Testing Denmark: a Danish Nationwide Surveillance Study of COVID-19.
Testing Denmark: a Danish Nationwide Surveillance Study of COVID-19.
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DOI：
10.1128/spectrum.01330-21
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发表时间：
2021-12-22
影响因子：
3.7
通讯作者：
Iversen K
中科院分区：
文献类型：
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作者：
Fogh K;Strange JE;Scharff BFSS;Eriksen ARR;Hasselbalch RB;Bundgaard H;Nielsen SD;Jørgensen CS;Erikstrup C;Norsk J;Nielsen PB;Kristensen JH;Østergaard L;Ellermann-Eriksen S;Andersen B;Nielsen H;Johansen IS;Wiese L;Simonsen L;Fischer TK;Folke F;Lippert F;Ostrowski SR;Benfield T;Mølbak K;Ethelberg S;Koch A;Sönksen UW;Vangsted AM;Krause TG;Fomsgaard A;Ullum H;Skov R;Iversen K
“检测丹麦”是一项在丹麦人群中进行的SARS-CoV-2全国性大规模流行病学监测研究。2020年9月至10月期间，约130万人（年龄>15岁）被随机邀请填写涵盖COVID-19暴露和症状的电子问卷。SARS-CoV-2抗体的流行率通过分发到参与者家庭地址的即时快速检测（POCT）来确定。共有318，552名参与者（24.5%的受邀者）完成了研究，2，519名（0.79%）血清反应阳性。在既往PCR检测阳性的参与者（n = 1，828）中，29.1%的POCT血清学阳性。尽管血清阳性率随着年龄的增长而增加，但61岁及以上的参与者报告的症状较少，测试频率也较低。血清阳性与与SARS-CoV-2感染者的身体接触有关（风险比[RR] 7.43，95%CI：6.57-8.41），特别是在家庭成员中（RR 17.70，95%CI：15.60-20.10）。与办公室工作人员相比，家庭护理人员的血清阳性风险更大（RR 2.09，95% CI：1.58-2.78）。据报告，国家预防建议得到高度遵守（例如，>80%使用口罩），但血清阳性和血清阴性参与者之间没有发现差异。血清阳性率结果受到POCT低于预期性能的影响。这可能是由于POCT的灵敏度较低或阅读测试结果存在问题，因此主要发现与风险相关。应更加重视年龄、职业和在当地社区的接触情况。重要性迄今为止，包括318，522名参与者，这是最大的基于人口的研究，具有广泛的全国参与，测试和问卷已发送到参与者的家中。我们发现，国家和地方当局对感染风险的重视应更多地放在受试者的年龄、职业类型以及在当地社区和家庭中的暴露上。为了应对难以收集广泛的全国性信息的挑战。本研究设计为开展研究的新方法奠定了基础。此外，本研究设计可用作未来一般检测策略的补充模型，用于持续监测人群中的COVID-19免疫力，包括既往感染和SARS-CoV-2疫苗接种，但要注意在家中进行和阅读POCT的复杂性。
“Testing Denmark” is a national, large-scale, epidemiological surveillance study of SARS-CoV-2 in the Danish population. Between September and October 2020, approximately 1.3 million people (age >15 years) were randomly invited to fill in an electronic questionnaire covering COVID-19 exposures and symptoms. The prevalence of SARS-CoV-2 antibodies was determined by point-of care rapid test (POCT) distributed to participants’ home addresses. In total, 318,552 participants (24.5% invitees) completed the study and 2,519 (0.79%) were seropositive. Of the participants with a prior positive PCR test (n = 1,828), 29.1% were seropositive in the POCT. Although seropositivity increased with age, participants 61 years and over reported fewer symptoms and were tested less frequently. Seropositivity was associated with physical contact with SARS-CoV-2 infected individuals (risk ratio [RR] 7.43, 95% CI: 6.57–8.41), particular in household members (RR 17.70, 95% CI: 15.60–20.10). A greater risk of seropositivity was seen in home care workers (RR 2.09, 95% CI: 1.58–2.78) compared to office workers. A high degree of adherence with national preventive recommendations was reported (e.g., >80% use of face masks), but no difference were found between seropositive and seronegative participants. The seroprevalence result was somewhat hampered by a lower-than-expected performance of the POCT. This is likely due to a low sensitivity of the POCT or problems reading the test results, and the main findings therefore relate to risk associations. More emphasis should be placed on age, occupation, and exposure in local communities. IMPORTANCE To date, including 318,522 participants, this is the largest population-based study with broad national participation where tests and questionnaires have been sent to participants’ homes. We found that more emphasis from national and local authorities toward the risk of infection should be placed on age of tested individuals, type of occupation, as well as exposure in local communities and households. To meet the challenge that broad nationwide information can be difficult to gather. This study design sets the stage for a novel way of conducting studies. Additionally, this study design can be used as a supplementary model in future general test strategy for ongoing monitoring of COVID-19 immunity in the population, both from past infection and from vaccination against SARS-CoV-2, however, with attention to the complexity of performing and reading the POCT at home.