苏格兰对 COVID-19 的强化监测：在疫情第一波期间对 SARS-CoV-2 进行基于人群的血清流行率监测。
Enhanced surveillance of COVID-19 in Scotland: population-based seroprevalence surveillance for SARS-CoV-2 during the first wave of the epidemic.
机构信息
Public Health Scotland, Glasgow, UK.
Public Health Scotland, Glasgow, UK; School of Health and Life Sciences, Glasgow Caledonian University, UK.
出版信息
Public Health. 2021 Jan;190:132-134. doi: 10.1016/j.puhe.2020.11.014. Epub 2020 Nov 24.
OBJECTIVES
The impact of the COVID-19 pandemic in Scotland has been amongst the most severe in Europe. Serological surveillance is critical to determine the overall extent of infection across populations and to inform the public health response. This study aimed to estimate the proportion of people who have antibodies to SARS-CoV-2 ('seroprevalence') in the general population of Scotland and to see if this changes over time.
STUDY DESIGN/METHODS: Between International Organization for Standardization (ISO) week 17 (i.e. week commencing 20th April) and ISO week 25 (week commencing 15 June), 4751 residual blood samples were obtained from regional biochemistry laboratories in six participating regional health authority areas covering approximately 75% of the Scottish population. Samples were tested for the presence of anti-SARS-CoV-2 IgG antibodies using the LIAISON®SARS-CoV-2 S1/S2 IgG assay (DiaSorin, Italy). Seroprevalence rates were adjusted for the sensitivity and specificity of the assay using Bayesian methods.
RESULTS
The combined adjusted seroprevalence across the study period was 4.3% (95% confidence interval: 4.2%-4.5%). The proportion varied each week between 1.9% and 6.8% with no difference in antibody positivity by age, sex or geographical area.
CONCLUSIONS
At the end of the first wave of the COVID-19 pandemic, only a small fraction of the Scottish population had antibodies to SARS-CoV-2. Control of COVID-19 requires the ability to detect asymptomatic and mild infections that would otherwise remain undetected through existing surveillance systems. This is important to determine the true number of infections within the general population which, in turn, can help to understand transmission, inform control measures and provide a denominator for the estimation of severity measures such as the proportion of infected people who have been hospitalised and/or have died.
目的
苏格兰的 COVID-19 大流行的影响在欧洲是最严重的之一。血清学监测对于确定人群中感染的总体范围以及为公共卫生应对措施提供信息至关重要。本研究旨在估计苏格兰一般人群中对 SARS-CoV-2 具有抗体的人的比例（“血清流行率”），并观察其是否随时间变化。
研究设计/方法：在国际标准化组织（ISO）第 17 周（即 4 月 20 日开始的那一周）和第 25 周（6 月 15 日开始的那一周）之间，从六个参与的区域卫生当局的区域生化实验室中获得了 4751 份剩余血液样本，这些实验室覆盖了苏格兰约 75%的人口。使用 LIAISON®SARS-CoV-2 S1/S2 IgG 测定法（意大利 DiaSorin）检测样本中是否存在抗 SARS-CoV-2 IgG 抗体。使用贝叶斯方法调整了基于检测的敏感性和特异性的血清流行率。
结果
研究期间的综合调整后血清流行率为 4.3%（95%置信区间：4.2%-4.5%）。每周的比例在 1.9%至 6.8%之间变化，抗体阳性率与年龄、性别或地理区域无关。
结论
在 COVID-19 大流行的第一波结束时，只有一小部分苏格兰人口对 SARS-CoV-2 具有抗体。控制 COVID-19 需要能够检测到无症状和轻度感染，否则这些感染将无法通过现有的监测系统检测到。这对于确定一般人群中的实际感染人数很重要，这反过来又可以帮助了解传播情况，为控制措施提供信息，并为估计严重程度措施（例如感染人群中有多少人住院和/或死亡）提供分母。
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