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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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