Child, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Mangiagalli Centre, Via M. Fanti, 6, 20122, Milan, Italy
- Department of Clinical Sciences and Community Health, Università Degli Studi Di Milano, Milan, Italy
| | - Sara Uceda Renteria
- Virology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Mangiagalli Centre, Milan, Italy
| | - Giussy Barbara
- Department of Woman, New-Born and Child, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Mangiagalli Centre, Via M. Fanti, 6, 20122, Milan, Italy
| | - Giovanna Lunghi
- Virology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Mangiagalli Centre, Milan, Italy
| | - Carlo Pietrasanta
- Department of Clinical Sciences and Community Health, Università Degli Studi Di Milano, Milan, Italy
- Neonatal Intensive Care Unit (NICU), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Mangiagalli Centre, Milan, Italy
| | - Enrico Ferrazzi
- Department of Woman, New-Born and Child, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Mangiagalli Centre, Via M. Fanti, 6, 20122, Milan, Italy
- Department of Clinical Sciences and Community Health, Università Degli Studi Di Milano, Milan, Italy
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De Nicolò A, Avataneo V, Cusato J, Palermiti A, Mula J, De Vivo E, Antonucci M, Bonora S, Calcagno A, Di Perri G, De Rosa FG, D’Avolio A. Analytical Validation and Clinical Application of Rapid Serological Tests for SARS-CoV-2 Suitable for Large-Scale Screening. Diagnostics (Basel) 2021; 11:869. [PMID: 34065954 PMCID: PMC8151461 DOI: 10.3390/diagnostics11050869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/06/2021] [Accepted: 05/10/2021] [Indexed: 11/18/2022] Open
Abstract
Recently, large-scale screening for COVID-19 has presented a major challenge, limiting timely countermeasures. Therefore, the application of suitable rapid serological tests could provide useful information, however, little evidence regarding their robustness is currently available. In this work, we evaluated and compared the analytical performance of a rapid lateral-flow test (LFA) and a fast semiquantitative fluorescent immunoassay (FIA) for anti-nucleocapsid (anti-NC) antibodies, with the reverse transcriptase real-time PCR assay as the reference. In 222 patients, LFA showed poor sensitivity (55.9%) within two weeks from PCR, while later testing was more reliable (sensitivity of 85.7% and specificity of 93.1%). Moreover, in a subset of 100 patients, FIA showed high sensitivity (89.1%) and specificity (94.1%) after two weeks from PCR. The coupled application for the screening of 183 patients showed satisfactory concordance (K = 0.858). In conclusion, rapid serological tests were largely not useful for early diagnosis, but they showed good performance in later stages of infection. These could be useful for back-tracing and/or to identify potentially immune subjects.
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Affiliation(s)
- Amedeo De Nicolò
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.A.); (J.C.); (A.P.); (J.M.); (E.D.V.); (M.A.); (S.B.); (A.C.); (G.D.P.); (F.G.D.R.); (A.D.)
| | - Valeria Avataneo
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.A.); (J.C.); (A.P.); (J.M.); (E.D.V.); (M.A.); (S.B.); (A.C.); (G.D.P.); (F.G.D.R.); (A.D.)
| | - Jessica Cusato
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.A.); (J.C.); (A.P.); (J.M.); (E.D.V.); (M.A.); (S.B.); (A.C.); (G.D.P.); (F.G.D.R.); (A.D.)
| | - Alice Palermiti
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.A.); (J.C.); (A.P.); (J.M.); (E.D.V.); (M.A.); (S.B.); (A.C.); (G.D.P.); (F.G.D.R.); (A.D.)
| | - Jacopo Mula
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.A.); (J.C.); (A.P.); (J.M.); (E.D.V.); (M.A.); (S.B.); (A.C.); (G.D.P.); (F.G.D.R.); (A.D.)
| | - Elisa De Vivo
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.A.); (J.C.); (A.P.); (J.M.); (E.D.V.); (M.A.); (S.B.); (A.C.); (G.D.P.); (F.G.D.R.); (A.D.)
| | - Miriam Antonucci
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.A.); (J.C.); (A.P.); (J.M.); (E.D.V.); (M.A.); (S.B.); (A.C.); (G.D.P.); (F.G.D.R.); (A.D.)
| | - Stefano Bonora
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.A.); (J.C.); (A.P.); (J.M.); (E.D.V.); (M.A.); (S.B.); (A.C.); (G.D.P.); (F.G.D.R.); (A.D.)
| | - Andrea Calcagno
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.A.); (J.C.); (A.P.); (J.M.); (E.D.V.); (M.A.); (S.B.); (A.C.); (G.D.P.); (F.G.D.R.); (A.D.)
| | - Giovanni Di Perri
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.A.); (J.C.); (A.P.); (J.M.); (E.D.V.); (M.A.); (S.B.); (A.C.); (G.D.P.); (F.G.D.R.); (A.D.)
- CoQua Lab, 10147 Torino, Italy
| | - Francesco Giuseppe De Rosa
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.A.); (J.C.); (A.P.); (J.M.); (E.D.V.); (M.A.); (S.B.); (A.C.); (G.D.P.); (F.G.D.R.); (A.D.)
| | - Antonio D’Avolio
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.A.); (J.C.); (A.P.); (J.M.); (E.D.V.); (M.A.); (S.B.); (A.C.); (G.D.P.); (F.G.D.R.); (A.D.)
- CoQua Lab, 10147 Torino, Italy
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8
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Pillonetto G, Bisiacco M, Palù G, Cobelli C. Tracking the time course of reproduction number and lockdown's effect on human behaviour during SARS-CoV-2 epidemic: nonparametric estimation. Sci Rep 2021; 11:9772. [PMID: 33963235 PMCID: PMC8105401 DOI: 10.1038/s41598-021-89014-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 04/14/2021] [Indexed: 01/10/2023] Open
Abstract
Understanding the SARS-CoV-2 dynamics has been subject of intense research in the last months. In particular, accurate modeling of lockdown effects on human behaviour and epidemic evolution is a key issue in order e.g. to inform health-care decisions on emergency management. In this regard, the compartmental and spatial models so far proposed use parametric descriptions of the contact rate, often assuming a time-invariant effect of the lockdown. In this paper we show that these assumptions may lead to erroneous evaluations on the ongoing pandemic. Thus, we develop a new class of nonparametric compartmental models able to describe how the impact of the lockdown varies in time. Our estimation strategy does not require significant Bayes prior information and exploits regularization theory. Hospitalized data are mapped into an infinite-dimensional space, hence obtaining a function which takes into account also how social distancing measures and people's growing awareness of infection's risk evolves as time progresses. This also permits to reconstruct a continuous-time profile of SARS-CoV-2 reproduction number with a resolution never reached before in the literature. When applied to data collected in Lombardy, the most affected Italian region, our model illustrates how people behaviour changed during the restrictions and its importance to contain the epidemic. Results also indicate that, at the end of the lockdown, around [Formula: see text] of people in Lombardy and [Formula: see text] in Italy was affected by SARS-CoV-2, with the fatality rate being 1.14%. Then, we discuss how the situation evolved after the end of the lockdown showing that the reproduction number dangerously increased in the summer, due to holiday relax, reaching values larger than one on August 1, 2020. Finally, we also document how Italy faced the second wave of infection in the last part of 2020. Since several countries still observe a growing epidemic and others could be subject to other waves, the proposed reproduction number tracking methodology can be of great help to health care authorities to prevent SARS-CoV-2 diffusion or to assess the impact of lockdown restrictions on human behaviour to contain the spread.
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Affiliation(s)
- G Pillonetto
- Department of Information Engineering, University of Padova, Padova, Italy.
| | - M Bisiacco
- Department of Information Engineering, University of Padova, Padova, Italy
| | - G Palù
- Department of Molecular Medicine, Professor Emeritus, University of Padova, Padova, Italy
- Member of the Scientific Technical Committee, Italian Ministry of Health, Rome, Italy
| | - C Cobelli
- Member of Consiglio Superiore di Sanità, Italian Ministry of Health, Rome, Italy
- Dipartimento di Salute della Donna e del Bambino, Professor Emeritus, University of Padova, Padova, Italy
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9
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Spada E, Vitale F, Bruno F, Castelli G, Reale S, Perego R, Baggiani L, Proverbio D. A pre- and during Pandemic Survey of Sars-Cov-2 Infection in Stray Colony and Shelter Cats from a High Endemic Area of Northern Italy. Viruses 2021; 13:618. [PMID: 33916759 PMCID: PMC8066308 DOI: 10.3390/v13040618] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/28/2021] [Accepted: 04/01/2021] [Indexed: 01/22/2023] Open
Abstract
Cats are susceptible to infection with severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). Whilst a number of studies have been performed worldwide on owned cats, limited data are available on stray, colony or shelter cats. We investigated SARS-CoV-2 infection in a stray cat population before and during human outbreaks of SARS-CoV-2 in cities in the Lombardy region in northern Italy, a high endemic region for SARS-CoV-2, using serological and molecular methods. A cohort of different samples were collected from 241 cats, including frozen archived serum samples from 136 cats collected before the 2019 coronavirus disease (COVID-19) pandemic and serum, pharyngeal and rectal swab samples from 105 cats collected during the SARS-CoV-2 outbreak. All pre-pandemic samples tested seronegative for antibodies against the nucleocapsid of SARS-CoV-2 using indirect enzyme linked immunosorbent assay (ELISA) test, while one serum sample collected during the pandemic was seropositive. No serological cross-reactivity was detected between SARS-CoV-2 antibodies and antibodies against feline enteric (FECV) and infectious peritonitis coronavirus (FIPC), Feline Immunodeficiency Virus (FIV), Feline Calicivirus (FCV), Feline Herpesvirus-1 (FHV-1), Feline Parvovirus (FPV), Leishmania infantum, Anaplasma phagocytophilum, Rickettsia spp., Toxoplasma gondii or Chlamydophila felis. No pharyngeal or rectal swab tested positive for SARS-CoV-2 RNA on real time reverse transcription-polymerase chain reaction (rRT-PCR). Our data show that SARS-CoV-2 did infect stray cats in Lombardy during the COVID-19 pandemic, but with lower prevalence than found in owned cats. This should alleviate public concerns about stray cats acting as SARS-CoV-2 carriers.
