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1. SARS-CoV-2 seroprevalence among the general population and healthcare workers in India, December 2020–January 2021

Author

Manoj V. Murhekar, Tarun Bhatnagar, Jeromie Wesley Vivian Thangaraj, V. Saravanakumar, Muthusamy Santhosh Kumar, Sriram Selvaraju, Kiran Rade, C.P. Girish Kumar, R. Sabarinathan, Alka Turuk, Smita Asthana, Rakesh Balachandar, Sampada Dipak Bangar, Avi Kumar Bansal, Vishal Chopra, Dasarathi Das, Alok Kumar Deb, Kangjam Rekha Devi, Vikas Dhikav, Gaurav Raj Dwivedi, S. Muhammad Salim Khan, M. Sunil Kumar, Avula Laxmaiah, Major Madhukar, Amarendra Mahapatra, Chethana Rangaraju, Jyotirmayee Turuk, Rajiv Yadav, Rushikesh Andhalkar, K. Arunraj, Dinesh Kumar Bharadwaj, Pravin Bharti, Debdutta Bhattacharya, Jyothi Bhat, Ashrafjit S. Chahal, Debjit Chakraborty, Anshuman Chaudhury, Hirawati Deval, Sarang Dhatrak, Rakesh Dayal, D. Elantamilan, Prathiksha Giridharan, Inaamul Haq, Ramesh Kumar Hudda, Babu Jagjeevan, Arshad Kalliath, Srikanta Kanungo, Nivethitha N. Krishnan, Jaya Singh Kshatri, Alok Kumar, Niraj Kumar, V.G. Vinoth Kumar, G.G.J. Naga Lakshmi, Ganesh Mehta, Nandan Kumar Mishra, Anindya Mitra, K. Nagbhushanam, Arlappa Nimmathota, A.R. Nirmala, Ashok Kumar Pandey, Ganta Venkata Prasad, Mariya Amin Qurieshi, Sirasanambatti Devarajulu Reddy, Aby Robinson, Seema Sahay, Rochak Saxena, Krithikaa Sekar, Vijay Kumar Shukla, Hari Bhan Singh, Prashant Kumar Singh, Pushpendra Singh, Rajeev Singh, Nivetha Srinivasan, Dantuluri Sheethal Varma, Ankit Viramgami, Vimith Cheruvathoor Wilson, Surabhi Yadav, Suresh Yadav, Kamran Zaman, Amit Chakrabarti, Aparup Das, R.S. Dhaliwal, Shanta Dutta, Rajni Kant, A.M. Khan, Kanwar Narain, Somashekar Narasimhaiah, Chandrasekaran Padmapriyadarshini, Krishna Pandey, Sanghamitra Pati, Shripad Patil, Hemalatha Rajkumar, Tekumalla Ramarao, Y.K. Sharma, Shalini Singh, Samiran Panda, D.C.S. Reddy, Balram Bhargava, Tanu Anand, Giridhara R. Babu, Himanshu Chauhan, Tanzin Dikid, Raman R. Gangakhedkar, Shashi Kant, Sanket Kulkarni, J.P. Muliyil, Ravindra Mohan Pandey, Swarup Sarkar, Naman Shah, Aakash Shrivastava, Sujeet K. Singh, Sanjay Zodpe, Anusha Hindupur, P.R. Asish, M. Chellakumar, D. Chokkalingam, Sauvik Dasgupta, M.M.E. Gowtham, Annamma Jose, K. Kalaiyarasi, N.N. Karthik, T. Karunakaran, G. Kiruthika, H. Dinesh Kumar, S. Sarath Kumar, M.P. Sarath Kumar, E. Michaelraj, Josephine Pradhan, E.B. Arun Prasath, D. Gladys Angelin Rachel, Sudha Rani, Amanda Rozario, R. Sivakumar, P. Gnana Soundari, K. Sujeetha, and Arya Vinod

Subjects
SARS-CoV-2, COVID-19, IgG, Seroprevalence, India, Infectious and parasitic diseases, RC109-216
Abstract

