Prevalence of SARS-CoV-2 in Spain (ENE-COVID): a nationwide, population-based seroepidemiological study
Prevalence of SARS-CoV-2 in Spain (ENE-COVID): a nationwide, population-based seroepidemiological study
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DOI：
10.1016/s0140-6736(20)31483-5
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发表时间：
2020-08-22
期刊：
影响因子：
168.9
通讯作者：
Yotti, Raquel
中科院分区：
文献类型：
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作者：
Pollan, Marina;Perez-Gomez, Beatriz;Yotti, Raquel
西班牙是受新冠肺炎疫情影响最严重的欧洲国家之一。鉴于存在无症状病例和很少获得诊断检测，血清学调查是评估疫情程度的宝贵工具。这项以全国人口为基础的研究旨在估计西班牙国家和地区一级SARS-CoV-2感染的血清流行率。方法采用分省、市两阶段随机抽样的方法，从地市级卷宗中抽取35883户家庭进行抽样调查。从2020年4月27日至5月11日，61 075名参与者（占选定家庭中所有接触者的75.1%）回答了一份关于与COVID-19相符的症状史和危险因素的问卷，接受了即时抗体检测，如果同意，则捐献血液样本用于化学发光微粒免疫分析法的额外检测。使用抽样权重和分层后调整IgG抗体的流行率，以考虑基于年龄组、性别和人口普查区收入的无应答率差异。利用这两项测试的结果，我们计算了血清阳性率范围，使特异性（两项测试均为阳性）或敏感性（两项测试均为阳性）最大化。结果：护理点检测血清阳性率为5.0% (95% CI 4.7-5.4)，免疫测定血清阳性率为4.6%(4.3-5.0)，特异性敏感性范围为3.7%（3.3-4.0；两项检测均阳性）至6.2%（5.8-6.6；两项检测均阳性），性别差异无统计学意义，10岁以下儿童血清阳性率较低（10%），沿海地区较低(
Background Spain is one of the European countries most affected by the COVID-19 pandemic. Serological surveys are a valuable tool to assess the extent of the epidemic, given the existence of asymptomatic cases and little access to diagnostic tests. This nationwide population-based study aims to estimate the seroprevalence of SARS-CoV-2 infection in Spain at national and regional level.Methods 35 883 households were selected from municipal rolls using two-stage random sampling stratified by province and municipality size, with all residents invited to participate. From April 27 to May 11, 2020, 61 075 participants (75.1% of all contacted individuals within selected households) answered a questionnaire on history of symptoms compatible with COVID-19 and risk factors, received a point-of-care antibody test, and, if agreed, donated a blood sample for additional testing with a chemiluminescent microparticle immunoassay. Prevalences of IgG antibodies were adjusted using sampling weights and post-stratification to allow for differences in non-response rates based on age group, sex, and census-tract income. Using results for both tests, we calculated a seroprevalence range maximising either specificity (positive for both tests) or sensitivity (positive for either test).Findings Seroprevalence was 5.0% (95% CI 4.7-5.4) by the point-of-care test and 4.6% (4.3-5.0) by immunoassay, with a specificity-sensitivity range of 3.7% (3.3-4.0; both tests positive) to 6.2% (5.8-6.6; either test positive), with no differences by sex and lower seroprevalence in children younger than 10 years (10%) and lower in coastal areas (