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Affiliation(s)
- Eva Spada
- Laboratorio di Ricerca di Medicina Emotrasfusionale Veterinaria (REvLab), Dipartimento di Medicina Veterinaria (DIMEVET), Università degli Studi di Milano, 26900 Lodi, Italy; (L.B.); (D.P.)
| | - Fabrizio Vitale
- Centro di Referenza Nazionale per le Leishmaniosi (C.Re.Na.L), Istituto Zooprofilattico Sperimentale (IZS) della Sicilia A. Mirri, 90129 Palermo, Italy; (F.V.); (F.B.); (G.C.); (S.R.)
| | - Federica Bruno
- Centro di Referenza Nazionale per le Leishmaniosi (C.Re.Na.L), Istituto Zooprofilattico Sperimentale (IZS) della Sicilia A. Mirri, 90129 Palermo, Italy; (F.V.); (F.B.); (G.C.); (S.R.)
| | - Germano Castelli
- Centro di Referenza Nazionale per le Leishmaniosi (C.Re.Na.L), Istituto Zooprofilattico Sperimentale (IZS) della Sicilia A. Mirri, 90129 Palermo, Italy; (F.V.); (F.B.); (G.C.); (S.R.)
| | - Stefano Reale
- Centro di Referenza Nazionale per le Leishmaniosi (C.Re.Na.L), Istituto Zooprofilattico Sperimentale (IZS) della Sicilia A. Mirri, 90129 Palermo, Italy; (F.V.); (F.B.); (G.C.); (S.R.)
| | - Roberta Perego
- Laboratorio di Ricerca di Medicina Emotrasfusionale Veterinaria (REvLab), Dipartimento di Medicina Veterinaria (DIMEVET), Università degli Studi di Milano, 26900 Lodi, Italy; (L.B.); (D.P.)
| | - Luciana Baggiani
- Laboratorio di Ricerca di Medicina Emotrasfusionale Veterinaria (REvLab), Dipartimento di Medicina Veterinaria (DIMEVET), Università degli Studi di Milano, 26900 Lodi, Italy; (L.B.); (D.P.)
| | - Daniela Proverbio
- Laboratorio di Ricerca di Medicina Emotrasfusionale Veterinaria (REvLab), Dipartimento di Medicina Veterinaria (DIMEVET), Università degli Studi di Milano, 26900 Lodi, Italy; (L.B.); (D.P.)
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Larremore DB, Fosdick BK, Bubar KM, Zhang S, Kissler SM, Metcalf CJE, Buckee CO, Grad YH. Estimating SARS-CoV-2 seroprevalence and epidemiological parameters with uncertainty from serological surveys. eLife 2021; 10:e64206. [PMID: 33666169 PMCID: PMC7979159 DOI: 10.7554/elife.64206] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 03/04/2021] [Indexed: 12/24/2022] Open
Abstract
Establishing how many people have been infected by SARS-CoV-2 remains an urgent priority for controlling the COVID-19 pandemic. Serological tests that identify past infection can be used to estimate cumulative incidence, but the relative accuracy and robustness of various sampling strategies have been unclear. We developed a flexible framework that integrates uncertainty from test characteristics, sample size, and heterogeneity in seroprevalence across subpopulations to compare estimates from sampling schemes. Using the same framework and making the assumption that seropositivity indicates immune protection, we propagated estimates and uncertainty through dynamical models to assess uncertainty in the epidemiological parameters needed to evaluate public health interventions and found that sampling schemes informed by demographics and contact networks outperform uniform sampling. The framework can be adapted to optimize serosurvey design given test characteristics and capacity, population demography, sampling strategy, and modeling approach, and can be tailored to support decision-making around introducing or removing interventions.
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Affiliation(s)
- Daniel B Larremore
- Department of Computer Science, University of Colorado BoulderBoulderUnited States
- BioFrontiers Institute, University of Colorado BoulderBoulderUnited States
| | - Bailey K Fosdick
- Department of Statistics, Colorado State UniversityFort CollinsUnited States
| | - Kate M Bubar
- Department of Applied Mathematics, University of Colorado BoulderBoulderUnited States
- IQ Biology Program, University of Colorado BoulderBoulderUnited States
| | - Sam Zhang
- Department of Applied Mathematics, University of Colorado BoulderBoulderUnited States
| | - Stephen M Kissler
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public HealthBostonUnited States
| | - C Jessica E Metcalf
- Department of Ecology and Evolutionary Biology and the Woodrow Wilson School, Princeton UniversityPrincetonUnited States
| | - Caroline O Buckee
- Department of Epidemiology, Harvard T.H. Chan School of Public HealthBostonUnited States
- Center for Communicable Disease Dynamics, Harvard T.H. Chan School of Public HealthBostonUnited States
| | - Yonatan H Grad
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public HealthBostonUnited States
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Sakalle S, Saroshe S, Shukla H, Mutha A, Vaze A, Arora A, Athotra A, Ramaswamy S, Jain A, Dhuria M, Patil AD, Rai A, Garg S, Jain SK, Bindal J, Singh SK. Seroprevalence of anti-SARS-CoV-2 antibodies in Indore, Madhya Pradesh: A community-based cross-sectional study, August 2020. J Family Med Prim Care 2021; 10:1479-1484. [PMID: 34041197 PMCID: PMC8140269 DOI: 10.4103/jfmpc.jfmpc_2015_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/02/2020] [Accepted: 12/16/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND In India, laboratory diagnosis of SARS - CoV-2 infection has been mostly based on real-time reverse transcriptase-polymerase chain reaction (RT-PCR). Studies have shown that Viral titres peak within the first week of symptoms but may decline later hampering RT-PCR-based diagnostic strategies. Exact estimate is difficult under high-risk screening strategy with evidences of having large number of asymptomatic cases. This has prompted a call for adoption of antibody testing as potential source of data. MATERIALS AND METHODS A cross-sectional study with a sample size of 7000 was conducted for 15 days including all the 85 wards under Indore Municipal Corporation. Stratified Random Sampling was used to collect the samples. Trained teams collected basic sociodemographic information and serum samples which were tested for the presence of specific antibodies to COVID-19 using ICMR-Kavach IgG ELISA kits. The data collected was compiled and analysed using appropriate statistical software. RESULTS Overall weighted seroprevalence of the study population was found to be 7.75%. The prevalence in males and females was comparable (7.91% vs 7.57%). Highest seropositivity (10.04%) was seen among individuals aged more than 60 years. Total number of infections in the population were estimated to be 2,03,160. Overall Case Infection Ratio was found to be 27.43. CONCLUSION The current seroprevalence study provides information on proportion of the population exposed, but the correlation between presence and absence of antibodies is not a marker of total or partial immunity. It must also be noted that more than 90 percent of the population is still susceptible for COVID-19 infection. Hence, non-pharmaceutical interventions like respiratory hygiene, physical distancing, hand sanitization, usage of personal protective equipment such as masks and implementation of public health measures need to be continued.
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Affiliation(s)
| | | | | | - Anita Mutha
- MGM Medical College, Indore, Madhya Pradesh, India
| | - Ameya Vaze
- Department of Health Service, Govt. of M.P., Madhya Pradesh, India
| | - Arpit Arora
- Indian Institute of Technology Bombay, Mumbai, Maharashtra, India
| | | | | | - Arania Jain
- Brain Above InfoSol Pvt. Ltd., Indore, Madhya Pradesh, India
| | - Meera Dhuria
- National Centre for Disease Control, New Delhi, India
| | - Anil D. Patil
- National Centre for Disease Control, New Delhi, India
| | - Arvind Rai
- National Centre for Disease Control, New Delhi, India
| | | | | | - Jyoti Bindal
- MGM Medical College, Indore, Madhya Pradesh, India
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12
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Rizzello F, Calabrese C, Salice M, Calandrini L, Privitera H, Melotti L, Peruzzi G, Dussias N, Belluzzi A, Scaioli E, Decorato A, Siniscalchi A, Filippone E, Laureti S, Rottoli M, Poggioli G, Gionchetti P. COVID-19 in IBD: The experience of a single tertiary IBD center. Dig Liver Dis 2021; 53:271-276. [PMID: 33451910 PMCID: PMC7764386 DOI: 10.1016/j.dld.2020.12.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 12/16/2020] [Accepted: 12/18/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Italy has been one of the most affected countries in the world by COVID-19. There has been increasing concern regarding the impact of COVID-19 on patients with inflammatory bowel disease (IBD), particularly in patients treated with immunosuppressants or biologics. The aim of our study is to understand the incidence of COVID-19 in a large cohort of patients with IBD. Furthermore, we analyzed possible risk factors for infection and severity of COVID-19. METHODS This was an observational study evaluating the impact of COVID-19 on IBD patients in a single tertiary center. A 23 multiple-choice-question anonymous survey was administered to 1200 patients with IBD between March 10th and June 10th 2020. RESULTS 1158 questionnaires were analyzed. The majority of patients had Crohn's disease (CD) (60%) and most of them were in clinical remission. Among the 26 patients (2.2%) who tested positive for COVID-19, only 5 (3CD) were on biological treatment and none required hospitalization. Two patients died and were on treatment with mesalazine only. Of the 1158 patients, 521 were on biological therapy, which was discontinued in 85 (16.3%) and delayed in 195 patients (37.4%). A worsening of IBD symptoms was observed in 200 patients on biological therapy (38.4%). Most of these patients, 189 (94.5%), had stopped or delayed biological treatment, while 11 (5.5%) had continued their therapy regularly (p<0.001). CONCLUSIONS Our data are in line with the current literature and confirm a higher incidence compared to the general population. Biological therapy for IBD seems to not be a risk factor for infection and should not be discontinued in order to avoid IBD relapse.
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Affiliation(s)
- Fernando Rizzello
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Carlo Calabrese
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Marco Salice
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Lucia Calandrini
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Hana Privitera
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Laura Melotti
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Giulia Peruzzi
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Nikolas Dussias
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Andrea Belluzzi
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Eleonora Scaioli
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Anastasio Decorato
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Antonio Siniscalchi
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Eleonora Filippone
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Silvio Laureti
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Matteo Rottoli
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Gilberto Poggioli
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Paolo Gionchetti
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy.
