1. Global seroprevalence of SARS-CoV-2 antibodies: A systematic review and meta-analysis
- Author
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Lucas Penny, Michael Liu, Matthew P. Cheng, Austin Atmaja, Jonathan Chevrier, Natasha Ilincic, Mitchell Segal, Jordan Van Wyk, Mercedes Yanes-Lane, Abel Joseph, Jesse Papenburg, Christian Cao, Emily Boucher, Tyler Williamson, Claire Donnici, Cedric P. Yansouni, Judy Chen, Timothy Grant Evans, Niklas Bobrovitz, Simona Rocco, Nathan Duarte, Mairead Whelan, Sara Perlman-Arrow, Rahul Krishan Arora, Hannah Rahim, David A. Clifton, and Tingting Yan
- Subjects
RNA viruses ,Viral Diseases ,Coronaviruses ,Epidemiology ,Antibodies, Viral ,Global Health ,Geographical Locations ,Medical Conditions ,Seroepidemiologic Studies ,Medicine and Health Sciences ,Medicine ,Public and Occupational Health ,Cumulative incidence ,Medical Personnel ,Child ,Pathology and laboratory medicine ,Virus Testing ,education.field_of_study ,Multidisciplinary ,Incidence ,Incidence (epidemiology) ,Middle Aged ,Medical microbiology ,Professions ,Infectious Diseases ,Meta-analysis ,Viruses ,SARS CoV 2 ,Pathogens ,Research Article ,Adult ,medicine.medical_specialty ,Asia ,Adolescent ,SARS coronavirus ,Health Personnel ,Science ,Population ,Sensitivity and Specificity ,Microbiology ,COVID-19 Serological Testing ,Herd immunity ,Young Adult ,Diagnostic Medicine ,Humans ,Seroprevalence ,education ,Aged ,Biology and life sciences ,business.industry ,Public health ,Organisms ,Viral pathogens ,COVID-19 ,Covid 19 ,Microbial pathogens ,Sample size determination ,Medical Risk Factors ,People and Places ,Population Groupings ,business ,Demography - Abstract
BackgroundMany studies report the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies. We aimed to synthesize seroprevalence data to better estimate the level and distribution of SARS-CoV-2 infection, identify high-risk groups, and inform public health decision making.MethodsIn this systematic review and meta-analysis, we searched publication databases, preprint servers, and grey literature sources for seroepidemiological study reports, from January 1, 2020 to December 31, 2020. We included studies that reported a sample size, study date, location, and seroprevalence estimate. We corrected estimates for imperfect test accuracy with Bayesian measurement error models, conducted meta-analysis to identify demographic differences in the prevalence of SARS-CoV-2 antibodies, and meta-regression to identify study-level factors associated with seroprevalence. We compared region-specific seroprevalence data to confirmed cumulative incidence. PROSPERO: CRD42020183634.ResultsWe identified 968 seroprevalence studies including 9.3 million participants in 74 countries. There were 472 studies (49%) at low or moderate risk of bias. Seroprevalence was low in the general population (median 4.5%, IQR 2.4–8.4%); however, it varied widely in specific populations from low (0.6% perinatal) to high (59% persons in assisted living and long-term care facilities). Median seroprevalence also varied by Global Burden of Disease region, from 0.6% in Southeast Asia, East Asia and Oceania to 19.5% in Sub-Saharan Africa (pDiscussionMost of the population remains susceptible to SARS-CoV-2 infection. Public health measures must be improved to protect disproportionately affected groups, including racial and ethnic minorities, until vaccine-derived herd immunity is achieved. Improvements in serosurvey design and reporting are needed for ongoing monitoring of infection prevalence and the pandemic response.
- Published
- 2021