Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada.
Microbiology Department, Canadian Blood Services, Ottawa, Ontario, Canada.
Transfusion. 2021 Mar;61(3):862-872. doi: 10.1111/trf.16296. Epub 2021 Feb 23.
Case detection underestimates the burden of the COVID-19 pandemic. Following the first COVID-19 wave, we estimated the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among blood donors across Canada.
This serial cross-sectional study was conducted between May 9 and July 21, 2020 from blood donors donating at all Canadian Blood Services locations. We used the Abbott Architect assay to detect SARS-CoV-2 IgG antibodies from retention plasma. Seroprevalence was standardized to population-level demographics and assay characteristics were adjusted using the Rogan-Gladen equation. Results were stratified by region, age, ethnicity, ABO groups, and quantiles of material and social deprivation indices. Temporal trends were evaluated at 2-week intervals. Univariate and multivariate logistic regression compared SARS-CoV-2 reactive to non-reactive donors by sociodemographic variables.
Overall 552/74642 donors, had detectable antibodies, adjusted seroprevalence was 7.0/1000 donors (95% CI; 6.3, 7.6). Prevalence was differential by geography, Ontario had the highest rate, 8.8/1000 donors (7.8, 9.8), compared to the Atlantic region 4.5/1000 donors (2.6, 6.4); adjusted odds ratio (aOR) 2.2 (1.5, 3.3). Donors that self-identified as an ethnic minority were more likely than white donors to be sero-reactive aOR 1.5 (1.2, 1.9). No temporal trends were observed.
Worldwide, blood services have leveraged their operational capacity to inform public health. While >99% of Canadians did not show humoral evidence of past infection, we found regional variability and disparities by ethnicity. Seroprevalence studies will continue to play a pivotal role in evaluating public health policies by identifying trends and monitor disparities.
病例检测低估了 COVID-19 大流行的负担。在第一波 COVID-19 之后,我们估计了加拿大各地献血者中严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)的血清流行率。
这是一项在 2020 年 5 月 9 日至 7 月 21 日期间进行的连续横断面研究,研究对象为所有加拿大血液服务中心的献血者。我们使用 Abbott Architect 测定法从保留血浆中检测 SARS-CoV-2 IgG 抗体。血清流行率按人群水平的人口统计学进行标准化,并使用 Rogan-Gladen 方程调整测定特征。结果按地区、年龄、种族、ABO 组以及物质和社会剥夺指数的分位数进行分层。每两周评估一次时间趋势。单变量和多变量逻辑回归比较了 SARS-CoV-2 反应性和非反应性献血者的社会人口统计学变量。
共有 552/74642 名献血者可检测到抗体,调整后的血清流行率为 7.0/1000 名献血者(95%CI;6.3,7.6)。流行率因地理位置而异,安大略省的患病率最高,为 8.8/1000 名献血者(7.8,9.8),而大西洋地区为 4.5/1000 名献血者(2.6,6.4);调整后的优势比(aOR)为 2.2(1.5,3.3)。自我认定为少数民族的献血者比白人献血者更有可能呈血清反应性,aOR 为 1.5(1.2,1.9)。未观察到时间趋势。
在全球范围内,血液服务机构利用其运营能力为公共卫生提供信息。虽然>99%的加拿大人没有显示过去感染的体液证据,但我们发现了地域差异和种族差异。血清流行率研究将继续在评估公共卫生政策方面发挥关键作用,通过确定趋势和监测差异来识别趋势。