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13
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Comelli A, Focà E, Sansone E, Tomasi C, Albini E, Quiros-Roldan E, Tomasoni LR, Sala E, Bonfanti C, Caccuri F, Caruso A, De Palma G, Castelli F. Serological Response to SARS-CoV-2 in Health Care Workers Employed in a Large Tertiary Hospital in Lombardy, Northern Italy. Microorganisms 2021; 9:488. [PMID: 33669151 PMCID: PMC7996483 DOI: 10.3390/microorganisms9030488] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/21/2021] [Accepted: 02/22/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND COVID-19 pandemic is requesting unprecedented efforts by health-care workers (HCWs) in all countries, and especially in Italy during the first semester of 2020. METHODS This is a retrospective, observational study conducted at the Spedali Civili General Hospital, in Brescia, Northern Italy during the SARS CoV-2 pandemic in the first semester of 2020. Serum samples from HCWs were tested for SARS-CoV-2 spike protein-specific antibodies. An online survey was used to collect demographic, clinical, and epidemiological data. RESULTS Of the 1893 HCWs included, 433 (22.9%) were found seropositive for SARS-CoV-2 IgG. The cumulative prevalence of SARS-CoV-2 infection (antibodies production or past positive RT-PCR on nasal/throat swab) was 25.1% (475/1893). Fifty-six out of 433 (13%) seropositive participants declared to have been asymptomatic during the study period. The development of COVID-19 signs or symptoms is the main determinant of seropositivity (OR: 11.3, p < 0.0001) along with their duration and severity. 40/290 (14.5%) HCWs with documented positive RT-PCR during the study period did not show any detectable antibody response. IgG levels positively correlate with age, COVID-19-compatible signs and symptoms experienced and their duration. CONCLUSIONS In this study, carried out in one of the most affected areas in Europe, we demonstrate that most HCWs with COVID-19 related symptoms develop a spike protein-specific antibodies with potential neutralizing effect.
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Affiliation(s)
- Agnese Comelli
- University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, 25123 Brescia, Italy; (E.F.); (E.Q.-R.); (L.R.T.); (F.C.)
| | - Emanuele Focà
- University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, 25123 Brescia, Italy; (E.F.); (E.Q.-R.); (L.R.T.); (F.C.)
| | - Emanuele Sansone
- Postgraduate School of Occupational Health, DSMC, University of Brescia, 25123 Brescia, Italy;
| | | | - Elisa Albini
- Unit of Occupational Health, Hygiene, Toxicology and Occupational Prevention, ASST Spedali Civili, 25123 Brescia, Italy; (E.A.); (E.S.)
| | - Eugenia Quiros-Roldan
- University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, 25123 Brescia, Italy; (E.F.); (E.Q.-R.); (L.R.T.); (F.C.)
| | - Lina Rachele Tomasoni
- University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, 25123 Brescia, Italy; (E.F.); (E.Q.-R.); (L.R.T.); (F.C.)
| | - Emma Sala
- Unit of Occupational Health, Hygiene, Toxicology and Occupational Prevention, ASST Spedali Civili, 25123 Brescia, Italy; (E.A.); (E.S.)
| | - Carlo Bonfanti
- Department of Microbiology and Virology, Spedali Civili, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (C.B.); (F.C.); (A.C.)
| | - Francesca Caccuri
- Department of Microbiology and Virology, Spedali Civili, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (C.B.); (F.C.); (A.C.)
| | - Arnaldo Caruso
- Department of Microbiology and Virology, Spedali Civili, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (C.B.); (F.C.); (A.C.)
| | - Giuseppe De Palma
- University Department of Occupational Health and Industrial Hygiene, DSMC, University of Brescia and ASST Spedali Civili, 25123 Brescia, Italy;
| | - Francesco Castelli
- University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, 25123 Brescia, Italy; (E.F.); (E.Q.-R.); (L.R.T.); (F.C.)
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14
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Qutob N, Awartani F, Salah Z, Asia M, Abu Khader I, Herzallah K, Balqis N, Sallam H. Seroprevalence of SARS-CoV-2 in the West Bank region of Palestine: a cross-sectional seroepidemiological study. BMJ Open 2021; 11:e044552. [PMID: 33542045 PMCID: PMC7868131 DOI: 10.1136/bmjopen-2020-044552] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 01/06/2021] [Accepted: 01/07/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Seroprevalence rates are important indicators to the epidemiology of COVID-19 and the extent of the pandemic given the existence of asymptomatic cases. The purpose of this study is to assess the seroprevalence rate in the Palestinian population residing in the West Bank. SETTING The study involved 1355 participants from 11 governorates, including 112 localities in the West Bank and 1136 individuals visiting Palestinian medical laboratories. PARTICIPANTS Blood samples were collected between 15th June 2020 and 30th June 2020 from 1355 individuals from randomly selected households in the West Bank, in addition to 1136 individuals visiting Palestinian medical laboratories between the 1st May 2020 and 9th July 2020 for a routine check-up. PRIMARY AND SECONDARY OUTCOME MEASURES Out of the 2491 blood samples collected, serological tests for 2455 adequate serum samples were done using an immunoassay for qualitative detection of antibodies against SARS-CoV-2. Seroprevalence was estimated as the proportion of individuals who had a positive result in the total SARS-CoV-2 antibodies in the immunoassay. RESULTS The random sample of Palestinians living in the West Bank yielded 0% seroprevalence with 95% and an adjusted CI (0% to 0.0043%), while the lab referral samples yielded an estimated seroprevalence of 0.354% with 95% and an adjusted CI (0.001325% to 0.011566%). CONCLUSIONS Our results indicate that as of mid-June 2020, seroprevalence in Palestine persists low and is inadequate to provide herd immunity, emphasising the need to maintain health measures to keep the outbreak under control. Population-based seroprevalence studies are to be conducted periodically to monitor the SARS-CoV-2 seroprevalence in Palestine and inform policymakers about the efficacy of their surveillance system.
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Affiliation(s)
- Nouar Qutob
- Department of Health Sciences, Faculty of Graduate Studies, Arab American University, Ramallah, Palestine
| | - Faisal Awartani
- Department of Health Sciences, Faculty of Graduate Studies, Arab American University, Ramallah, Palestine
| | - Zaidoun Salah
- Department of Health Sciences, Faculty of Graduate Studies, Arab American University, Ramallah, Palestine
| | - Mohammad Asia
- Department of Health Sciences, Faculty of Graduate Studies, Arab American University, Ramallah, Palestine
| | - Imad Abu Khader
- Department of Health Sciences, Faculty of Graduate Studies, Arab American University, Ramallah, Palestine
| | - Khaled Herzallah
- Department of Health Sciences, Faculty of Graduate Studies, Arab American University, Ramallah, Palestine
| | - Nadeen Balqis
- Department of Health Sciences, Faculty of Graduate Studies, Arab American University, Ramallah, Palestine
| | - Husam Sallam
- Department of Health Sciences, Faculty of Graduate Studies, Arab American University, Ramallah, Palestine
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15
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La Rosa G, Mancini P, Bonanno Ferraro G, Veneri C, Iaconelli M, Bonadonna L, Lucentini L, Suffredini E. SARS-CoV-2 has been circulating in northern Italy since December 2019: Evidence from environmental monitoring. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021. [PMID: 32835962 DOI: 10.1101/2020.06.25.20140061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is responsible for the coronavirus disease COVID-19, a public health emergency worldwide, and Italy is among the most severely affected countries. The first autochthonous Italian case of COVID-19 was documented on February 21, 2020. We investigated the possibility that SARS-CoV-2 emerged in Italy earlier than that date, by analysing 40 composite influent wastewater samples collected - in the framework of other wastewater-based epidemiology projects - between October 2019 and February 2020 from five wastewater treatment plants (WWTPs) in three cities and regions in northern Italy (Milan/Lombardy, Turin/Piedmont and Bologna/Emilia Romagna). Twenty-four additional samples collected in the same WWTPs between September 2018 and June 2019 (i.e. long before the onset of the epidemic) were included as 'blank' samples. Viral concentration was performed according to the standard World Health Organization procedure for poliovirus sewage surveillance, with modifications. Molecular analysis was undertaken with both nested RT-PCR and real-rime RT-PCR assays. A total of 15 positive samples were confirmed by both methods. The earliest dates back to 18 December 2019 in Milan and Turin and 29 January 2020 in Bologna. Virus concentration in the samples ranged from below the limit of detection (LOD) to 5.6 × 104 genome copies (g.c.)/L, and most of the samples (23 out of 26) were below the limit of quantification of PCR. Our results demonstrate that SARS-CoV-2 was already circulating in northern Italy at the end of 2019. Moreover, it was circulating in different geographic regions simultaneously, which changes our previous understanding of the geographical circulation of the virus in Italy. Our study highlights the importance of environmental surveillance as an early warning system, to monitor the levels of virus circulating in the population and identify outbreaks even before cases are notified to the healthcare system.
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Affiliation(s)
- Giuseppina La Rosa
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy.
| | - Pamela Mancini
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | | | - Carolina Veneri
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | - Marcello Iaconelli
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | - Lucia Bonadonna
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | - Luca Lucentini
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | - Elisabetta Suffredini
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
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16
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Uyoga S, Adetifa IMO, Karanja HK, Nyagwange J, Tuju J, Wanjiku P, Aman R, Mwangangi M, Amoth P, Kasera K, Ng'ang'a W, Rombo C, Yegon C, Kithi K, Odhiambo E, Rotich T, Orgut I, Kihara S, Otiende M, Bottomley C, Mupe ZN, Kagucia EW, Gallagher KE, Etyang A, Voller S, Gitonga JN, Mugo D, Agoti CN, Otieno E, Ndwiga L, Lambe T, Wright D, Barasa E, Tsofa B, Bejon P, Ochola-Oyier LI, Agweyu A, Scott JAG, Warimwe GM. Seroprevalence of anti-SARS-CoV-2 IgG antibodies in Kenyan blood donors. Science 2021; 371:79-82. [PMID: 33177105 PMCID: PMC7877494 DOI: 10.1126/science.abe1916] [Citation(s) in RCA: 174] [Impact Index Per Article: 58.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 11/06/2020] [Indexed: 12/13/2022]
Abstract
The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Africa is poorly described. The first case of SARS-CoV-2 in Kenya was reported on 12 March 2020, and an overwhelming number of cases and deaths were expected, but by 31 July 2020, there were only 20,636 cases and 341 deaths. However, the extent of SARS-CoV-2 exposure in the community remains unknown. We determined the prevalence of anti-SARS-CoV-2 immunoglobulin G among blood donors in Kenya in April-June 2020. Crude seroprevalence was 5.6% (174 of 3098). Population-weighted, test-performance-adjusted national seroprevalence was 4.3% (95% confidence interval, 2.9 to 5.8%) and was highest in urban counties Mombasa (8.0%), Nairobi (7.3%), and Kisumu (5.5%). SARS-CoV-2 exposure is more extensive than indicated by case-based surveillance, and these results will help guide the pandemic response in Kenya and across Africa.
