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We report anti-SARS-CoV-2 nucleocapsid IgG seroconversion rates from a population-based cohort in Manaus, between August and November 2020, before the COVID-19 second wave in Brazil. Among seronegative and uninfected participants, we observed an overall incidence of 13.06% (95%CI, 11.52-14.79) and 6.78% (95%CI, 5.61-8.10) for symptomatic seroconversion. Risk factors for seroconversion were: having a COVID-19 case in the household, not wearing a mask during contact, relaxation of protective measures, and non-remote work. We observed an intense infection transmission period that preceded the second wave of COVID-19 in Manaus, and identified several modifiable behaviors that increased the risk of seroconversion.
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