Serological evidence of human infection with SARS-CoV-2: a systematic review and meta-analysis.
Serological evidence of human infection with SARS-CoV-2: a systematic review and meta-analysis.
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DOI：
10.1016/s2214-109x(21)00026-7
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发表时间：
2021-05
期刊：
影响因子：
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通讯作者：
Yu H
中科院分区：
文献类型：
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作者：
Chen X;Chen Z;Azman AS;Deng X;Sun R;Zhao Z;Zheng N;Chen X;Lu W;Zhuang T;Yang J;Viboud C;Ajelli M;Leung DT;Yu H
全球范围内关于 SARS-CoV-2 抗体的血清学调查数量迅速增加。我们的目标是综合、组合和评估这个庞大的数据集。在这项系统综述和荟萃分析中，我们搜索了 PubMed、Embase、Web of Science 和五个预印本服务器，查找 2019 年 12 月 1 日至 2020 年 12 月 22 日期间以英文发表的文章。其中包括在该地区发现首例病例后评估人类 SARS-CoV-2 血清阳性率的研究。仅报告 COVID-19 患者血清学反应、使用已知感染状态样本的研究或任何动物实验均被排除。用于分析的所有数据均从包含的论文中提取。使用标准化量表评估研究质量。我们估计了世界卫生组织各区域和不同暴露水平亚人群的特定年龄、特定性别和特定种族血清流行率，以及血清学鉴定的感染与病毒学确诊病例的比率。本研究已在 PROSPERO 注册，CRD42020198253。初步检索中确定了 16-506 项研究，在删除重复项和不适当的标题和摘要后评估了 2523 项研究的资格，荟萃分析中纳入了 404 项血清学研究（代表 5-168-360 名个体的测试）。在 82 项高质量研究中，密切接触者（18·0%，95% CI 15·7–20·3）和高危医护人员（17·1%，9·9–24·4）的血清阳性率高于低危医护人员（4·2%，1·5–6·9）和一般人群（8·0%，6·8–9·2）。纳入研究之间的异质性很高，总体 I2 为 99·9% (p<0·0001)。 WHO 各区域的血清阳性率差异很大，西太平洋区域一般人群的血清阳性率最低（1·7%，95% CI 0·0–5·0）。美洲地区（6·9，95% CI 2·7–17·3）和欧洲地区（8·4，6·5–10·7）的汇总感染病例比相似，但印度（56·5，28·5–112·0）更高，印度是东南亚地区唯一有数据的国家。在大多数情况下，抗体介导的群体免疫还远未达到。对世卫组织各区域每例病毒学确诊病例中血清学检测到的感染的比例进行估计，有助于从常规确认数据中了解感染人口的真实比例。国家杰出青年科学基金、上海市科委重点攻关项目、上海市学术/技术带头人计划、国家科技重大专项、美国国立卫生研究院。有关摘要的中文翻译，请参阅补充材料部分。
A rapidly increasing number of serological surveys for antibodies to SARS-CoV-2 have been reported worldwide. We aimed to synthesise, combine, and assess this large corpus of data. In this systematic review and meta-analysis, we searched PubMed, Embase, Web of Science, and five preprint servers for articles published in English between Dec 1, 2019, and Dec 22, 2020. Studies evaluating SARS-CoV-2 seroprevalence in humans after the first identified case in the area were included. Studies that only reported serological responses among patients with COVID-19, those using known infection status samples, or any animal experiments were all excluded. All data used for analysis were extracted from included papers. Study quality was assessed using a standardised scale. We estimated age-specific, sex-specific, and race-specific seroprevalence by WHO regions and subpopulations with different levels of exposures, and the ratio of serology-identified infections to virologically confirmed cases. This study is registered with PROSPERO, CRD42020198253. 16 506 studies were identified in the initial search, 2523 were assessed for eligibility after removal of duplicates and inappropriate titles and abstracts, and 404 serological studies (representing tests in 5 168 360 individuals) were included in the meta-analysis. In the 82 studies of higher quality, close contacts (18·0%, 95% CI 15·7–20·3) and high-risk health-care workers (17·1%, 9·9–24·4) had higher seroprevalence than did low-risk health-care workers (4·2%, 1·5–6·9) and the general population (8·0%, 6·8–9·2). The heterogeneity between included studies was high, with an overall I2 of 99·9% (p<0·0001). Seroprevalence varied greatly across WHO regions, with the lowest seroprevalence of general populations in the Western Pacific region (1·7%, 95% CI 0·0–5·0). The pooled infection-to-case ratio was similar between the region of the Americas (6·9, 95% CI 2·7–17·3) and the European region (8·4, 6·5–10·7), but higher in India (56·5, 28·5–112·0), the only country in the South-East Asia region with data. Antibody-mediated herd immunity is far from being reached in most settings. Estimates of the ratio of serologically detected infections per virologically confirmed cases across WHO regions can help provide insights into the true proportion of the population infected from routine confirmation data. National Science Fund for Distinguished Young Scholars, Key Emergency Project of Shanghai Science and Technology Committee, Program of Shanghai Academic/Technology Research Leader, National Science and Technology Major project of China, the US National Institutes of Health. For the Chinese translation of the abstract see Supplementary Materials section.