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Affiliation(s)
- Sophie Uyoga
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.
| | - Ifedayo M O Adetifa
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | | | | | - James Tuju
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Rashid Aman
- Ministry of Health, Government of Kenya, Nairobi, Kenya
| | | | - Patrick Amoth
- Ministry of Health, Government of Kenya, Nairobi, Kenya
| | | | - Wangari Ng'ang'a
- Presidential Policy and Strategy Unit, The Presidency, Government of Kenya, Nairobi, Kenya
| | - Charles Rombo
- Kenya National Blood Transfusion Services, Ministry of Health, Nairobi, Kenya
| | - Christine Yegon
- Kenya National Blood Transfusion Services, Ministry of Health, Nairobi, Kenya
| | - Khamisi Kithi
- Kenya National Blood Transfusion Services, Ministry of Health, Nairobi, Kenya
| | - Elizabeth Odhiambo
- Kenya National Blood Transfusion Services, Ministry of Health, Nairobi, Kenya
| | - Thomas Rotich
- Kenya National Blood Transfusion Services, Ministry of Health, Nairobi, Kenya
| | - Irene Orgut
- Kenya National Blood Transfusion Services, Ministry of Health, Nairobi, Kenya
| | - Sammy Kihara
- Kenya National Blood Transfusion Services, Ministry of Health, Nairobi, Kenya
| | - Mark Otiende
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Christian Bottomley
- Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | - Zonia N Mupe
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Katherine E Gallagher
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | | | - Shirine Voller
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | | | - Daisy Mugo
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Edward Otieno
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Teresa Lambe
- Nuffield Department of Medicine, Oxford University, Oxford, UK
| | - Daniel Wright
- Nuffield Department of Medicine, Oxford University, Oxford, UK
| | - Edwine Barasa
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Philip Bejon
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Nuffield Department of Medicine, Oxford University, Oxford, UK
| | | | | | - J Anthony G Scott
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | - George M Warimwe
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Nuffield Department of Medicine, Oxford University, Oxford, UK
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17
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Uyoga S, Adetifa IMO, Karanja HK, Nyagwange J, Tuju J, Wanjiku P, Aman R, Mwangangi M, Amoth P, Kasera K, Ng'ang'a W, Rombo C, Yegon C, Kithi K, Odhiambo E, Rotich T, Orgut I, Kihara S, Otiende M, Bottomley C, Mupe ZN, Kagucia EW, Gallagher KE, Etyang A, Voller S, Gitonga JN, Mugo D, Agoti CN, Otieno E, Ndwiga L, Lambe T, Wright D, Barasa E, Tsofa B, Bejon P, Ochola-Oyier LI, Agweyu A, Scott JAG, Warimwe GM. Seroprevalence of anti-SARS-CoV-2 IgG antibodies in Kenyan blood donors. Science 2021; 371:79-82. [PMID: 33177105 DOI: 10.1101/2020.07.27.20162693] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 11/06/2020] [Indexed: 05/24/2023]
Abstract
The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Africa is poorly described. The first case of SARS-CoV-2 in Kenya was reported on 12 March 2020, and an overwhelming number of cases and deaths were expected, but by 31 July 2020, there were only 20,636 cases and 341 deaths. However, the extent of SARS-CoV-2 exposure in the community remains unknown. We determined the prevalence of anti-SARS-CoV-2 immunoglobulin G among blood donors in Kenya in April-June 2020. Crude seroprevalence was 5.6% (174 of 3098). Population-weighted, test-performance-adjusted national seroprevalence was 4.3% (95% confidence interval, 2.9 to 5.8%) and was highest in urban counties Mombasa (8.0%), Nairobi (7.3%), and Kisumu (5.5%). SARS-CoV-2 exposure is more extensive than indicated by case-based surveillance, and these results will help guide the pandemic response in Kenya and across Africa.
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Affiliation(s)
- Sophie Uyoga
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.
| | - Ifedayo M O Adetifa
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | | | | | - James Tuju
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Rashid Aman
- Ministry of Health, Government of Kenya, Nairobi, Kenya
| | | | - Patrick Amoth
- Ministry of Health, Government of Kenya, Nairobi, Kenya
| | | | - Wangari Ng'ang'a
- Presidential Policy and Strategy Unit, The Presidency, Government of Kenya, Nairobi, Kenya
| | - Charles Rombo
- Kenya National Blood Transfusion Services, Ministry of Health, Nairobi, Kenya
| | - Christine Yegon
- Kenya National Blood Transfusion Services, Ministry of Health, Nairobi, Kenya
| | - Khamisi Kithi
- Kenya National Blood Transfusion Services, Ministry of Health, Nairobi, Kenya
| | - Elizabeth Odhiambo
- Kenya National Blood Transfusion Services, Ministry of Health, Nairobi, Kenya
| | - Thomas Rotich
- Kenya National Blood Transfusion Services, Ministry of Health, Nairobi, Kenya
| | - Irene Orgut
- Kenya National Blood Transfusion Services, Ministry of Health, Nairobi, Kenya
| | - Sammy Kihara
- Kenya National Blood Transfusion Services, Ministry of Health, Nairobi, Kenya
| | - Mark Otiende
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Christian Bottomley
- Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | - Zonia N Mupe
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Katherine E Gallagher
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | | | - Shirine Voller
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | | | - Daisy Mugo
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Edward Otieno
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Teresa Lambe
- Nuffield Department of Medicine, Oxford University, Oxford, UK
| | - Daniel Wright
- Nuffield Department of Medicine, Oxford University, Oxford, UK
| | - Edwine Barasa
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Philip Bejon
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Nuffield Department of Medicine, Oxford University, Oxford, UK
| | | | | | - J Anthony G Scott
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | - George M Warimwe
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Nuffield Department of Medicine, Oxford University, Oxford, UK
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18
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Galipeau Y, Greig M, Liu G, Driedger M, Langlois MA. Humoral Responses and Serological Assays in SARS-CoV-2 Infections. Front Immunol 2020; 11:610688. [PMID: 33391281 PMCID: PMC7775512 DOI: 10.3389/fimmu.2020.610688] [Citation(s) in RCA: 168] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 11/23/2020] [Indexed: 12/14/2022] Open
Abstract
In December 2019, the novel betacoronavirus Severe Acute Respiratory Disease Coronavirus 2 (SARS-CoV-2) was first detected in Wuhan, China. SARS-CoV-2 has since become a pandemic virus resulting in hundreds of thousands of deaths and deep socioeconomic implications worldwide. In recent months, efforts have been directed towards detecting, tracking, and better understanding human humoral responses to SARS-CoV-2 infection. It has become critical to develop robust and reliable serological assays to characterize the abundance, neutralization efficiency, and duration of antibodies in virus-exposed individuals. Here we review the latest knowledge on humoral immune responses to SARS-CoV-2 infection, along with the benefits and limitations of currently available commercial and laboratory-based serological assays. We also highlight important serological considerations, such as antibody expression levels, stability and neutralization dynamics, as well as cross-reactivity and possible immunological back-boosting by seasonal coronaviruses. The ability to accurately detect, measure and characterize the various antibodies specific to SARS-CoV-2 is necessary for vaccine development, manage risk and exposure for healthcare and at-risk workers, and for monitoring reinfections with genetic variants and new strains of the virus. Having a thorough understanding of the benefits and cautions of standardized serological testing at a community level remains critically important in the design and implementation of future vaccination campaigns, epidemiological models of immunity, and public health measures that rely heavily on up-to-date knowledge of transmission dynamics.
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Affiliation(s)
- Yannick Galipeau
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON, Canada
| | - Matthew Greig
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON, Canada
| | - George Liu
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON, Canada
| | | | - Marc-André Langlois
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON, Canada
- uOttawa Center for Infection, Immunity and Inflammation (CI3), Ottawa, ON, Canada
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19
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De Carlo A, Lo Caputo S, Paolillo C, Rosa AM, D’Orsi U, De Palma M, Reveglia P, Lacedonia D, Cinnella G, Foschino MP, Margaglione M, Mirabella L, Santantonio TA, Corso G, Dattoli V. SARS-COV-2 Serological Profile in Healthcare Professionals of a Southern Italy Hospital. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9324. [PMID: 33322150 PMCID: PMC7764094 DOI: 10.3390/ijerph17249324] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/26/2020] [Accepted: 12/08/2020] [Indexed: 12/15/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the first coronavirus that has caused a pandemic. Assessing the prevalence of anti-SARS-CoV-2 in healthcare worker groups offers a unique opportunity to study the correlation between seroconversion and immunization because of their occupational exposure and a higher risk of contagion. The study enrolled 3242 asymptomatic employees of "Policlinico Riuniti", Foggia. After the first screening, we collected sequential serum samples for up to 23 weeks from the same subjects. In order to perform a longitudinal follow-up study and get information about the titration of IgG levels, we analyzed data from subjects (33) with at least two consecutive serological IgG-positive tests; 62 (1.9%; 95% CI: 1.4-2.3) tested positive for at least one anti-SARS-CoV-2 antibody. The seroprevalence was lower in the high-risk group 1.4% (6/428; 95% CI: 0.5-2.6) vs. the intermediate-risk group 2.0% (55/2736; 95% CI: 1.5-2.5). Overall, within eight weeks, we detected a mean reduction of -17% in IgG levels. Our data suggest a reduction of about 9.27 AU/mL every week (R2 = 0.35, p = 0.0003). This study revealed the prevalence of SARS-CoV-2 antibodies among Foggia's hospital healthcare staff (1.9%). Moreover, the IgG level reduction suggests that the serological response fades fast in asymptomatic infections.
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Affiliation(s)
- Armando De Carlo
- Azienda Ospedaliera-Universitaria Policlinico Riuniti di Foggia, 71122 Foggia, Italy; (A.D.C.); (S.L.C.); (A.M.R.); (U.D.); (M.D.P.); (D.L.); (G.C.); (M.P.F.); (M.M.); (L.M.); (T.A.S.); (V.D.)
| | - Sergio Lo Caputo
- Azienda Ospedaliera-Universitaria Policlinico Riuniti di Foggia, 71122 Foggia, Italy; (A.D.C.); (S.L.C.); (A.M.R.); (U.D.); (M.D.P.); (D.L.); (G.C.); (M.P.F.); (M.M.); (L.M.); (T.A.S.); (V.D.)
