Antibodies to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in All of Us Research Program Participants, 2 January to 18 March 2020
Antibodies to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in All of Us Research Program Participants, 2 January to 18 March 2020
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DOI：
10.1093/cid/ciab519
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发表时间：
2021-08-06
影响因子：
11.8
通讯作者：
Schully, Sheri D.
中科院分区：
文献类型：
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作者：
Althoff, Keri N.;Schlueter, David J.;Schully, Sheri D.
7人检测到严重急性呼吸综合征冠状病毒2（SARS-CoV-2）免疫球蛋白G在伊利诺伊州、马萨诸塞州、威斯康星州、宾夕法尼亚州和密西西比的首批确诊病例之前，这表明SARS-CoV-2感染发生在美国至少5个州确认病例之前数周。背景在疫情开始时（2020年1月至3月），美国的SARS-CoV-2检测能力主要集中在2月份有旅行史的症状患者身上，模糊了SARS-CoV-2播种和社区传播的情况。我们试图在美国流行的最初几周确定具有SARS-CoV-2抗体的个体。方法美国所有50个州的所有研究参与者在2020年1月2日至3月18日的研究访视期间提供了血液样本。如果受试者在序贯检测算法中使用Abbott Architect SARS-CoV-2 IgG酶联免疫吸附试验（ELISA）和EUROIMMUN SARS-CoV-2 ELISA检测SARS-CoV-2免疫球蛋白G（IgG）抗体呈阳性，则认为其血清反应阳性。估计这些ELISA的灵敏度和特异性以及序贯检验算法的净灵敏度和特异性，沿着95%置信区间（CI）。结果Abbott和EUROIMMUN试剂盒的敏感性均为100%（107/107 [95% CI：96.6%-100%]和90.7%（97/107 [83.5%-95.4%]），估计特异性为99.5%（995/1000 [98.8%-99.8%]）和99.7%（997/1000 [99.1%-99.9%]）。我们的序贯检验算法的净灵敏度和特异性分别为90.7%（97/107 [95%CI：83.5%-95.4%]）和100.0%（1000/1000 [99.6%-100%]）。在2020年1月2日至3月18日期间有血液标本的24079名研究参与者中，9人血清学阳性，7人在伊利诺伊州、马萨诸塞州、威斯康星州、宾夕法尼亚州和密西西比出现首例确诊病例之前。结论我们的研究结果在美国5个州的第一例确诊病例前几周就发现了SARS-CoV-2感染。
Seven individuals had detectable severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin G before the first confirmed cases in Illinois, Massachusetts, Wisconsin, Pennsylvania, and Mississippi, suggesting that SARS-CoV-2 infections occurred weeks before recognized cases in at least 5 US states.Background With limited severe acute respiratory syndrome coronavirus (SARS-CoV-2) testing capacity in the United States at the start of the epidemic (January-March 2020), testing was focused on symptomatic patients with a travel history throughout February, obscuring the picture of SARS-CoV-2 seeding and community transmission. We sought to identify individuals with SARS-CoV-2 antibodies in the early weeks of the US epidemic. Methods All of Us study participants in all 50 US states provided blood specimens during study visits from 2 January to 18 March 2020. Participants were considered seropositive if they tested positive for SARS-CoV-2 immunoglobulin G (IgG) antibodies with the Abbott Architect SARS-CoV-2 IgG enzyme-linked immunosorbent assay (ELISA) and the EUROIMMUN SARS-CoV-2 ELISA in a sequential testing algorithm. The sensitivity and specificity of these ELISAs and the net sensitivity and specificity of the sequential testing algorithm were estimated, along with 95% confidence intervals (CIs). Results The estimated sensitivities of the Abbott and EUROIMMUN assays were 100% (107 of 107 [95% CI: 96.6%-100%]) and 90.7% (97 of 107 [83.5%-95.4%]), respectively, and the estimated specificities were 99.5% (995 of 1000 [98.8%-99.8%]) and 99.7% (997 of 1000 [99.1%-99.9%]), respectively. The net sensitivity and specificity of our sequential testing algorithm were 90.7% (97 of 107 [95% CI: 83.5%-95.4%]) and 100.0% (1000 of 1000 [99.6%-100%]), respectively. Of the 24 079 study participants with blood specimens from 2 January to 18 March 2020, 9 were seropositive, 7 before the first confirmed case in the states of Illinois, Massachusetts, Wisconsin, Pennsylvania, and Mississippi. Conclusions Our findings identified SARS-CoV-2 infections weeks before the first recognized cases in 5 US states.