Background: Earlier serosurveys in India revealed seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) of 0.73% in May–June 2020 and 7.1% in August–September 2020. A third serosurvey was conducted between December 2020 and January 2021 to estimate the seroprevalence of SARS-CoV-2 infection among the general population and healthcare workers (HCWs) in India. Methods: The third serosurvey was conducted in the same 70 districts as the first and second serosurveys. For each district, at least 400 individuals aged ≥10 years from the general population and 100 HCWs from subdistrict-level health facilities were enrolled. Serum samples from the general population were tested for the presence of immunoglobulin G (IgG) antibodies against the nucleocapsid (N) and spike (S1-RBD) proteins of SARS-CoV-2, whereas serum samples from HCWs were tested for anti-S1-RBD. Weighted seroprevalence adjusted for assay characteristics was estimated. Results: Of the 28,598 serum samples from the general population, 4585 (16%) had IgG antibodies against the N protein, 6647 (23.2%) had IgG antibodies against the S1-RBD protein, and 7436 (26%) had IgG antibodies against either the N protein or the S1-RBD protein. Weighted and assay-characteristic-adjusted seroprevalence against either of the antibodies was 24.1% [95% confidence interval (CI) 23.0–25.3%]. Among 7385 HCWs, the seroprevalence of anti-S1-RBD IgG antibodies was 25.6% (95% CI 23.5–27.8%). Conclusions: Nearly one in four individuals aged ≥10 years from the general population as well as HCWs in India had been exposed to SARS-CoV-2 by December 2020.

Published
2021
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2. SARS-CoV-2 antibody seroprevalence in India, August–September, 2020: findings from the second nationwide household serosurvey

Author

Shanta Dutta, Harpreet Singh Pawar, Giridhara R Babu, V. Saravanakumar, Kanwar Narain, Ezhilarasan Ilayaperumal, Sanjay Zodpey, Babu Jagjeevan, Swarup Sarkar, Srikanta Kanungo, Tekumalla Ramarao, Vijay K. Shukla, Jaya Singh Kshatri, Ashrafjit S. Chahal, Aparup Das, Balram Bhargava, Hari Bhan Singh, R Anusha, Chethana Rangaraju, Dinesh Kumar Baradwaj, Smita Asthana, Ravindra Mohan Pandey, Prashant Singh, T Sivakumar, Krithikaa Sekar, Dasarathi Das, Arlappa Nimmathota, Sampada Dipak Bangar, Kamran Zaman, M. Sunil Kumar, Sujeet Kumar Singh, R. Sabarinathan, Naman Shah, Hirawati Deval, Arshad Kalliath, K Kalaiyarasi, Kamalesh Sarkar, Muthusamy Santhosh Kumar, Seema Sahay, Rajiv Yadav, Sanket Kulkarni, Alok Kumar, Vishal Chopra, Rajeev Gupta, C. P. Girish Kumar, Rajeev K. Singh, Kiran Rade, Kangjam Rekha Devi, Shripad A. Patil, Alka Turuk, T Karunakaran, Jyothi Bhat, Annamma Jose, J P Muliyil, Kushal Singh Rathore, Shalini Singh, Tanzin Dikid, Nivethitha N Krishnan, A.R. Nirmala, Hemalatha Rajkumar, G G J Naga Lakshmi, Shashi Kant, Avula Laxmaiah, Major Madhukar, Pradeep Das, Amarendra Mahapatra, Manoj V Murhekar, Gaurav Raj Dwivedi, Pushpendra Singh, Jeromie Wesley Vivian Thangaraj, Sarang Dhatrak, Tanu Anand, K Kiran, Gurudayal S Toteja, Ankit Viramgami, Rakesh Balachandar, Ganta Venkata Prasad, Sauvik Dasgupta, Samiran Panda, Ashok Kumar Pandey, Sanghamitra Pati, Suman Sundar Mohanty, Dantuluri Sheethal Varma, S. Muhammad Salim Khan, Vimith Cheruvathoor Wilson, Mariya Amin Qurieshi, Anshuman Chaudhury, Sriram Selvaraju, Alok Kumar Deb, Avi Kumar Bansal, Tarun Bhatnagar, D C S Reddy, Himanshu Chauhan, Rushikesh Andhalkar, Ashwini Yadav, Inaamul Haq, Falguni Debnath, Rajni Kant, Josephine Pradhan, Anindya Mitra, Somashekar Narasimhaiah, Ramesh Kumar Sangwan, Raman R. Gangakhedkar, Aakash Shrivastava, VG Vinoth Kumar, Ramesh Chandra Jha, Aby Robinson, and K. Nagbhushanam