- Dipartimento di Medicina Clinica e Sperimentale, Università di Foggia, 71122 Foggia, Italy; (C.P.); (P.R.)
| | - Carmela Paolillo
- Dipartimento di Medicina Clinica e Sperimentale, Università di Foggia, 71122 Foggia, Italy; (C.P.); (P.R.)
| | - Anna Maria Rosa
- Azienda Ospedaliera-Universitaria Policlinico Riuniti di Foggia, 71122 Foggia, Italy; (A.D.C.); (S.L.C.); (A.M.R.); (U.D.); (M.D.P.); (D.L.); (G.C.); (M.P.F.); (M.M.); (L.M.); (T.A.S.); (V.D.)
| | - Umberto D’Orsi
- Azienda Ospedaliera-Universitaria Policlinico Riuniti di Foggia, 71122 Foggia, Italy; (A.D.C.); (S.L.C.); (A.M.R.); (U.D.); (M.D.P.); (D.L.); (G.C.); (M.P.F.); (M.M.); (L.M.); (T.A.S.); (V.D.)
| | - Maria De Palma
- Azienda Ospedaliera-Universitaria Policlinico Riuniti di Foggia, 71122 Foggia, Italy; (A.D.C.); (S.L.C.); (A.M.R.); (U.D.); (M.D.P.); (D.L.); (G.C.); (M.P.F.); (M.M.); (L.M.); (T.A.S.); (V.D.)
| | - Pierluigi Reveglia
- Dipartimento di Medicina Clinica e Sperimentale, Università di Foggia, 71122 Foggia, Italy; (C.P.); (P.R.)
| | - Donato Lacedonia
- Azienda Ospedaliera-Universitaria Policlinico Riuniti di Foggia, 71122 Foggia, Italy; (A.D.C.); (S.L.C.); (A.M.R.); (U.D.); (M.D.P.); (D.L.); (G.C.); (M.P.F.); (M.M.); (L.M.); (T.A.S.); (V.D.)
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Foggia, 71122 Foggia, Italy
| | - Gilda Cinnella
- Azienda Ospedaliera-Universitaria Policlinico Riuniti di Foggia, 71122 Foggia, Italy; (A.D.C.); (S.L.C.); (A.M.R.); (U.D.); (M.D.P.); (D.L.); (G.C.); (M.P.F.); (M.M.); (L.M.); (T.A.S.); (V.D.)
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Foggia, 71122 Foggia, Italy
| | - Maria Pia Foschino
- Azienda Ospedaliera-Universitaria Policlinico Riuniti di Foggia, 71122 Foggia, Italy; (A.D.C.); (S.L.C.); (A.M.R.); (U.D.); (M.D.P.); (D.L.); (G.C.); (M.P.F.); (M.M.); (L.M.); (T.A.S.); (V.D.)
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Foggia, 71122 Foggia, Italy
| | - Maurizio Margaglione
- Azienda Ospedaliera-Universitaria Policlinico Riuniti di Foggia, 71122 Foggia, Italy; (A.D.C.); (S.L.C.); (A.M.R.); (U.D.); (M.D.P.); (D.L.); (G.C.); (M.P.F.); (M.M.); (L.M.); (T.A.S.); (V.D.)
- Dipartimento di Medicina Clinica e Sperimentale, Università di Foggia, 71122 Foggia, Italy; (C.P.); (P.R.)
| | - Lucia Mirabella
- Azienda Ospedaliera-Universitaria Policlinico Riuniti di Foggia, 71122 Foggia, Italy; (A.D.C.); (S.L.C.); (A.M.R.); (U.D.); (M.D.P.); (D.L.); (G.C.); (M.P.F.); (M.M.); (L.M.); (T.A.S.); (V.D.)
| | - Teresa Antonia Santantonio
- Azienda Ospedaliera-Universitaria Policlinico Riuniti di Foggia, 71122 Foggia, Italy; (A.D.C.); (S.L.C.); (A.M.R.); (U.D.); (M.D.P.); (D.L.); (G.C.); (M.P.F.); (M.M.); (L.M.); (T.A.S.); (V.D.)
- Dipartimento di Medicina Clinica e Sperimentale, Università di Foggia, 71122 Foggia, Italy; (C.P.); (P.R.)
| | - Gaetano Corso
- Azienda Ospedaliera-Universitaria Policlinico Riuniti di Foggia, 71122 Foggia, Italy; (A.D.C.); (S.L.C.); (A.M.R.); (U.D.); (M.D.P.); (D.L.); (G.C.); (M.P.F.); (M.M.); (L.M.); (T.A.S.); (V.D.)
- Dipartimento di Medicina Clinica e Sperimentale, Università di Foggia, 71122 Foggia, Italy; (C.P.); (P.R.)
| | - Vitangelo Dattoli
- Azienda Ospedaliera-Universitaria Policlinico Riuniti di Foggia, 71122 Foggia, Italy; (A.D.C.); (S.L.C.); (A.M.R.); (U.D.); (M.D.P.); (D.L.); (G.C.); (M.P.F.); (M.M.); (L.M.); (T.A.S.); (V.D.)
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20
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Patterson EI, Elia G, Grassi A, Giordano A, Desario C, Medardo M, Smith SL, Anderson ER, Prince T, Patterson GT, Lorusso E, Lucente MS, Lanave G, Lauzi S, Bonfanti U, Stranieri A, Martella V, Solari Basano F, Barrs VR, Radford AD, Agrimi U, Hughes GL, Paltrinieri S, Decaro N. Evidence of exposure to SARS-CoV-2 in cats and dogs from households in Italy. Nat Commun 2020; 11:6231. [PMID: 33277505 PMCID: PMC7718263 DOI: 10.1038/s41467-020-20097-0] [Citation(s) in RCA: 240] [Impact Index Per Article: 60.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 11/13/2020] [Indexed: 01/20/2023] Open
Abstract
SARS-CoV-2 emerged from animals and is now easily transmitted between people. Sporadic detection of natural cases in animals alongside successful experimental infections of pets, such as cats, ferrets and dogs, raises questions about the susceptibility of animals under natural conditions of pet ownership. Here, we report a large-scale study to assess SARS-CoV-2 infection in 919 companion animals living in northern Italy, sampled at a time of frequent human infection. No animals tested PCR positive. However, 3.3% of dogs and 5.8% of cats had measurable SARS-CoV-2 neutralizing antibody titers, with dogs from COVID-19 positive households being significantly more likely to test positive than those from COVID-19 negative households. Understanding risk factors associated with this and their potential to infect other species requires urgent investigation.
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Affiliation(s)
- E I Patterson
- Centre for Neglected Tropical Disease, Departments of Vector Biology and Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - G Elia
- Department of Veterinary Medicine, University of Bari Aldo Moro, Strada Prov. per Casamassima Km 3, 70010, Valenzano, BA, Italy
| | - A Grassi
- I-VET srl, Laboratorio di Analisi Veterinarie, Via Ettore Majorana, 10 - 25020, Flero, BS, Italy
| | - A Giordano
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Milan, Via dell'Università 6, 26900, Lodi, Italy
| | - C Desario
- Department of Veterinary Medicine, University of Bari Aldo Moro, Strada Prov. per Casamassima Km 3, 70010, Valenzano, BA, Italy
| | - M Medardo
- La Vallonèa Veterinary Diagnostic Laboratory, via G. Sirtori 9, 20017, Passirana di Rho, MI, Italy
| | - S L Smith
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston, CH64 7TE, UK
| | - E R Anderson
- Centre for Neglected Tropical Disease, Departments of Vector Biology and Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - T Prince
- NIHR Health Protection Unit in Emerging and Zoonotic Infections, Department of Clinical Infection, Microbiology and Immunology, University of Liverpool, Liverpool, UK
| | - G T Patterson
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston, CH64 7TE, UK
| | - E Lorusso
- Department of Veterinary Medicine, University of Bari Aldo Moro, Strada Prov. per Casamassima Km 3, 70010, Valenzano, BA, Italy
| | - M S Lucente
- Department of Veterinary Medicine, University of Bari Aldo Moro, Strada Prov. per Casamassima Km 3, 70010, Valenzano, BA, Italy
| | - G Lanave
- Department of Veterinary Medicine, University of Bari Aldo Moro, Strada Prov. per Casamassima Km 3, 70010, Valenzano, BA, Italy
| | - S Lauzi
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Milan, Via dell'Università 6, 26900, Lodi, Italy
| | - U Bonfanti
- La Vallonèa Veterinary Diagnostic Laboratory, via G. Sirtori 9, 20017, Passirana di Rho, MI, Italy
| | - A Stranieri
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Milan, Via dell'Università 6, 26900, Lodi, Italy
| | - V Martella
- Department of Veterinary Medicine, University of Bari Aldo Moro, Strada Prov. per Casamassima Km 3, 70010, Valenzano, BA, Italy
| | - F Solari Basano
- Arcoblu s.r.l., via Alessandro Milesi 5, 20133, Milan, Italy
| | - V R Barrs
- City University's Jockey Club College of Veterinary Medicine and Life Sciences, 5/F, Block 1A, To Yuen Building, 31 To Yuen Street, Kowloon, Hong Kong
| | - A D Radford
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston, CH64 7TE, UK
| | - U Agrimi
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy
| | - G L Hughes
- Centre for Neglected Tropical Disease, Departments of Vector Biology and Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - S Paltrinieri
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Milan, Via dell'Università 6, 26900, Lodi, Italy
| | - N Decaro
- Department of Veterinary Medicine, University of Bari Aldo Moro, Strada Prov. per Casamassima Km 3, 70010, Valenzano, BA, Italy.
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21
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Peirlinck M, Linka K, Sahli Costabal F, Bhattacharya J, Bendavid E, Ioannidis JPA, Kuhl E. Visualizing the invisible: The effect of asymptomatic transmission on the outbreak dynamics of COVID-19. COMPUTER METHODS IN APPLIED MECHANICS AND ENGINEERING 2020; 372:113410. [PMID: 33518823 PMCID: PMC7831913 DOI: 10.1016/j.cma.2020.113410] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 08/28/2020] [Accepted: 08/31/2020] [Indexed: 05/04/2023]
Abstract
Understanding the outbreak dynamics of the COVID-19 pandemic has important implications for successful containment and mitigation strategies. Recent studies suggest that the population prevalence of SARS-CoV-2 antibodies, a proxy for the number of asymptomatic cases, could be an order of magnitude larger than expected from the number of reported symptomatic cases. Knowing the precise prevalence and contagiousness of asymptomatic transmission is critical to estimate the overall dimension and pandemic potential of COVID-19. However, at this stage, the effect of the asymptomatic population, its size, and its outbreak dynamics remain largely unknown. Here we use reported symptomatic case data in conjunction with antibody seroprevalence studies, a mathematical epidemiology model, and a Bayesian framework to infer the epidemiological characteristics of COVID-19. Our model computes, in real time, the time-varying contact rate of the outbreak, and projects the temporal evolution and credible intervals of the effective reproduction number and the symptomatic, asymptomatic, and recovered populations. Our study quantifies the sensitivity of the outbreak dynamics of COVID-19 to three parameters: the effective reproduction number, the ratio between the symptomatic and asymptomatic populations, and the infectious periods of both groups. For nine distinct locations, our model estimates the fraction of the population that has been infected and recovered by Jun 15, 2020 to 24.15% (95% CI: 20.48%-28.14%) for Heinsberg (NRW, Germany), 2.40% (95% CI: 2.09%-2.76%) for Ada County (ID, USA), 46.19% (95% CI: 45.81%-46.60%) for New York City (NY, USA), 11.26% (95% CI: 7.21%-16.03%) for Santa Clara County (CA, USA), 3.09% (95% CI: 2.27%-4.03%) for Denmark, 12.35% (95% CI: 10.03%-15.18%) for Geneva Canton (Switzerland), 5.24% (95% CI: 4.84%-5.70%) for the Netherlands, 1.53% (95% CI: 0.76%-2.62%) for Rio Grande do Sul (Brazil), and 5.32% (95% CI: 4.77%-5.93%) for Belgium. Our method traces the initial outbreak date in Santa Clara County back to January 20, 2020 (95% CI: December 29, 2019-February 13, 2020). Our results could significantly change our understanding and management of the COVID-19 pandemic: A large asymptomatic population will make isolation, containment, and tracing of individual cases challenging. Instead, managing community transmission through increasing population awareness, promoting physical distancing, and encouraging behavioral changes could become more relevant.
