Seroprevalence of anti-SARS-CoV-2 antibodies in Iquitos, Peru in July and August, 2020: a population-based study.
Seroprevalence of anti-SARS-CoV-2 antibodies in Iquitos, Peru in July and August, 2020: a population-based study.
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DOI：
10.1016/s2214-109x(21)00173-x
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发表时间：
2021-07
期刊：
影响因子：
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通讯作者：
Quispe AM
中科院分区：
文献类型：
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作者：
Álvarez-Antonio C;Meza-Sánchez G;Calampa C;Casanova W;Carey C;Alava F;Rodríguez-Ferrucci H;Quispe AM
在有感染风险的人群中检测抗sars - cov -2抗体对于了解COVID-19过去的传播情况和人群对持续传播的易感性至关重要，如果连续检测，则可以了解社区中一段时间内持续传播的强度。我们的目的是在伊基托斯的一个代表性人群队列中估计COVID-19的血清阳性率，伊基托斯是秘鲁COVID-19死亡率最高的地区之一，2020年3月发生了大量病例。我们在两个时间点对伊基托斯的SARS-CoV-2传播进行了基于人群的研究：2020年7月13日至18日（基线）和2020年8月13日至18日（1个月随访）。我们使用2017年人口普查数据获得了城市人口的地理分层代表性样本，该数据于2020年1月20日更新。我们纳入了自秘鲁发现COVID-19（2020年3月6日）或更早之前居住在伊基托斯的人。我们排除了生活在机构中的人、接受任何COVID-19药物治疗的人、有任何静脉切开术禁忌症的人、卫生工作者或与在职卫生工作者一起生活的个人。我们使用COVID-19 IgG/IgM快速检测试剂盒（中国浙江东方基因生物技术公司）检测每位参与者的抗sars - cov -2抗体IgG和IgM。我们使用调查分析方法来估计血清患病率，考虑到抽样设计效应和测试性能特征。我们确定了726名符合条件的个体，共招募了716名参与者（99%），分布在40个阶层（4个地区、2个性别和5个年龄组）。我们排除了10名未获得父母或法定代理人同意的个人（n=3），在2020年3月6日之后搬到伊基托斯（n=3），正在过境（n=2）或有呼吸道症状（n=1）。在调整研究抽样效应和检测的敏感性和特异性后，我们估计基线时血清阳性率为70% (95% CI 67-73)，随访1个月时血清阳性率为66% (95% CI 62-70)，复检阳性率为65% (95% CI 61-68)，新暴露发生率为2% （95% CI 1 - 3）。我们观察到不同年龄组之间血清阳性率的显著差异，18-29岁的参与者血清阳性率低于12岁以下的参与者（患病率比0.85 [95% CI 0.73 - 0.98]; p= 0.029）。在第一个流行高峰之后，伊基托斯是全球抗sars - cov -2抗体血清阳性率最高的地区之一。然而，从2021年1月开始，该市经历了第二波，可能是由于SARS-CoV-2 P1变体的出现，该变体显示出更高的传播性和再感染率。Dirección秘鲁洛雷托地区（DIRESA），洛雷托。关于摘要的西班牙语翻译，请参见补充资料部分。
Detection of anti-SARS-CoV-2 antibodies among people at risk of infection is crucial for understanding both the past transmission of COVID-19 and vulnerability of the population to continuing transmission and, when done serially, the intensity of ongoing transmission over an interval in a community. We aimed to estimate the seroprevalence of COVID-19 in a representative population-based cohort in Iquitos, one of the regions with the highest mortality rates from COVID-19 in Peru, where a devastating number of cases occurred in March, 2020. We did a population-based study of SARS-CoV-2 transmission in Iquitos at two timepoints: July 13–18, 2020 (baseline), and Aug 13–18, 2020 (1-month follow-up). We obtained a geographically stratified representative sample of the city population using the 2017 census data, which was updated on Jan 20, 2020. We included people who were inhabitants of Iquitos since COVID-19 was identified in Peru (March 6, 2020) or earlier. We excluded people living in institutions, people receiving any pharmacological treatment for COVID-19, people with any contraindication for phlebotomy, and health workers or individuals living with an active health worker. We tested each participant for IgG and IgM anti-SARS-CoV-2 antibodies using the COVID-19 IgG/IgM Rapid Test (Zhejiang Orient Gene Biotech, China). We used survey analysis methods to estimate seroprevalence accounting for the sampling design effect and test performance characteristics. We identified 726 eligible individuals and enrolled a total of 716 participants (99%), distributed across 40 strata (four districts, two sexes, and five age groups). We excluded ten individuals who: did not have consent from a parent or legal representative (n=3), had moved to Iquitos after March 6, 2020 (n=3), were in transit (n=2), or had respiratory symptoms (n=1). After adjusting for the study sampling effects and sensitivity and specificity of the test, we estimated a seroprevalence of 70% (95% CI 67–73) at baseline and 66% (95% CI 62–70) at 1 month of follow-up, with a test-retest positivity of 65% (95% CI 61–68), and an incidence of new exposures of 2% (95% CI 1–3). We observed significant differences in the seroprevalence between age groups, with participants aged 18–29 years having lower seroprevalence than those aged younger than 12 years (prevalence ratio 0·85 [95% CI 0·73–0·98]; p=0·029). After the first epidemic peak, Iquitos had one of the highest rates of seroprevalence of anti-SARS-CoV-2 antibodies worldwide. Nevertheless, the city experienced a second wave starting in January, 2021, probably due to the emergence of the SARS-CoV-2 P1 variant, which has shown higher transmissibility and reinfection rates. Dirección Regional de Salud de Loreto (DIRESA), Loreto, Peru. For the Spanish translation of the abstract see Supplementary Materials section.