Background: During the COVID-19 pandemic, SARS-CoV-2 serology tests have been used to understand the extent to which populations have been infected. The objective of this study was to synthesize literature on SARS-CoV-2 seroprevalence studies, including sampling frames, study characteristics, assay test performance characteristics, and proportion of participants with IgG and IgM SARS-CoV-2 antibodies.Methods: Bibliometric databases, trial registers, pre-print servers, and grey literature were searched through May 27, 2020 using a published protocol to identify eligible studies. Title and abstract screening and full-text reviewing were performed in duplicate. Study-level data were extracted, and a narrative synthesis was performed. Results: Of the 4,049 studies screened for inclusion, 27 published reports were included, and 85 studies are ongoing. Most (52%) published reports were available through pre-print servers. Sample sizes ranged from 200 to 113,033 participants. Healthcare worker (n=9 studies, 33%) and non-representative, general population (n=10 studies, 37%) sampling frames were more commonly used than representative, general population sampling frames (n=7, 26%). Mean age ranged from 18 up to 69 years, and the proportion of females ranged from 25% to 85%. Test performance characteristics varied, including IgG sensitivity (range: 63.3% to 100%) and IgG specificity (range: 97.0% to 100%). IgG seroprevalence estimates ranged from 0.5% to 21.0%, and IgM seroprevalence ranged from 1.1% to 18.9%.Conclusion: More high-quality SARS-CoV-2 seroprevalence studies using validated assays with larger sample sizes from representative and targeted sampling frames are needed to better understand the true burden of disease, differential spread of the virus, and infection fatality rate.
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