Seroprevalence of SARS-CoV-2 antibodies in an entirely PCR-sampled and quarantined community after a COVID-19 outbreak - the CoNAN study

Weis, Sebastian; Scherag, André; Baier, Michael; Kiehntopf, Michael; Kamradt, Thomas; Kolanos, Steffi; Ankert, Juliane; Glöckner, Stefan; Makarewicz, Oliwia; Hagel, Stefan; Bahrs, Christina; Kimmig, Aurelia; Proquitté, Hans; Guerra, Joel; Loeffler, Bettina; Pletz, Mathias W.

doi:10.1101/2020.07.15.20154112

Cited by 32 publications

(53 citation statements)

References 31 publications

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“…Our results of 12% IgG-seropositive participants corrected for test performance and a proportion of 25% asymptomatic infections are in line with the results from the German high-prevalence towns Gangelt [10] and Neustadt am Rennsteig [11]. Seroepidemiological studies conducted in Germany [12] The increased odds of infection after travelling abroad and after participating in larger events are in line with the outbreak history in Kupferzell.…”

Section: Discussionsupporting

confidence: 85%

“…Seroepidemiological studies conducted in Germany [12] The increased odds of infection after travelling abroad and after participating in larger events are in line with the outbreak history in Kupferzell. From our study and the three other German studies with available data, the underascertainment ratio has been smaller than 6 [11,13,14] and not 10 or higher as in a number of international locations [17]. The association of seropositivity with very good self-reported health, although not statistically significant, may be indicative of lower risk awareness and less protective behaviour.…”

Section: Discussioncontrasting

confidence: 43%

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Serology- and PCR-based cumulative incidence of SARS-CoV-2 infection in adults in a successfully contained early hotspot (CoMoLo study), Germany, May to June 2020

et al. 2020

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Three months after a coronavirus disease (COVID-19) outbreak in Kupferzell, Germany, a population-based study (n = 2,203) found no RT-PCR-positives. IgG-ELISA seropositivity with positive virus neutralisation tests was 7.7% (95% confidence interval (CI): 6.5–9.1) and 4.3% with negative neutralisation tests. We estimate 12.0% (95% CI: 10.4–14.0%) infected adults (24.5% asymptomatic), six times more than notified. Full hotspot containment confirms the effectiveness of prompt protection measures. However, 88% naïve adults are still at high COVID-19 risk.

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Section: Discussionsupporting

confidence: 85%

Section: Discussioncontrasting

confidence: 43%

Serology- and PCR-based cumulative incidence of SARS-CoV-2 infection in adults in a successfully contained early hotspot (CoMoLo study), Germany, May to June 2020

et al. 2020

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“…A total of 18 studies were contact-tracing studies (CTSs), 7,10,12,16-31 with 3 based in schools, [29][30][31] and 14 studies were population screening studies. 7, [32][33][34][35][36][37][38][39][40][41][42][43][44][45] Two were high quality, 33,35 22 were medium quality, 10,12,16,21,22,[24][25][26][27][29][30][31][32]34,36,38,[40][41][42][43][44][45] 7 were low quality, [17][18][19][20]23,28,39 and 1 was uncertain quality. 7,37…”

Section: Resultsmentioning

confidence: 99%

“…Data from prevalence studies for children and adolescents compared with adults are shown in Figure 4. 7, [32][33][34][35][36][38][39][40][41][42][43][44][45] We did not undertake a meta-analysis of population screening studies given the important differences in the populations, epidemic time points, and methodologies involved.…”

Section: Population Screening Studiesmentioning

confidence: 99%

Susceptibility to SARS-CoV-2 Infection Among Children and Adolescents Compared With Adults

