Seroprevalence of IgG antibodies against SARS-CoV-2 among the general population and healthcare workers in India, June-July 2021: A population-based cross-sectional study.
Seroprevalence of IgG antibodies against SARS-CoV-2 among the general population and healthcare workers in India, June-July 2021: A population-based cross-sectional study.
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DOI：
10.1371/journal.pmed.1003877
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发表时间：
2021-12
期刊：
影响因子：
15.8
通讯作者：
ICMR serosurveillance group
中科院分区：
文献类型：
--
作者：
Murhekar MV;Bhatnagar T;Thangaraj JWV;Saravanakumar V;Santhosh Kumar M;Selvaraju S;Rade K;Kumar CPG;Sabarinathan R;Asthana S;Balachandar R;Bangar SD;Bansal AK;Bhat J;Chakraborty D;Chopra V;Das D;Devi KR;Dwivedi GR;Jain A;Khan SMS;Kumar MS;Laxmaiah A;Madhukar M;Mahapatra A;Ramesh T;Rangaraju C;Turuk J;Yadav S;Bhargava B;ICMR serosurveillance group
印度于2021年1月开始接种COVID-19疫苗，最初针对医疗保健和一线工作人员。疫苗接种战略分阶段扩大，目前覆盖所有18岁及以上的人。印度于二零二一年三月至六月经历了严重的第二波COVID-19疫情。我们进行了第四次全国性血清调查，以估计SARS-CoV-2抗体在≥6岁的普通人群和医护人员（HCW）中的流行率。我们在2021年6月14日至7月6日期间在20个州和1个联邦领土的70个地区进行了一项横断面研究，其中进行了前三轮血清调查。从每个区，10个集群（农村地区的村庄和城市地区的病房）选择的概率与人口规模成比例的方法。每个区至少纳入400名来自一般人群的≥6岁个体（每个群集40名个体）和100名来自区公共卫生机构的HCW。用化学发光免疫法检测血清中抗S1-RBD和SARS-CoV-2核衣壳蛋白IgG抗体的存在。我们基于S1-RBD和/或核衣壳蛋白的抗体的存在，估计了抗SARS-CoV-2的IgG抗体的加权和测试调整的血清阳性率，沿着95%CI。在参与调查的28，975人中，2，892人（10%）年龄在6-9岁之间，5，798人（20%）年龄在10-17岁之间，20，285人（70%）年龄在18岁以上; 15，160人（52.3%）为女性，21，794人（75.2%）居住在农村地区。在≥6岁的一般人群中，抗S1-RBD和/或核衣壳蛋白IgG抗体的加权和检测校正患病率为67.6%（95% CI 66.4%至68.7%）。血清阳性率随年龄增长而增加（p < 0.001），农村和城市地区无差异（p = 0.822）。与未接种疫苗的成人（62.3%，95% CI 60.9%至63.7%）相比，接种1剂疫苗（81.0%，95% CI 79.6%至82.3%，p < 0.001）和2剂疫苗（89.8%，95% CI 88.4%至91.1%，p < 0.001）的个体血清阳性率显著较高。7，252名HCW中IgG抗体的血清阳性率为85.2%（95%CI 83.5%至86.7%）。该研究的重要局限性包括调查设计，其目的是在国家一级而不是在次国家一级估计血清阳性率，以及19%的合格个体未参与调查。到2021年6月至7月，印度一般人群中近三分之二的年龄≥6岁的个体和85%的HCW具有SARS-CoV-2抗体。由于三分之一的人口仍然是血清阴性，因此有必要加快成年人中COVID-19疫苗接种的覆盖率，并继续坚持非药物干预措施。Manoj Murhekar及其同事报告了印度抗SARS-CoV-2抗体的血清阳性率。早些时候在印度进行的全国性COVID-19血清调查显示，血清阳性率从0.73%上升到（95%CI 0.34%至1.13%）至2020年9月至10月的6.6%（95%CI 5.8%至7.4%）及2020年12月至2021年1月的24.1%（95%CI 23.0%至25.3%）。印度于2021年1月开始接种COVID-19疫苗，最初针对医疗保健和一线工作人员。疫苗接种战略分阶段扩大，目前覆盖所有18岁及以上的人。2021年3月至6月，印度经历了第二波严重的COVID-19疫情。第四次全国性血清调查显示，截至2021年6月至7月，印度约三分之二的6岁以上人口具有SARS-CoV-2抗体。血清阳性率随年龄增长而增加，但在城市贫民窟、城市非贫民窟和农村地区没有差异。与未接种疫苗的个体相比，接种2剂COVID-19疫苗的个体的血清阳性率显著较高。在区级卫生机构工作的医护人员中，约85%有SARS-CoV-2抗体。印度人口中抗SARS-CoV-2抗体的高血清阳性率应该为该国未来的COVID-19浪潮提供一定程度的保护。截至2021年6月至7月，印度约有三分之一的人口没有可检测到的SARS-CoV-2抗体。因此，有必要加快成人COVID-19疫苗接种的覆盖率。
India began COVID-19 vaccination in January 2021, initially targeting healthcare and frontline workers. The vaccination strategy was expanded in a phased manner and currently covers all individuals aged 18 years and above. India experienced a severe second wave of COVID-19 during March–June 2021. We conducted a fourth nationwide serosurvey to estimate prevalence of SARS-CoV-2 antibodies in the general population aged ≥6 years and healthcare workers (HCWs). We did a cross-sectional study between 14 June and 6 July 2021 in the same 70 districts across 20 states and 1 union territory where 3 previous rounds of serosurveys were conducted. From each district, 10 clusters (villages in rural areas and wards in urban areas) were selected by the probability proportional to population size method. From each district, a minimum of 400 individuals aged ≥6 years from the general population (40 individuals from each cluster) and 100 HCWs from the district