Estimating the Cumulative Incidence of SARS-CoV-2 Infection and the Infection Fatality Ratio in Light of Waning Antibodies.
Estimating the Cumulative Incidence of SARS-CoV-2 Infection and the Infection Fatality Ratio in Light of Waning Antibodies.
复制标题
DOI：
10.1097/ede.0000000000001361
复制
发表时间：
2021-07-01
期刊：
影响因子：
--
通讯作者：
Lopman BA
中科院分区：
文献类型：
--
作者：
Shioda K;Lau MSY;Kraay ANM;Nelson KN;Siegler AJ;Sullivan PS;Collins MH;Weitz JS;Lopman BA
补充数字内容可在文本中找到。血清学检测可以识别以前的感染，并有助于估计总感染人数。然而，据报道，针对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的免疫球蛋白下降到血清学检测的可检测水平以下（不一定等于保护性免疫的持续时间）。我们通过血清学研究估计SARS-CoV-2感染的累积发病率，解释抗体获得（血清转化）和减弱（血清逆转）的预期水平，并使用来自纽约市和康涅狄格州的数据应用该框架。我们使用纽约市和康涅狄格州2020年3月至10月的死亡率数据和2020年4月至8月的人群水平横断面血清阳性率数据，估计了从血清转换到血清逆转的时间和感染病死率（IFR）。然后，我们估计了SARS-CoV-2感染的每日血清阳性率和累积发病率。估计从血清转换到血清逆转的平均时间为3-4个月。纽约市的估计IFR为1.1%（95%可信区间，1.0%，1.2%），康涅狄格州为1.4%（1.1，1.7%）。估计的每日血清阳性率在春季达到高峰后下降。9月底，估计的累积发病率在纽约市达到26.8%（24.2%，29.7%），在康涅狄格州达到8.8%（7.1%，11.3%），分别高于最高血清阳性率测量值（22.1%和6.1%）。SARS-CoV-2感染的累积发病率被低估，使用横断面血清学数据，而没有调整减弱的抗体。我们的方法可以帮助量化低估的程度，并调整对减弱抗体的估计。
Supplemental Digital Content is available in the text. Serology tests can identify previous infections and facilitate estimation of the number of total infections. However, immunoglobulins targeting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been reported to wane below the detectable level of serologic assays (which is not necessarily equivalent to the duration of protective immunity). We estimate the cumulative incidence of SARS-CoV-2 infection from serology studies, accounting for expected levels of antibody acquisition (seroconversion) and waning (seroreversion), and apply this framework using data from New York City and Connecticut. We estimated time from seroconversion to seroreversion and infection fatality ratio (IFR) using mortality data from March to October 2020 and population-level cross-sectional seroprevalence data from April to August 2020 in New York City and Connecticut. We then estimated the daily seroprevalence and cumulative incidence of SARS-CoV-2 infection. The estimated average time from seroconversion to seroreversion was 3–4 months. The estimated IFR was 1.1% (95% credible interval, 1.0%, 1.2%) in New York City and 1.4% (1.1, 1.7%) in Connecticut. The estimated daily seroprevalence declined after a peak in the spring. The estimated cumulative incidence reached 26.8% (24.2%, 29.7%) at the end of September in New York City and 8.8% (7.1%, 11.3%) in Connecticut, higher than maximum seroprevalence measures (22.1% and 6.1%), respectively. The cumulative incidence of SARS-CoV-2 infection is underestimated using cross-sectional serology data without adjustment for waning antibodies. Our approach can help quantify the magnitude of underestimation and adjust estimates for waning antibodies.