Subjects
Adult, Male, Adolescent, Coronavirus disease 2019 (COVID-19), Cross-sectional study, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), 030231 tropical medicine, Population, India, Antibodies, Viral, 03 medical and health sciences, 0302 clinical medicine, Seroepidemiologic Studies, Prevalence, Humans, Medicine, Seroprevalence, 030212 general & internal medicine, Occupations, Child, education, education.field_of_study, biology, SARS-CoV-2, business.industry, COVID-19, Articles, General Medicine, Middle Aged, Serum samples, Cross-Sectional Studies, Immunoglobulin G, biology.protein, Female, Antibody, Rural area, business, Demography
Abstract

BACKGROUND: The first national severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serosurvey in India, done in May-June, 2020, among adults aged 18 years or older from 21 states, found a SARS-CoV-2 IgG antibody seroprevalence of 0·73% (95% CI 0·34-1·13). We aimed to assess the more recent nationwide seroprevalence in the general population in India. METHODS: We did a second household serosurvey among individuals aged 10 years or older in the same 700 villages or wards within 70 districts in India that were included in the first serosurvey. Individuals aged younger than 10 years and households that did not respond at the time of survey were excluded. Participants were interviewed to collect information on sociodemographics, symptoms suggestive of COVID-19, exposure history to laboratory-confirmed COVID-19 cases, and history of COVID-19 illness. 3-5 mL of venous blood was collected from each participant and blood samples were tested using the Abbott SARS-CoV-2 IgG assay. Seroprevalence was estimated after applying the sampling weights and adjusting for clustering and assay characteristics. We randomly selected one adult serum sample from each household to compare the seroprevalence among adults between the two serosurveys. FINDINGS: Between Aug 18 and Sept 20, 2020, we enrolled and collected serum samples from 29 082 individuals from 15 613 households. The weighted and adjusted seroprevalence of SARS-CoV-2 IgG antibodies in individuals aged 10 years or older was 6·6% (95% CI 5·8-7·4). Among 15 084 randomly selected adults (one per household), the weighted and adjusted seroprevalence was 7·1% (6·2-8·2). Seroprevalence was similar across age groups, sexes, and occupations. Seroprevalence was highest in urban slum areas followed by urban non-slum and rural areas. We estimated a cumulative 74·3 million infections in the country by Aug 18, 2020, with 26-32 infections for every reported COVID-19 case. INTERPRETATION: Approximately one in 15 individuals aged 10 years or older in India had SARS-CoV-2 infection by Aug 18, 2020. The adult seroprevalence increased approximately tenfold between May and August, 2020. Lower infection-to-case ratio in August than in May reflects a substantial increase in testing across the country. FUNDING: Indian Council of Medical Research.

Published
2021
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3. SARS-CoV-2 Sero-Prevalence Among General Population and Healthcare Workers in India, December 2020 - January 2021