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Affiliation(s)
- Mathias Peirlinck
- Department of Mechanical Engineering, Stanford University School of Engineering, Stanford, CA, United States
| | - Kevin Linka
- Department of Mechanical Engineering, Stanford University School of Engineering, Stanford, CA, United States
| | - Francisco Sahli Costabal
- Department of Mechanical and Metallurgical Engineering and Institute for Biological and Medical Engineering, Schools of Engineering, Biology and Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Jay Bhattacharya
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Eran Bendavid
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - John P A Ioannidis
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, United States
| | - Ellen Kuhl
- Department of Mechanical Engineering, Stanford University School of Engineering, Stanford, CA, United States
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22
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Flower B, Brown JC, Simmons B, Moshe M, Frise R, Penn R, Kugathasan R, Petersen C, Daunt A, Ashby D, Riley S, Atchison CJ, Taylor GP, Satkunarajah S, Naar L, Klaber R, Badhan A, Rosadas C, Khan M, Fernandez N, Sureda-Vives M, Cheeseman HM, O'Hara J, Fontana G, Pallett SJC, Rayment M, Jones R, Moore LSP, McClure MO, Cherepanov P, Tedder R, Ashrafian H, Shattock R, Ward H, Darzi A, Elliot P, Barclay WS, Cooke GS. Clinical and laboratory evaluation of SARS-CoV-2 lateral flow assays for use in a national COVID-19 seroprevalence survey. Thorax 2020; 75:1082-1088. [PMID: 32796119 PMCID: PMC7430184 DOI: 10.1136/thoraxjnl-2020-215732] [Citation(s) in RCA: 98] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 07/22/2020] [Accepted: 07/25/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Accurate antibody tests are essential to monitor the SARS-CoV-2 pandemic. Lateral flow immunoassays (LFIAs) can deliver testing at scale. However, reported performance varies, and sensitivity analyses have generally been conducted on serum from hospitalised patients. For use in community testing, evaluation of finger-prick self-tests, in non-hospitalised individuals, is required. METHODS Sensitivity analysis was conducted on 276 non-hospitalised participants. All had tested positive for SARS-CoV-2 by reverse transcription PCR and were ≥21 days from symptom onset. In phase I, we evaluated five LFIAs in clinic (with finger prick) and laboratory (with blood and sera) in comparison to (1) PCR-confirmed infection and (2) presence of SARS-CoV-2 antibodies on two 'in-house' ELISAs. Specificity analysis was performed on 500 prepandemic sera. In phase II, six additional LFIAs were assessed with serum. FINDINGS 95% (95% CI 92.2% to 97.3%) of the infected cohort had detectable antibodies on at least one ELISA. LFIA sensitivity was variable, but significantly inferior to ELISA in 8 out of 11 assessed. Of LFIAs assessed in both clinic and laboratory, finger-prick self-test sensitivity varied from 21% to 92% versus PCR-confirmed cases and from 22% to 96% versus composite ELISA positives. Concordance between finger-prick and serum testing was at best moderate (kappa 0.56) and, at worst, slight (kappa 0.13). All LFIAs had high specificity (97.2%-99.8%). INTERPRETATION LFIA sensitivity and sample concordance is variable, highlighting the importance of evaluations in setting of intended use. This rigorous approach to LFIA evaluation identified a test with high specificity (98.6% (95%CI 97.1% to 99.4%)), moderate sensitivity (84.4% with finger prick (95% CI 70.5% to 93.5%)) and moderate concordance, suitable for seroprevalence surveys.
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Affiliation(s)
- Barnaby Flower
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
- NIHR BRC, Imperial College NHS Trust, London, UK
| | - Jonathan C Brown
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | - Bryony Simmons
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | - Maya Moshe
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | - Rebecca Frise
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | - Rebecca Penn
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | - Ruthiran Kugathasan
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | | | - Anna Daunt
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
- Imperial College Healthcare NHS Trust, London, UK
| | - Deborah Ashby
- Department of Epidemiology and Public Health, Imperial College London, London, UK
| | - Steven Riley
- Department of Epidemiology and Public Health, Imperial College London, London, UK
| | - Christina Joanne Atchison
- NIHR BRC, Imperial College NHS Trust, London, UK
- Department of Epidemiology and Public Health, Imperial College London, London, UK
| | - Graham P Taylor
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | - Sutha Satkunarajah
- Institute of Global Health Innovation, Imperial College London, London, UK
| | - Lenny Naar
- Institute of Global Health Innovation, Imperial College London, London, UK
| | | | - Anjna Badhan
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | - Carolina Rosadas
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | - Maryam Khan
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | - Natalia Fernandez
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | - Macià Sureda-Vives
- Synthetic Biology Group, MRC London Institute of Medical Sciences, Imperial College London, London, UK
| | - Hannah M Cheeseman
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | - Jessica O'Hara
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | - Gianluca Fontana
- Institute of Global Health Innovation, Imperial College London, London, UK
| | - Scott J C Pallett
- Centre for Defence Pathology, British Army, Birmingham, UK
- Chelsea and Westminster Healthcare NHS Trust, London, UK
| | | | - Rachael Jones
- Chelsea and Westminster Healthcare NHS Trust, London, UK
| | - Luke S P Moore
- Chelsea and Westminster Healthcare NHS Trust, London, UK
- NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK
| | - Myra O McClure
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | - Peter Cherepanov
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | - Richard Tedder
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | - Hutan Ashrafian
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Robin Shattock
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | - Helen Ward
- NIHR BRC, Imperial College NHS Trust, London, UK
- Department of Epidemiology and Public Health, Imperial College London, London, UK
| | - Ara Darzi
- NIHR BRC, Imperial College NHS Trust, London, UK
- Institute of Global Health Innovation, Imperial College London, London, UK
| | - Paul Elliot
- NIHR BRC, Imperial College NHS Trust, London, UK
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Wendy S Barclay
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | - Graham S Cooke
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
- NIHR BRC, Imperial College NHS Trust, London, UK
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23
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Levin AT, Hanage WP, Owusu-Boaitey N, Cochran KB, Walsh SP, Meyerowitz-Katz G. Assessing the age specificity of infection fatality rates for COVID-19: systematic review, meta-analysis, and public policy implications. Eur J Epidemiol 2020; 35:1123-1138. [PMID: 33289900 PMCID: PMC7721859 DOI: 10.1007/s10654-020-00698-1] [Citation(s) in RCA: 464] [Impact Index Per Article: 116.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 11/10/2020] [Indexed: 12/17/2022]
Abstract
Determine age-specific infection fatality rates for COVID-19 to inform public health policies and communications that help protect vulnerable age groups. Studies of COVID-19 prevalence were collected by conducting an online search of published articles, preprints, and government reports that were publicly disseminated prior to 18 September 2020. The systematic review encompassed 113 studies, of which 27 studies (covering 34 geographical locations) satisfied the inclusion criteria and were included in the meta-analysis. Age-specific IFRs were computed using the prevalence data in conjunction with reported fatalities 4 weeks after the midpoint date of the study, reflecting typical lags in fatalities and reporting. Meta-regression procedures in Stata were used to analyze the infection fatality rate (IFR) by age. Our analysis finds a exponential relationship between age and IFR for COVID-19. The estimated age-specific IFR is very low for children and younger adults (e.g., 0.002% at age 10 and 0.01% at age 25) but increases progressively to 0.4% at age 55, 1.4% at age 65, 4.6% at age 75, and 15% at age 85. Moreover, our results indicate that about 90% of the variation in population IFR across geographical locations reflects differences in the age composition of the population and the extent to which relatively vulnerable age groups were exposed to the virus. These results indicate that COVID-19 is hazardous not only for the elderly but also for middle-aged adults, for whom the infection fatality rate is two orders of magnitude greater than the annualized risk of a fatal automobile accident and far more dangerous than seasonal influenza. Moreover, the overall IFR for COVID-19 should not be viewed as a fixed parameter but as intrinsically linked to the age-specific pattern of infections. Consequently, public health measures to mitigate infections in older adults could substantially decrease total deaths.
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Affiliation(s)
- Andrew T Levin
- Dartmouth College, Hanover, USA
- National Bureau for Economic Research, Cambridge, USA
- Centre for Economic Policy Research, London, United Kingdom
| | | | | | | | | | - Gideon Meyerowitz-Katz
- University of Wollongong, Wollongong, Australia.
- Western Sydney Local Health District, PO Box 792, Seven Hills, NSW, 2147, Australia.