et al. 2021

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The degree to which children and adolescents are infected by and transmit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is unclear. The role of children and adolescents in transmission of SARS-CoV-2 is dependent on susceptibility, symptoms, viral load, social contact patterns, and behavior. OBJECTIVE To systematically review the susceptibility to and transmission of SARS-CoV-2 among children and adolescents compared with adults. DATA SOURCES PubMed and medRxiv were searched from database inception to July 28, 2020, and a total of 13 926 studies were identified, with additional studies identified through hand searching of cited references and professional contacts. STUDY SELECTION Studies that provided data on the prevalence of SARS-CoV-2 in children and adolescents (younger than 20 years) compared with adults (20 years and older) derived from contact tracing or population screening were included. Single-household studies were excluded. DATA EXTRACTION AND SYNTHESIS PRISMA guidelines for abstracting data were followed, which was performed independently by 2 reviewers. Quality was assessed using a critical appraisal checklist for prevalence studies. Random-effects meta-analysis was undertaken. MAIN OUTCOMES AND MEASURES Secondary infection rate (contact-tracing studies) or prevalence or seroprevalence (population screening studies) among children and adolescents compared with adults. RESULTS A total of 32 studies comprising 41 640 children and adolescents and 268 945 adults met inclusion criteria, including 18 contact-tracing studies and 14 population screening studies. The pooled odds ratio of being an infected contact in children compared with adults was 0.56 (95% CI, 0.37-0.85), with substantial heterogeneity (I 2 = 94.6%). Three school-based contact-tracing studies found minimal transmission from child or teacher index cases. Findings from population screening studies were heterogenous and were not suitable for meta-analysis. Most studies were consistent with lower seroprevalence in children compared with adults, although seroprevalence in adolescents appeared similar to adults. CONCLUSIONS AND RELEVANCE In this meta-analysis, there is preliminary evidence that children and adolescents have lower susceptibility to SARS-CoV-2, with an odds ratio of 0.56 for being an infected contact compared with adults. There is weak evidence that children and adolescents play a lesser role than adults in transmission of SARS-CoV-2 at a population level. This study provides no information on the infectivity of children.

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“…16,17 The current seroprevalence estimates are lower than the two other German community-based serosurveys. 14,15 However, both these previous serosurveys were conducted in communities following super-spreading events, and are unlikely to reflect the state of other regions in Germany with relatively low COVID-19 burden. 14,15 Neutralizing antibodies were detected in only about one third of the participants who tested positive on a widely used immunoassay.…”

Section: Discussionmentioning

confidence: 99%

Seroprevalence and correlates of SARS-CoV-2 neutralizing antibodies: Results from a population-based study in Bonn, Germany

Aziz

Corman

Echterhoff

et al. 2020

Preprint

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Background Accurate estimates of SARS-CoV-2 seroprevalence are crucial for the implementation of effective public health measures, but are currently largely lacking in regions with low infection rates. This is further complicated by inadequate test performance of many widely used serological assays. We therefore aimed to assess SARS-CoV-2 seroprevalence in a region with low COVID-19 burden, especially focusing on neutralizing antibodies that presumably constitute a major component of acquired immunity. Methods We invited all individuals who were enrolled in the Rhineland Study, an ongoing community-based prospective cohort study in people aged 30 years and above in the city of Bonn, Germany (N=5427). Between April 24th and June 30th, 2020, 4771 (88%) of these individuals participated in the serosurvey. Anti-SARS-CoV-2 IgG levels were measured using an ELISA assay, and all positive or borderline results were subsequently examined through both a recombinant immunofluorescent assay and a plaque reduction neutralisation test (PRNT). Findings Seroprevalence was 0.97% (95% CI: 0.72-1.30) by ELISA and 0.36% (95% CI: 0.21-0.61) by PRNT, and did not vary with either age or sex. All PRNT+ individuals reported having experienced at least one symptom (odds ratio (OR) of PRNT+ for each additional symptom: 1.12 (95% CI: 1.04-1.21)). Apart from living in a household with a SARS-CoV-2 confirmed or suspected person, a recent history of reduced taste or smell, fever, chills/hot flashes, pain while breathing, pain in arms/legs, as well as muscle pain and weakness were significantly associated with the presence of neutralizing antibodies in those with mild to moderate infection (ORs 3.44 to 9.97, all p<0.018). Interpretation Our findings indicate a relatively low SARS-CoV-2 seroprevalence in Bonn, Germany (until June 30th, 2020), with neutralizing antibodies detectable in only one third of those with a positive immunoassay result, implying that almost the entire population in this region remains susceptible to SARS-CoV-2 infection.

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Seroprevalence of SARS-CoV-2 antibodies in an entirely PCR-sampled and quarantined community after a COVID-19 outbreak - the CoNAN study

Cited by 32 publications

References 31 publications

Serology- and PCR-based cumulative incidence of SARS-CoV-2 infection in adults in a successfully contained early hotspot (CoMoLo study), Germany, May to June 2020

Serology- and PCR-based cumulative incidence of SARS-CoV-2 infection in adults in a successfully contained early hotspot (CoMoLo study), Germany, May to June 2020

Susceptibility to SARS-CoV-2 Infection Among Children and Adolescents Compared With Adults

Seroprevalence and correlates of SARS-CoV-2 neutralizing antibodies: Results from a population-based study in Bonn, Germany

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