Monitoring the proportion of the population infected by SARS-CoV-2 using age-stratified hospitalisation and serological data: a modelling study.
Monitoring the proportion of the population infected by SARS-CoV-2 using age-stratified hospitalisation and serological data: a modelling study.
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DOI：
10.1016/s2468-2667(21)00064-5
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发表时间：
2021-06
期刊：
影响因子：
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通讯作者：
Cauchemez S
中科院分区：
文献类型：
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作者：
Hozé N;Paireau J;Lapidus N;Tran Kiem C;Salje H;Severi G;Touvier M;Zins M;de Lamballerie X;Lévy-Bruhl D;Carrat F;Cauchemez S
对感染SARS-CoV-2的人口比例进行区域监测对指导当地的疫情管理很重要，但在缺乏定期的全国性血清调查的情况下很难做到这一点。我们的目标是近乎实时地估计成年人感染SARS-CoV-2的比例。在这项模型研究中，我们开发了一种方法来重建感染SARS-CoV-2的成年人的比例和被检测到的感染比例，使用年龄分层的血清阳性率、住院和病例数据的联合分析，以及去卷积方法。我们开发了我们的方法，数据集包括2020年5月法国两个受影响最严重地区的9,782名参与者(年龄20岁)的血清阳性率估计，并将我们的方法应用于2020年3月至2021年1月期间的13个法国大都市地区。我们使用2020年5月至6月期间进行的全国血清阳性率研究的数据在外部验证了我们的方法。我们估计，到2020年5月11日，法国大都市有5.7%(95%可信区间为5·1-6·4)的成年人感染了SARS-CoV-2。这一比例在2020年8月之前保持稳定，到2021年1月15日增加到14.9%(13.2-16.9)。截至2021年1月，法国(巴黎地区)26.5%(23.429.8%)的成年居民感染了艾滋病，而布列塔尼为5.1%(4.55.8%)，地区差异仍然很大(变异系数[CV]0.50)，尽管比2020年5月(CV 0.74)小。20~49岁人群感染率(20.4%，15.6~26.3%)是50岁及以上人群(9.7%，6.9~14.1%)的两倍。2020年6月至8月，成人感染率为40.2%(34.3%-46.3%)，而2020年11月至2021年1月为49.3%(42.9%-55.9%)。我们对血清阳性率的地区估计与外部验证数据集(相关系数为0.89)有很强的相关性。我们估计成人感染SARS-CoV-2比例的简单方法，可以帮助表征SARS-CoV-2感染的负担、流行动态和不同地区的监测表现。欧盟复兴基金会、国家复兴基金会、梅迪卡莱基金会、圣安德烈国家研究院。
Regional monitoring of the proportion of the population who have been infected by SARS-CoV-2 is important to guide local management of the epidemic, but is difficult in the absence of regular nationwide serosurveys. We aimed to estimate in near real time the proportion of adults who have been infected by SARS-CoV-2. In this modelling study, we developed a method to reconstruct the proportion of adults who have been infected by SARS-CoV-2 and the proportion of infections being detected, using the joint analysis of age-stratified seroprevalence, hospitalisation, and case data, with deconvolution methods. We developed our method on a dataset consisting of seroprevalence estimates from 9782 participants (aged ≥20 years) in the two worst affected regions of France in May, 2020, and applied our approach to the 13 French metropolitan regions over the period March, 2020, to January, 2021. We validated our method externally using data from a national seroprevalence study done between May and June, 2020. We estimate that 5·7% (95% CI 5·1–6·4) of adults in metropolitan France had been infected with SARS-CoV-2 by May 11, 2020. This proportion remained stable until August, 2020, and increased to 14·9% (13·2–16·9) by Jan 15, 2021. With 26·5% (23·4–29·8) of adult residents having been infected in Île-de-France (Paris region) compared with 5·1% (4·5–5·8) in Brittany by January, 2021, regional variations remained large (coefficient of variation [CV] 0·50) although less so than in May, 2020 (CV 0·74). The proportion infected was twice as high (20·4%, 15·6–26·3) in 20–49-year-olds than in individuals aged 50 years or older (9·7%, 6·9–14·1). 40·2% (34·3–46·3) of infections in adults were detected in June to August, 2020, compared with 49·3% (42·9–55·9) in November, 2020, to January, 2021. Our regional estimates of seroprevalence were strongly correlated with the external validation dataset (coefficient of correlation 0·89). Our simple approach to estimate the proportion of adults that have been infected with SARS-CoV-2 can help to characterise the burden of SARS-CoV-2 infection, epidemic dynamics, and the performance of surveillance in different regions. EU RECOVER, Agence Nationale de la Recherche, Fondation pour la Recherche Médicale, Institut National de la Santé et de la Recherche Médicale (Inserm).