public health facilities were included. The serum samples were tested for the presence of IgG antibodies against S1-RBD and nucleocapsid protein of SARS-CoV-2 using chemiluminescence immunoassay. We estimated the weighted and test-adjusted seroprevalence of IgG antibodies against SARS-CoV-2, along with 95% CIs, based on the presence of antibodies to S1-RBD and/or nucleocapsid protein. Of the 28,975 individuals who participated in the survey, 2,892 (10%) were aged 6–9 years, 5,798 (20%) were aged 10–17 years, and 20,285 (70%) were aged ≥18 years; 15,160 (52.3%) participants were female, and 21,794 (75.2%) resided in rural areas. The weighted and test-adjusted prevalence of IgG antibodies against S1-RBD and/or nucleocapsid protein among the general population aged ≥6 years was 67.6% (95% CI 66.4% to 68.7%). Seroprevalence increased with age (p < 0.001) and was not different in rural and urban areas (p = 0.822). Compared to unvaccinated adults (62.3%, 95% CI 60.9% to 63.7%), seroprevalence was significantly higher among individuals who had received 1 vaccine dose (81.0%, 95% CI 79.6% to 82.3%, p < 0.001) and 2 vaccine doses (89.8%, 95% CI 88.4% to 91.1%, p < 0.001). The seroprevalence of IgG antibodies among 7,252 HCWs was 85.2% (95% CI 83.5% to 86.7%). Important limitations of the study include the survey design, which was aimed to estimate seroprevalence at the national level and not at a sub-national level, and the non-participation of 19% of eligible individuals in the survey. Nearly two-thirds of individuals aged ≥6 years from the general population and 85% of HCWs had antibodies against SARS-CoV-2 by June–July 2021 in India. As one-third of the population is still seronegative, it is necessary to accelerate the coverage of COVID-19 vaccination among adults and continue adherence to non-pharmaceutical interventions. Manoj Murhekar and co-workers report on the seroprevalence of anti-SARS-CoV-2 antibodies in India. Earlier nationwide COVID-19 serosurveys conducted in India indicated an increase in seroprevalence from 0.73% (95% CI 0.34% to 1.13%) in May–June 2020 to 6.6% (95% CI 5.8% to 7.4%) in September–October 2020 and 24.1% (95% CI 23.0% to 25.3%) in December 2020–January 2021. India began COVID-19 vaccination in January 2021, initially targeting healthcare and frontline workers. The vaccination strategy was expanded in a phased manner and currently covers all individuals aged 18 years and above. India witnessed a severe second wave of COVID-19 in March–June 2021. The fourth nationwide serosurvey indicated that about two-thirds of India’s population aged ≥6 years had antibodies against SARS-CoV-2 by June–July 2021. Seroprevalence increased with age, but was not different in urban slum, urban non-slum, and rural areas. Seroprevalence was significantly higher among individuals who had received 2 doses of COVID-19 vaccine compared to unvaccinated individuals. About 85% of healthcare workers working in district-level health facilities had antibodies against SARS-CoV-2. The substantial seroprevalence of anti-SARS-CoV-2 antibodies in the Indian population should provide some measure of protection against future waves of COVID-19 in the country. About one-third of the population in India did not have detectable antibodies against SARS-CoV-2 by June–July 2021. It is therefore necessary to accelerate the coverage of COVID-19 vaccination among adults.
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