Author

Kiran Rade, Somashekar Narasimhaiah, Gaurav Raj Dwivedi, D. Elantamilan, Muthusamy Santhosh Kumar, Debdutta Bhattacharya, Niraj Kumar, R. Sabarinathan, M. Sunil Kumar, Krishna Pandey, Seema Sahay, Suresh Yadav, Rakesh Balachandar, Jeromie Wesley Vivian Thangaraj, Samiran Panda, Vishal Chopra, Gangeti Gandhi Jayanthi Naga Lakshmi, Virendra Kumar, Shripad A. Patil, Hemalatha Rajkumar, Chethana Rangaraju, Kanwar Narain, Kamran Zaman, Anindya Mitra, Amit Chakrabarti, Nivetha Srinivasan, Dinesh Kumar Baradwaj, Jyotirmayee Turuk, A.M. Khan, Tekumalla Ramarao, Pushpendra Singh, Amit Kumar, R S Dhaliwal, Shalini Singh, Vimith Cheruvathoor Wilson, Rajni Kant, Ashok Kumar Pandey, Srikanta Kanungo, Anshuman Chaudhury, Smita Asthana, Amarendra Mahapatra, Manoj V Murhekar, Rajiv Yadav, Ganta Venkata Prasad, Nandan Kumar Mishra, C. P. Girish Kumar, Ramesh Kumar Hudda, Shanta Dutta, Aby Robinson, D C S Reddy, Chandrasekaran Padmapriyadarshini, Vijay K. Shukla, Babu Jagjeevan, Jaya Singh Kshatri, Dantuluri Sheethal Varma, Nimmathota Arlappa, K. Nagbhushanam, Alok Kumar Deb, Jyothi Bhat, Hirawati Deval, Alka Turuk, Pravin Bharti, Arshad Kalliath, Balram Bhargava, S. Muhammad Salim Khan, Hari Bhan Singh, Dasarathi Das, Avula Laxmaiah, Sriram Selvaraju, V. Saravanakumar, Tarun Bhatnagar, Nivethitha N Krishnan, K. Arunraj, Inaamul Haq, A.R. Nirmala, Major Madhukar, Y.K. Sharma, Ashrafjit S. Chahal, Aparup Das, Krithikaa Sekar, Surabhi Yadav, Mariya Amin Qurieshi, Ganesh Mehta, Rakesh Dayal, Vikas Dhikav, Kangjam Rekha Devi, Sirasanambatti Devarajulu Reddy, Ankit Viramgami, Sanghamitra Pati, Prashant Singh, Sampada Dipak Bangar, Rajeev K. Singh, Rushikesh Andhalkar, Prathiksha Giridharan, Debjit Chakraborty, Avi Kumar Bansal, Sarang Dhatrak, and Rochak Saxena

Subjects
medicine.medical_specialty, education.field_of_study, business.industry, Public health, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), education, Population, Epidemiology, Pandemic, Health care, medicine, Seroprevalence, Rural area, business, Demography
Abstract

Background: Repeated cross-sectional serosurveys in the same geographic area establish the trend of the evolving pandemic. We present the findings of the third round of a national serosurvey to estimate the seroprevalence of SARS-CoV-2 infection among the general population and health care workers of India. Methods: We conducted the third population-based serosurvey between Dec 18, 2020 and Jan 6, 2021 in the same 700 villages or wards from 70 districts in 21 states across India, which were selected for the first and second serosurveys. We enrolled from each district, at least 400 individuals aged ≥ 10 years from general population and 100 HCWs from sub-district level public health facilities. Serum samples from general population were tested for the presence of IgG antibodies against nucleocapsid (N) and spike protein (S1-RBD) of SARS-CoV-2 using the Abbott and Siemens assays respectively, whereas sera from HCWs were tested for anti-S1-RBD. For general population, sera positive for either of the antibodies were considered positive, while sera positive for anti-S1-RBD were considered as positive for HCW. Weighted seroprevalence estimates were adjusted for sensitivity and specificity of respective assays. Findings: Of the 28,598 sera from general population, 4585 (16%) had IgG antibodies against N, 6647 (23.2%) against S1-RBD and 7436 (26%) against either. The weighted and assay characteristic adjusted seroprevalence against either of the antibodies was 24.1 (95%CI: 23.0% to 25.3%). Seroprevalence was lower in rural areas (21.4%, 95% CI: 20.3% to 22.6%) compared to urban non-slum (29.4%, 95% CI: 26.9% - 32.1%) and slum areas (34.6%, 95% CI: 31.0% to 38.3%). Among 7385 HCWs, the seroprevalence of anti-S1-RBD IgG antibodies was 25.6% (95% CI: 23.5% to 27.8%). Interpretation: Nearly one in four individuals aged 10 years or older from general population as well as HCWs were exposed to SARS-CoV-2 by December 2020 amounting to 271 million infections in India. Funding Statement: Indian Council of Medical Research Declaration of Interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare no competing interests Ethics Approval Statement: The project was approved by Institutional Human Ethics Committee at ICMR-National Institute of Epidemiology.