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24
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Lai AG, Pasea L, Banerjee A, Hall G, Denaxas S, Chang WH, Katsoulis M, Williams B, Pillay D, Noursadeghi M, Linch D, Hughes D, Forster MD, Turnbull C, Fitzpatrick NK, Boyd K, Foster GR, Enver T, Nafilyan V, Humberstone B, Neal RD, Cooper M, Jones M, Pritchard-Jones K, Sullivan R, Davie C, Lawler M, Hemingway H. Estimated impact of the COVID-19 pandemic on cancer services and excess 1-year mortality in people with cancer and multimorbidity: near real-time data on cancer care, cancer deaths and a population-based cohort study. BMJ Open 2020; 10:e043828. [PMID: 33203640 PMCID: PMC7674020 DOI: 10.1136/bmjopen-2020-043828] [Citation(s) in RCA: 185] [Impact Index Per Article: 46.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/20/2020] [Accepted: 10/23/2020] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES To estimate the impact of the COVID-19 pandemic on cancer care services and overall (direct and indirect) excess deaths in people with cancer. METHODS We employed near real-time weekly data on cancer care to determine the adverse effect of the pandemic on cancer services. We also used these data, together with national death registrations until June 2020 to model deaths, in excess of background (pre-COVID-19) mortality, in people with cancer. Background mortality risks for 24 cancers with and without COVID-19-relevant comorbidities were obtained from population-based primary care cohort (Clinical Practice Research Datalink) on 3 862 012 adults in England. RESULTS Declines in urgent referrals (median=-70.4%) and chemotherapy attendances (median=-41.5%) to a nadir (lowest point) in the pandemic were observed. By 31 May, these declines have only partially recovered; urgent referrals (median=-44.5%) and chemotherapy attendances (median=-31.2%). There were short-term excess death registrations for cancer (without COVID-19), with peak relative risk (RR) of 1.17 at week ending on 3 April. The peak RR for all-cause deaths was 2.1 from week ending on 17 April. Based on these findings and recent literature, we modelled 40% and 80% of cancer patients being affected by the pandemic in the long-term. At 40% affected, we estimated 1-year total (direct and indirect) excess deaths in people with cancer as between 7165 and 17 910, using RRs of 1.2 and 1.5, respectively, where 78% of excess deaths occured in patients with ≥1 comorbidity. CONCLUSIONS Dramatic reductions were detected in the demand for, and supply of, cancer services which have not fully recovered with lockdown easing. These may contribute, over a 1-year time horizon, to substantial excess mortality among people with cancer and multimorbidity. It is urgent to understand how the recovery of general practitioner, oncology and other hospital services might best mitigate these long-term excess mortality risks.
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Affiliation(s)
- Alvina G Lai
- Institute of Health Informatics, University College London, London, UK
- Health Data Research UK, University College London, London, UK
| | - Laura Pasea
- Institute of Health Informatics, University College London, London, UK
- Health Data Research UK, University College London, London, UK
| | - Amitava Banerjee
- Institute of Health Informatics, University College London, London, UK
- Health Data Research UK, University College London, London, UK
- Barts Health NHS Trust, The Royal London Hospital, Whitechapel Rd, London, UK
| | - Geoff Hall
- DATA-CAN, Health Data Research UK hub for cancer hosted by UCLPartners, London, UK
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Spiros Denaxas
- Institute of Health Informatics, University College London, London, UK
- Health Data Research UK, University College London, London, UK
- University College London Hospitals NIHR Biomedical Research Centre, London, UK
- The Alan Turing Institute, London, UK
| | - Wai Hoong Chang
- Institute of Health Informatics, University College London, London, UK
- Health Data Research UK, University College London, London, UK
| | - Michail Katsoulis
- Institute of Health Informatics, University College London, London, UK
| | - Bryan Williams
- University College London Hospitals NIHR Biomedical Research Centre, London, UK
- Institute of Cardiovascular Science, University College London, London, UK
- University College London Hospitals NHS Trust, London, UK
| | - Deenan Pillay
- Division of Infection and Immunity, University College London, London, UK
| | - Mahdad Noursadeghi
- Division of Infection and Immunity, University College London, London, UK
| | - David Linch
- University College London Hospitals NIHR Biomedical Research Centre, London, UK
- Department of Hematology, University College London Cancer Institute, London, UK
| | - Derralynn Hughes
- University College London Cancer Institute, London, UK
- Royal Free NHS Foundation Trust, London, UK
| | - Martin D Forster
- University College London Hospitals NHS Trust, London, UK
- University College London Cancer Institute, London, UK
| | - Clare Turnbull
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - Natalie K Fitzpatrick
- Institute of Health Informatics, University College London, London, UK
- Health Data Research UK, University College London, London, UK
| | - Kathryn Boyd
- Northern Ireland Cancer Network, Northern Ireland, UK
| | - Graham R Foster
- Barts Liver Centre, Blizard Institute, Queen Mary University of London, London, UK
| | - Tariq Enver
- University College London Cancer Institute, London, UK
| | | | | | - Richard D Neal
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Matt Cooper
- DATA-CAN, Health Data Research UK hub for cancer hosted by UCLPartners, London, UK
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - Monica Jones
- DATA-CAN, Health Data Research UK hub for cancer hosted by UCLPartners, London, UK
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - Kathy Pritchard-Jones
- DATA-CAN, Health Data Research UK hub for cancer hosted by UCLPartners, London, UK
- UCLPartners Academic Health Science Partnership, London, UK
- Centre for Cancer Outcomes, University College London Hospitals NHS Foundation Trust, London, UK
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Richard Sullivan
- Conflict and Health Research Group, Institute of Cancer Policy, King's College London, London, UK
| | - Charlie Davie
- DATA-CAN, Health Data Research UK hub for cancer hosted by UCLPartners, London, UK
- Royal Free NHS Foundation Trust, London, UK
- UCLPartners Academic Health Science Partnership, London, UK
| | - Mark Lawler
- DATA-CAN, Health Data Research UK hub for cancer hosted by UCLPartners, London, UK
- Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK
| | - Harry Hemingway
- Institute of Health Informatics, University College London, London, UK
- Health Data Research UK, University College London, London, UK
- University College London Hospitals NIHR Biomedical Research Centre, London, UK
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25
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Gastaldelli A, Gastaldelli M, Bastianoni S. COVID-19 Infection Pandemic: From the Frontline in Italy. J Am Coll Nutr 2020; 39:677-684. [PMID: 33064066 DOI: 10.1080/07315724.2020.1779147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The infection caused by COVID-19 (i.e. corona virus disease 2019) has caused more than 5.2 million cases and more than 337,000 deaths worldwide. Italy was the European epicenter for virus spread and one with most cases and deaths. The first Italian patient was diagnosed on February 18th, a young man hospitalized in Lombardy (Northern Italy). The Italian government not only isolated the village where he lived, but a few days later put the entire country in lockdown. We have here analyzed the COVID-19 Italian data during the first three months after the outbreak and the effect of lockdown. COVID-19 virus has a high transmission rate and is associated with high fatality rate especially in the older population. The initial reproduction rate of the virus (R0) in Italy was between 2.1 and 3.3 in different Italian regions, with a doubling time between 2.7 and 3.2 days. The number of confirmed cases has now reached 229,000 but after the lockdown R0 is finally below 1. Despite the lockdown, the number of infected and deceased patients in Italy was very high, with a lethality rate higher than in other countries. It is likely that number of cases is underestimating the real since the number of asymptomatic and paucisymptomatic is relatively high. It is important to investigate which patients are more vulnerable and also if other co-factors can account for this high fatality rate, since this pandemia is far from being resolved.
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Affiliation(s)
- Amalia Gastaldelli
- Institute of Clinical Physiology, CNR, Cardiometabolic Risk Unit, Pisa, Italy
| | - Mirco Gastaldelli
- Polyclinic of Abano Terme, Anesthesia and Intensive Care Unit, Padova, Italy
| | - Simone Bastianoni
- Ecodynamics Group, Department of Physical Science, Earth and Environment, University of Siena, Siena, Italy
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26
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Gujski M, Jankowski M, Pinkas J, Wierzba W, Samel-Kowalik P, Zaczyński A, Jędrusik P, Pańkowski I, Juszczyk G, Rakocy K, Raciborski F. Prevalence of Current and Past SARS-CoV-2 Infections among Police Employees in Poland, June-July 2020. J Clin Med 2020; 9:E3245. [PMID: 33050603 PMCID: PMC7600317 DOI: 10.3390/jcm9103245] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 09/30/2020] [Accepted: 10/07/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to determine the prevalence of current and past SARS-CoV-2 infections among police employees. METHODS This cross-sectional survey was undertaken among 5082 police employees from Mazowieckie Province, Poland. RT-PCR testing for current SARS-CoV-2 infection and serological tests (ELISA) for the presence of anti-SARS-CoV-2 IgM+IgA and IgG antibodies were performed. RESULTS All RT-PCR tests were negative. The anti-SARS-CoV-2 IgM+IgA index was positive (>8) in 8.9% of participants, including 11.2% women and 7.7% men (p < 0.001). Equivocal IgM+IgA index (6-8) was found in 9.8% of participants, including 11.9% women and 8.7% men (p < 0.001). The IgG index was positive (>6) in 4.3% and equivocal (4-6) in 13.2% of participants. A higher odds of positive IgM+IgA index was found in women vs. men (OR: 1.742) and police officers vs. civilian employees (OR: 1.411). Participants aged ≥60 years had a higher odds of positive IgG index vs. those aged 20-29 years (OR: 3.309). Daily vaping also increased the odds of positive IgG index (OR: 2.058). CONCLUSIONS The majority of Polish police employees are seronegative for SARS-CoV-2 infection. Vaping and older age (≥60 years) were associated with a higher risk of SARS-CoV-2 infection.
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Affiliation(s)
- Mariusz Gujski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, 02-091 Warsaw, Poland; (M.G.); (P.S.-K.); (F.R.)
| | - Mateusz Jankowski
- School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland;
| | - Jarosław Pinkas
- School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland;
| | - Waldemar Wierzba
- Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, 02-507 Warsaw, Poland; (W.W.); (A.Z.); (I.P.)
- UHE Satellite Campus in Warsaw, University of Humanities and Economics in Łódź, 01-513 Warsaw, Poland
| | - Piotr Samel-Kowalik
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, 02-091 Warsaw, Poland; (M.G.); (P.S.-K.); (F.R.)
| | - Artur Zaczyński
- Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, 02-507 Warsaw, Poland; (W.W.); (A.Z.); (I.P.)
| | - Piotr Jędrusik
- Department of Internal Disease, Hypertension and Vascular Diseases, Medical University of Warsaw, 02-097 Warsaw, Poland;
| | - Igor Pańkowski
- Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, 02-507 Warsaw, Poland; (W.W.); (A.Z.); (I.P.)
| | - Grzegorz Juszczyk
- Department of Public Health, Medical University of Warsaw, 02-097 Warsaw, Poland;
| | | | - Filip Raciborski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, 02-091 Warsaw, Poland; (M.G.); (P.S.-K.); (F.R.)
