期刊
EPIDEMIOLOGY
卷 32, 期 4, 页码 518-524出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/EDE.0000000000001361
关键词
Antibody; Case ascertainment ratio; COVID-19; Cumulative incidence; Infection fatality ratio; SARS-CoV-2; Seroprevalence; Waning antibody
资金
- US National Science Foundation [2032082, 2032084]
- US National Institute of Allergy and Infectious Diseases [3R01AI143875-02S1]
- Division Of Environmental Biology
- Direct For Biological Sciences [2032082, 2032084] Funding Source: National Science Foundation
Through analysis of data from New York City and Connecticut, researchers found that serology data without adjustment for waning antibodies underestimates the cumulative incidence of SARS-CoV-2 infection. They successfully estimated the infection fatality ratio and time for antibody waning, providing a basis for adjusting estimates.
Background: Serology tests can identify previous infections and facilitate estimation of the number of total infections. However, immunoglobulins targeting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been reported to wane below the detectable level of serologic assays (which is not necessarily equivalent to the duration of protective immunity). We estimate the cumulative incidence of SARS-CoV-2 infection from serology studies, accounting for expected levels of antibody acquisition (seroconversion) and waning (seroreversion), and apply this framework using data from New York City and Connecticut. Methods: We estimated time from seroconversion to seroreversion and infection fatality ratio (IFR) using mortality data from March to October 2020 and population-level cross-sectional seroprevalence data from April to August 2020 in New York City and Connecticut. We then estimated the daily seroprevalence and cumulative incidence of SARS-CoV-2 infection. Results: The estimated average time from seroconversion to seroreversion was 3-4 months. The estimated IFR was 1.1% (95% credible interval, 1.0%, 1.2%) in New York City and 1.4% (1.1, 1.7%) in Connecticut. The estimated daily seroprevalence declined after a peak in the spring. The estimated cumulative incidence reached 26.8% (24.2%, 29.7%) at the end of September in New York City and 8.8% (7.1%, 11.3%) in Connecticut, higher than maximum seroprevalence measures (22.1% and 6.1%), respectively. Conclusions: The cumulative incidence of SARS-CoV-2 infection is underestimated using cross-sectional serology data without adjustment for waning antibodies. Our approach can help quantify the magnitude of underestimation and adjust estimates for waning antibodies.
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