Published
2021
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4. SARS-CoV-2 Sero-Prevalence among General Population and Healthcare Workers in India, December 2020 - January 2021

Author

Manoj V. Murhekar, Tarun Bhatnagar, Jeromie Wesley Vivian Thangaraj, V. Saravanakumar, Muthusamy Santhosh Kumar, Sriram Selvaraju, Kiran Rade, Girish Kumar CP, R. Sabarinathan, Alka Turuk, Smita Asthana, Rakesh Balachandar, Sampada Dipak Bangar, Avi Kumar Bansal, Vishal Chopra, Dasarathi Das, Alok Kumar Deb, Kangjam Rekha Devi, Vikas Dhikav, Gaurav Raj Dwivedi, S. Muhammad Salim Khan, M. Sunil Kumar, Avula Laxmaiah, Major Madhukar, Amarendra Mahapatra, Chethana Rangaraju, Jyotirmayee Turuk, Rajiv Yadav, Rushikesh Andhalkar, K. Arunraj, Dinesh Kumar Baradwaj, Pravin Bharti, Debdutta Bhattacharya, Jyothi Bhat, Ashrafjit S. Chahal, Debjit Chakraborty, Anshuman Chaudhury, Hirawati Deval, Sarang Dhatrak, Rakesh Dayal, D. Elantamilan, Prathiksha Giridharan, Inaamul Haq, Ramesh Kumar Hudda, Babu Jagjeevan, Arshad Kalliath, Srikanta Kanungo, Nivethitha N. Krishnan, Jaya Singh Kshatri, Alok Kumar, Niraj Kumar, V.G. Vinoth Kumar, Gangeti Gandhi Jayanthi Naga Lakshmi, Ganesh Mehta, Nandan Kumar Mishra, Anindya Mitra, K. Nagbhushanam, Arlappa Nimmathota, A.R. Nirmala, Ashok Kumar Pandey, Ganta Venkata Prasad, Mariya Amin Qurieshi, Sirasanambatti Devarajulu Reddy, Aby Robinson, Seema Sahay, Rochak Saxena, Krithikaa Sekar, Vijay Kumar Shukla, Hari Bhan Singh, Prashant Kumar Singh, Pushpendra Singh, Rajeev Singh, Nivetha Srinivasan, Dantuluri Sheethal Varma, Ankit Viramgami, Vimith Cheruvathoor Wilson, Surabhi Yadav, Suresh Yadav, Kamran Zaman, Amit Chakrabarti, Aparup Das, R.S. Dhaliwal, Shanta Dutta, Rajni Kant, A M Khan, Kanwar Narain, Somashekar Narasimhaiah, Chandrasekaran Padmapriyadarshini, Krishna Pandey, Sanghamitra Pati, Shripad Patil, Hemalatha Rajkumar, Tekumalla Ramarao, Y.K. Sharma, Shalini Singh, Samiran Panda, D.C.S. Reddy, Balram Bhargava, and ICMR Serosurveillance Group

Published
2021
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5. Prevalence of Igg Antibodies Against SARS-CoV-2 Among the General Population and Healthcare Workers in India, June–July 2021