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27
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Nardone M, Cordone A, Petti S. Occupational COVID-19 risk to dental staff working in a public dental unit in the outbreak epicenter. Oral Dis 2020; 28 Suppl 1:878-890. [PMID: 32881190 DOI: 10.1111/odi.13632] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 08/14/2020] [Accepted: 08/27/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The management of the COVID-19 outbreak occurred in Lombardy (Italy) implied that non-COVID-19 health care was remodeled, limiting adequate resources in non-hospital public dental healthcare settings. This situation offered the opportunity to investigate the occupational COVID-19 risk to dental staff in public non-hospital dental units. METHODS An infection control protocol was designed for dental health care in the Territorial Health and Social Services Authority (ASST) "Melegnano and Martesana" (Milan). Since specific guidance from central authorities was lacking, information was gathered from international public health organizations. The probability to visit asymptomatic COVID-19-infected patients was estimated, and the occupational risk to dental staff was calculated. RESULTS The probability to visit asymptomatic patients passed from 1.2% (95% confidence interval -95 CI, 0.6%-2.5%) in the first period (20 February-15 March 2020) to 11.1% (95 CI, 5.8%-23.6%) in the second period (16 March-30 April). Dentists and dental assistants did not develop COVID-19, while one nurse did, the nature of her occupational risk was unclear, as nurses provided prevalently non-dental health care. The probabilities of developing COVID-19 per worked hour per person excluding and including this uncertain situation were 0.0% (95 CI, 0.0%-3.2%) and 0.9% (95 CI, 0.1%-4.7%). CONCLUSION Relatively simple infection control procedures were enough to control occupational COVID-19 risk during the outbreak.
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Affiliation(s)
- Michele Nardone
- Territorial Health and Social Services Authority (ASST) "Melegnano and Martesana", Milan, Italy
| | - Angelo Cordone
- Territorial Health and Social Services Authority (ASST) "Melegnano and Martesana", Milan, Italy
| | - Stefano Petti
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
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28
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Peirlinck M, Linka K, Costabal FS, Bhattacharya J, Bendavid E, Ioannidis JPA, Kuhl E. Visualizing the invisible: The effect of asymptomatic transmission on the outbreak dynamics of COVID-19. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.05.23.20111419. [PMID: 32869035 PMCID: PMC7457606 DOI: 10.1101/2020.05.23.20111419] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Understanding the outbreak dynamics of the COVID-19 pandemic has important implications for successful containment and mitigation strategies. Recent studies suggest that the population prevalence of SARS-CoV-2 antibodies, a proxy for the number of asymptomatic cases, could be an order of magnitude larger than expected from the number of reported symptomatic cases. Knowing the precise prevalence and contagiousness of asymptomatic transmission is critical to estimate the overall dimension and pandemic potential of COVID-19. However, at this stage, the effect of the asymptomatic population, its size, and its outbreak dynamics remain largely unknown. Here we use reported symptomatic case data in conjunction with antibody seroprevalence studies, a mathematical epidemiology model, and a Bayesian framework to infer the epidemiological characteristics of COVID-19. Our model computes, in real time, the time-varying contact rate of the outbreak, and projects the temporal evolution and credible intervals of the effective reproduction number and the symptomatic, asymptomatic, and recovered populations. Our study quantifies the sensitivity of the outbreak dynamics of COVID-19 to three parameters: the effective reproduction number, the ratio between the symptomatic and asymptomatic populations, and the infectious periods of both groups For nine distinct locations, our model estimates the fraction of the population that has been infected and recovered by Jun 15, 2020 to 24.15% (95% CI: 20.48%-28.14%) for Heinsberg (NRW, Germany), 2.40% (95% CI: 2.09%-2.76%) for Ada County (ID, USA), 46.19% (95% CI: 45.81%-46.60%) for New York City (NY, USA), 11.26% (95% CI: 7.21%-16.03%) for Santa Clara County (CA, USA), 3.09% (95% CI: 2.27%-4.03%) for Denmark, 12.35% (95% CI: 10.03%-15.18%) for Geneva Canton (Switzerland), 5.24% (95% CI: 4.84%-5.70%) for the Netherlands, 1.53% (95% CI: 0.76%-2.62%) for Rio Grande do Sul (Brazil), and 5.32% (95% CI: 4.77%-5.93%) for Belgium. Our method traces the initial outbreak date in Santa Clara County back to January 20, 2020 (95% CI: December 29, 2019 - February 13, 2020). Our results could significantly change our understanding and management of the COVID-19 pandemic: A large asymptomatic population will make isolation, containment, and tracing of individual cases challenging. Instead, managing community transmission through increasing population awareness, promoting physical distancing, and encouraging behavioral changes could become more relevant.
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Affiliation(s)
- Mathias Peirlinck
- Department of Mechanical Engineering, Stanford University School of Engineering, Stanford, California, United States
| | - Kevin Linka
- Department of Mechanical Engineering, Stanford University School of Engineering, Stanford, California, United States
| | - Francisco Sahli Costabal
- Department of Mechanical and Metallurgical Engineering and Institute for Biological and Medical Engineering, Schools of Engineering, Biology and Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Jay Bhattacharya
- Department of Medicine, Stanford University School of Medicine, Stanford, California, United States
| | - Eran Bendavid
- Department of Medicine, Stanford University School of Medicine, Stanford, California, United States
| | - John P A Ioannidis
- Department of Medicine, Stanford University School of Medicine, Stanford, California, United States
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, United States
| | - Ellen Kuhl
- Department of Mechanical Engineering, Stanford University School of Engineering, Stanford, California, United States
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29
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Patterson EI, Elia G, Grassi A, Giordano A, Desario C, Medardo M, Smith SL, Anderson ER, Prince T, Patterson GT, Lorusso E, Lucente MS, Lanave G, Lauzi S, Bonfanti U, Stranieri A, Martella V, Basano FS, Barrs VR, Radford AD, Agrimi U, Hughes GL, Paltrinieri S, Decaro N. Evidence of exposure to SARS-CoV-2 in cats and dogs from households in Italy. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2020. [PMID: 32743588 DOI: 10.1101/2020.07.21.214346] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
SARS-CoV-2 originated in animals and is now easily transmitted between people. Sporadic detection of natural cases in animals alongside successful experimental infections of pets, such as cats, ferrets and dogs, raises questions about the susceptibility of animals under natural conditions of pet ownership. Here we report a large-scale study to assess SARS-CoV-2 infection in 817 companion animals living in northern Italy, sampled at a time of frequent human infection. No animals tested PCR positive. However, 3.4% of dogs and 3.9% of cats had measurable SARS-CoV-2 neutralizing antibody titers, with dogs from COVID-19 positive households being significantly more likely to test positive than those from COVID-19 negative households. Understanding risk factors associated with this and their potential to infect other species requires urgent investigation. One Sentence Summary SARS-CoV-2 antibodies in pets from Italy.
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30
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Röst G, Bartha FA, Bogya N, Boldog P, Dénes A, Ferenci T, Horváth KJ, Juhász A, Nagy C, Tekeli T, Vizi Z, Oroszi B. Early Phase of the COVID-19 Outbreak in Hungary and Post-Lockdown Scenarios. Viruses 2020; 12:E708. [PMID: 32629880 PMCID: PMC7412537 DOI: 10.3390/v12070708] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 06/25/2020] [Accepted: 06/26/2020] [Indexed: 02/07/2023] Open
Abstract
COVID-19 epidemic has been suppressed in Hungary due to timely non-pharmaceutical interventions, prompting a considerable reduction in the number of contacts and transmission of the virus. This strategy was effective in preventing epidemic growth and reducing the incidence of COVID-19 to low levels. In this report, we present the first epidemiological and statistical analysis of the early phase of the COVID-19 outbreak in Hungary. Then, we establish an age-structured compartmental model to explore alternative post-lockdown scenarios. We incorporate various factors, such as age-specific measures, seasonal effects, and spatial heterogeneity to project the possible peak size and disease burden of a COVID-19 epidemic wave after the current measures are relaxed.
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Affiliation(s)
- Gergely Röst
- Bolyai Institute, University of Szeged, 6720 Szeged, Hungary; (G.R.); (N.B.); (P.B.); (A.D.); (K.J.H.); (A.J.); (C.N.); (T.T.); (Z.V.); (B.O.)
| | - Ferenc A. Bartha
- Bolyai Institute, University of Szeged, 6720 Szeged, Hungary; (G.R.); (N.B.); (P.B.); (A.D.); (K.J.H.); (A.J.); (C.N.); (T.T.); (Z.V.); (B.O.)
| | - Norbert Bogya
- Bolyai Institute, University of Szeged, 6720 Szeged, Hungary; (G.R.); (N.B.); (P.B.); (A.D.); (K.J.H.); (A.J.); (C.N.); (T.T.); (Z.V.); (B.O.)
| | - Péter Boldog
- Bolyai Institute, University of Szeged, 6720 Szeged, Hungary; (G.R.); (N.B.); (P.B.); (A.D.); (K.J.H.); (A.J.); (C.N.); (T.T.); (Z.V.); (B.O.)
| | - Attila Dénes
- Bolyai Institute, University of Szeged, 6720 Szeged, Hungary; (G.R.); (N.B.); (P.B.); (A.D.); (K.J.H.); (A.J.); (C.N.); (T.T.); (Z.V.); (B.O.)
| | - Tamás Ferenci
- Physiological Controls Research Center, Óbuda University, 1034 Budapest, Hungary;
| | - Krisztina J. Horváth
- Bolyai Institute, University of Szeged, 6720 Szeged, Hungary; (G.R.); (N.B.); (P.B.); (A.D.); (K.J.H.); (A.J.); (C.N.); (T.T.); (Z.V.); (B.O.)
| | - Attila Juhász
- Bolyai Institute, University of Szeged, 6720 Szeged, Hungary; (G.R.); (N.B.); (P.B.); (A.D.); (K.J.H.); (A.J.); (C.N.); (T.T.); (Z.V.); (B.O.)
- Department of Public Health, Government Office of Capital City Budapest, 1034 Budapest, Hungary
| | - Csilla Nagy
- Bolyai Institute, University of Szeged, 6720 Szeged, Hungary; (G.R.); (N.B.); (P.B.); (A.D.); (K.J.H.); (A.J.); (C.N.); (T.T.); (Z.V.); (B.O.)
- Department of Public Health, Government Office of Capital City Budapest, 1034 Budapest, Hungary
| | - Tamás Tekeli
- Bolyai Institute, University of Szeged, 6720 Szeged, Hungary; (G.R.); (N.B.); (P.B.); (A.D.); (K.J.H.); (A.J.); (C.N.); (T.T.); (Z.V.); (B.O.)
| | - Zsolt Vizi
- Bolyai Institute, University of Szeged, 6720 Szeged, Hungary; (G.R.); (N.B.); (P.B.); (A.D.); (K.J.H.); (A.J.); (C.N.); (T.T.); (Z.V.); (B.O.)
| | - Beatrix Oroszi
- Bolyai Institute, University of Szeged, 6720 Szeged, Hungary; (G.R.); (N.B.); (P.B.); (A.D.); (K.J.H.); (A.J.); (C.N.); (T.T.); (Z.V.); (B.O.)
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