Vos Eric R A, den Hartog Gerco, Schepp Rutger M, Kaaijk Patricia, van Vliet Jeffrey, Helm Kina, Smits Gaby, Wijmenga-Monsuur Alienke, Verberk Janneke D M, van Boven Michiel, van Binnendijk Rob S, de Melker Hester E, Mollema Liesbeth, van der Klis Fiona R M
Centre for Infectious Disease Control, RIVM, Bilthoven, Netherlands.
Centre for Infectious Disease Control, RIVM, Bilthoven, Netherlands
J Epidemiol Community Health. 2020 Nov 28;75(6):489-95. doi: 10.1136/jech-2020-215678.
We aimed to detect SARS-CoV-2 serum antibodies in the general population of the Netherlands and identify risk factors for seropositivity amidst the first COVID-19 epidemic wave.
Participants (n=3207, aged 2-90 years), enrolled from a previously established nationwide serosurveillance study, provided a self-collected fingerstick blood sample and completed a questionnaire (median inclusion date 3 April 2020). IgG antibodies targeted against the spike S1-protein of SARS-CoV-2 were quantified using a validated multiplex-immunoassay. Seroprevalence was estimated controlling for survey design, individual pre-pandemic concentration, and test performance. Random-effects logistic regression identified risk factors for seropositivity.
Overall seroprevalence in the Netherlands was 2.8% (95% CI 2.1 to 3.7), with no differences between sexes or ethnic background, and regionally ranging between 1.3 and 4.0%. Estimates were highest among 18-39 year-olds (4.9%), and lowest in children 2-17 years (1.7%). Multivariable analysis revealed that persons taking immunosuppressants and those from the Orthodox-Reformed Protestant community had over four times higher odds of being seropositive compared to others. Anosmia/ageusia was the most discriminative symptom between seropositive (53%) and seronegative persons (4%, p<0.0001). Antibody concentrations in seropositive persons were significantly higher in those with fever or dyspnoea in contrast to those without (p=0.01 and p=0.04, respectively).
In the midst of the first epidemic wave, 2.8% of the Dutch population was estimated to be infected with SARS-CoV-2, that is, 30 times higher than reported. This study identified independent groups with increased odds for seropositivity that may require specific surveillance measures to guide future protective interventions internationally, including vaccination once available.
我们旨在检测荷兰普通人群中的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）血清抗体，并确定在第一波新冠疫情期间血清反应阳性的风险因素。
参与者（n = 3207，年龄2至90岁）来自先前建立的全国性血清学监测研究，提供自行采集的指尖血样本并完成一份问卷（中位纳入日期为2020年4月3日）。使用经过验证的多重免疫测定法定量针对SARS-CoV-2刺突S1蛋白的IgG抗体。在控制调查设计、个体疫情前浓度和检测性能的情况下估计血清阳性率。随机效应逻辑回归确定血清反应阳性的风险因素。
荷兰的总体血清阳性率为2.8%（95%置信区间2.1至3.7），性别或种族背景之间无差异，地区范围在1.3%至4.0%之间。估计在18至39岁人群中最高（4.9%），在2至17岁儿童中最低（1.7%）。多变量分析显示，与其他人相比，服用免疫抑制剂的人和来自东正教改革新教社区的人血清反应阳性的几率高出四倍多。嗅觉丧失/味觉丧失是血清反应阳性者（53%）和血清反应阴性者（4%，p<0.0001）之间最具区分性的症状。与无发热或呼吸困难的血清反应阳性者相比，有发热或呼吸困难的血清反应阳性者的抗体浓度显著更高（分别为p = 0.01和p = 0.04）。
在第一波疫情期间，估计2.8%的荷兰人口感染了SARS-CoV-2，即比报告的高出30倍。本研究确定了血清反应阳性几率增加的独立群体，可能需要采取特定监测措施，以指导未来国际上的保护性干预措施，包括疫苗可用时的接种。
