학술논문
German federal-state-wide seroprevalence study of 1st SARS-CoV-2 pandemic wave shows importance of long-term antibody test performance
Document Type
Original Paper
Author
Lohse, Stefan; Sternjakob-Marthaler, Anna; Lagemann, Paul; Schöpe, Jakob; Rissland, Jürgen; Seiwert, Nastasja; Pfuhl, Thorsten; Müllendorff, Alana; Kiefer, Laurent S.; Vogelgesang, Markus; Vella, Luca; Denk, Katharina; Vicari, Julia; Zwick, Anabel; Lang, Isabelle; Weber, Gero; Geisel, Jürgen; Rech, Jörg; Schnabel, Bernd; Hauptmann, Gunter; Holleczek, Bernd; Scheiblauer, Heinrich; Wagenpfeil, Stefan; Smola, Sigrun
Source
Communications Medicine. 2(1)
Subject
Language
English
ISSN
2730-664X
Abstract
Background: Reliable data on the adult SARS-CoV-2 infection fatality rate in Germany are still scarce. We performed a federal state-wide cross-sectional seroprevalence study named SaarCoPS, that is representative for the adult population including elderly individuals and nursing home residents in the Saarland.Methods: Serum was collected from 2940 adults via stationary or mobile teams during the 1st pandemic wave steady state period. We selected an antibody test system with maximal specificity, also excluding seroreversion effects due to a high longitudinal test performance. For the calculations of infection and fatality rates, we accounted for the delays of seroconversion and death after infection.Results: Using a highly specific total antibody test detecting anti-SARS-CoV-2 responses over more than 180 days, we estimate an adult infection rate of 1.02% (95% CI: [0.64; 1.44]), an underreporting rate of 2.68-fold (95% CI: [1.68; 3.79]) and infection fatality rates of 2.09% (95% CI: (1.48; 3.32]) or 0.36% (95% CI: [0.25; 0.59]) in all adults including elderly individuals, or adults younger than 70 years, respectively.Conclusion: The study highlights the importance of study design and test performance for seroprevalence studies, particularly when seroprevalences are low. Our results provide a valuable baseline for evaluation of future pandemic dynamics and impact of public health measures on virus spread and human health in comparison to neighbouring countries such as Luxembourg or France.
Plain language summary: To date, few reliable data are available on the proportion of adults who were infected with SARS-CoV-2 or the proportion who died from COVID-19 during the first pandemic wave in Germany. We tested a representative subset of adults in the Saarland region of Germany for antibodies, proteins circulating in the blood that are indicative of previous infection with SARS-CoV-2. We used three different antibody tests at different time points after the first pandemic wave and compared the results obtained using the different tests. Using the test with the best performance, we estimate nearly three fold of infections were previously unreported. We estimate 2.09% of adults who were infected with SARS-CoV-2 went on to die. This reduced to 0.36% for individuals under 70 years of age. Our data highlight the importance of selecting the right antibody test system with high longitudinal test performance for such studies.
Lohse, Sternjakob-Marthaler et al. assess anti-SARS-CoV-2 antibody responses of adults in the Saarland region of Germany after the first pandemic wave. They calculate infection and fatality rates, demonstrating that SARS-Cov-2 infections during this period were underreported.
Plain language summary: To date, few reliable data are available on the proportion of adults who were infected with SARS-CoV-2 or the proportion who died from COVID-19 during the first pandemic wave in Germany. We tested a representative subset of adults in the Saarland region of Germany for antibodies, proteins circulating in the blood that are indicative of previous infection with SARS-CoV-2. We used three different antibody tests at different time points after the first pandemic wave and compared the results obtained using the different tests. Using the test with the best performance, we estimate nearly three fold of infections were previously unreported. We estimate 2.09% of adults who were infected with SARS-CoV-2 went on to die. This reduced to 0.36% for individuals under 70 years of age. Our data highlight the importance of selecting the right antibody test system with high longitudinal test performance for such studies.
Lohse, Sternjakob-Marthaler et al. assess anti-SARS-CoV-2 antibody responses of adults in the Saarland region of Germany after the first pandemic wave. They calculate infection and fatality rates, demonstrating that SARS-Cov-2 infections during this period were underreported.