Accounting for assay performance when estimating the temporal dynamics in SARS-CoV-2 seroprevalence in the U.S.

Accounting for assay performance when estimating the temporal dynamics in SARS-CoV-2 seroprevalence in the U.S.
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DOI:
10.1038/s41467-023-37944-5
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发表时间:
2023-04-19
影响因子:
16.6
通讯作者:
Cummings, Derek A. T.
Cummings, Derek A. T.
中科院分区:
综合性期刊1区
文献类型:
--
作者:
Garcia-Carreras, Bernardo;Hitchings, Matt D. T.;Johansson, Michael A.;Biggerstaff, Matthew;Slayton, Rachel B.;Healy, Jessica M.;Lessler, Justin;Quandelacy, Talia;Salje, Henrik;Huang, Angkana T.;Cummings, Derek A. T.

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重建SARS-CoV-2感染的发病率是了解大流行状态的核心。血清阳性试验经常被用来评估累积感染,因为它们可以识别无症状感染。自2020年7月以来,商业实验室已在全国范围内为美国疾控中心进行了血清学检查。他们使用了三种不同灵敏度和特异度的分析方法,可能会在血清阳性率估计中引入偏差。使用模型,我们表明,考虑到检测解释了一些观察到的血清阳性率在州与州之间的变化,当整合病例和死亡监测数据时,我们表明,当使用雅培检测时,对感染比例的估计可能与血清阳性率估计有很大不同。我们还发现,受感染比例较高的州(在接种疫苗之前或之后)的疫苗接种覆盖率较低,这一模式得到了单独数据集的证实。最后,为了了解与病例增加相关的疫苗接种率,我们估计了感染前接种疫苗的人口比例。SARS-CoV-2血清阳性率调查旨在估计已感染人群的比例,但其准确性取决于所使用的检测方法的特点。在这里,作者使用统计模型来评估使用不同的检测方法对美国的血清阳性率估计的影响。
Reconstructing the incidence of SARS-CoV-2 infection is central to understanding the state of the pandemic. Seroprevalence studies are often used to assess cumulative infections as they can identify asymptomatic infection. Since July 2020, commercial laboratories have conducted nationwide serosurveys for the U.S. CDC. They employed three assays, with different sensitivities and specificities, potentially introducing biases in seroprevalence estimates. Using models, we show that accounting for assays explains some of the observed state-to-state variation in seroprevalence, and when integrating case and death surveillance data, we show that when using the Abbott assay, estimates of proportions infected can differ substantially from seroprevalence estimates. We also found that states with higher proportions infected (before or after vaccination) had lower vaccination coverages, a pattern corroborated using a separate dataset. Finally, to understand vaccination rates relative to the increase in cases, we estimated the proportions of the population that received a vaccine prior to infection. SARS-CoV-2 seroprevalence surveys aim to estimate the proportion of the population that has been infected, but their accuracy depends on the characteristics of the test assay used. Here, the authors use statistical models to assess the impact of the use of different assays on estimates of seroprevalence in the United States.
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