Author

Dayal R, Chethana Rangaraju, Dinesh Kumar Baradwaj, Srikanta Kanungo, Sharma Ak, Chopra, Y.K. Sharma, Ashrafjit S. Chahal, Hirawati Deval, Sarang Dhatrak, Aparup Das, Pravin Bharti, Kanwar Narain, Jaya Singh Kshatri, Krithikaa Sekar, Shalini Singh, Pushpendra Singh, Amarendra Mahapatra, Balram Bhargava, Manoj V Murhekar, Saravanakumar, R. Sabarinathan, Khan Sms, Rajiv Yadav, Alka Turuk, Jyotirmayee Turuk, Shanta Dutta, Bashir K, A.R. Nirmala, Krishna Pandey, Jyothi Bhat, Major Madhukar, Gaurav Raj Dwivedi, Avula Laxmaiah, Manjula Singh, Chandrasekaran Padmapriyadarshini, D C S Reddy, Dantuluri Sheethal Varma, Smita Asthana, Arshad Kalliath, Sumit Yadav, Kumar, Behera Sp, Srinivasan N, P. K. Anand, Menon Pa, Dasarathi Das, Sriram Selvaraju, Lakshmi Ggjn, Avi Kumar Bansal, Mariya Amin Qurieshi, Ankit Viramgami, Mehta G, Virendra Kumar, Alok Kumar Deb, Kirankumar Rade, Nimmathota Arlappa, Rushikesh Andhalkar, Nivethitha N Krishnan, Subrat Kumar Palo, Debjit Chakraborty, Tarun Bhatnagar, Pandey Ak, Ramesh Kumar Sangwan, A.M. Khan, Jagjeevan B, Prathiksha Giridharan, Kangjam Rekha Devi, Inaamul Haq, Karunakaran T, Seema Sahay, Saxena R, Rajeev K. Singh, Ganta Venkata Prasad, Sabaharwal, Anindya Mitra, Hemalatha Rajkumar, Rajni Kant, Himmat Singh, Aby Robinson, K. Nagbhushanam, Somashekar Narasimhaiah, Niraj Kumar, Anshuman Chaudhury, Vijay K. Shukla, Thakor M, Ramesh T, Rakesh Balachandar, Pucha Uk, Thangaraj Jwv, Samiran Panda, Muthusamy Santhosh Kumar, Debdutta Bhattacharya, Jain A, Dhikav, Sanghamitra Pati, Amit Chakrabarti, Kumar Cg, Prashant Singh, and Sampada Dipak Bangar

Subjects
medicine.medical_specialty, education.field_of_study, biology, business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Public health, education, Population, Vaccination, Health care, Epidemiology, medicine, biology.protein, Seroprevalence, Antibody, business, Demography
Abstract

Background: India witnessed a severe second wave of COVID-19 during March and June 2021. We did the fourth nationwide serosurvey to estimate prevalence of SARS-CoV-2 antibodies in the general population aged >=6 years and health care workers (HCWs). Methods: We did a cross-sectional study between 14 June and 6 July 2021 in 700 clusters in the same 70 districts across 21 states/Union Territory. From each district, a minimum of 400 individuals aged >=6 years from general population and 100 HCWs from the district public health facilities were included. The serum samples were tested for the presence of IgG antibodies against S1-RBD and nucleocapsid protein of SARS-CoV-2 using chemiluminescence immunoassay. We estimated the weighted and test adjusted seroprevalence of IgG antibodies against S1-RBD and/or nucleocapsid protein along with 95% CI. Findings: Of the 28,975 sera tested, the weighted and test adjusted prevalence of IgG antibodies against S1-RBD and/or nucleocapsid protein among the general population aged >=6 years was 67.6% (95% CI: 66.4 – 68.7). The seroprevalence increased with age and was not different in rural and urban areas. Compared to unvaccinated adults (62.3%, 95% CI: 60.9 – 63.7), seroprevalence was significantly higher among individuals who received one (81.0%, 95% CI: 79.6 - 82.3) and two doses (89.8%, 95% CI: 88.4 - 91.1). The seroprevalence of IgG antibodies among 7,252 health care workers was 85.2% (95% CI: 83.5 - 86.7). Interpretation: Nearly one third of the population is still seronegative. It is necessary to accelerate the coverage of COVID-19 vaccination among adults and continue adherence to non-pharmaceutical interventions. Funding: Indian Council of Medical Research. Declaration of Interest: None to declare. Ethical Approval: The Institutional Human Ethics Committee of the ICMR National Institute of Epidemiology, Chennai approved the study protocol.

Published
2021
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