King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
J Infect Public Health. 2021 Jul;14(7):832-838. doi: 10.1016/j.jiph.2021.04.006. Epub 2021 Apr 24.
Estimated seroprevalence of Coronavirus Infectious Disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) is a critical evidence for a better evaluation of the virus spread and monitoring the progress of COVID-19 pandemic in a population. In the Kingdom of Saudi Arabia (KSA), SARS-CoV-2 seroprevalence has been reported in specific regions, but an extensive nationwide study has not been reported. Here, we report a nationwide study to determine the prevalence of SARS-CoV-2 in the population of KSA during the pandemic, using serum samples from healthy blood donors, non-COVID patients and healthcare workers (HCWs) in six different regions of the kingdom, with addition samples from COVID-19 patients.
A total of 11,703 serum samples were collected from different regions of the KSA including; 5395 samples from residual healthy blood donors (D); 5877 samples from non-COVID patients collected through residual sera at clinical biochemistry labs from non-COVID patients (P); and 400 samples from consented HCWs. To determine the seroprevalence of SARS-CoV-2, all serum samples, in addition to positive control sera from RT-PCR confirmed COVID-19 patients, were subjected to in-house ELISA with a sample pooling strategy, which was further validated by testing individual samples that make up some of the pools, with a statistical estimation method to report seroprevalence estimates.
Overall (combining D and P groups) seroprevalence estimate was around 11% in Saudi Arabia; and was 5.1% (Riyadh), 1.5% (Jazan), 18.4% (Qassim), 20.8% (Hail), 14.7% (ER; Alahsa), and 18.8% in Makkah. Makkah samples were only D group and had a rate of 24.4% and 12.8% in the cities of Makkah and Jeddah, respectively. The seroprevalence in Saudi Arabia across the sampled areas would be 12 times the reported COVID-19 infection rate. Among HCWs, 7.5% (4.95-10.16 CI 95%) had reactive antibodies to SARS-CoV-2 without reporting any previously confirmed infection. This was higher in HCWs with hypertension. The study also presents the demographics and prevalence of co-morbidities in HCWs and subset of non-COVID-19 population.
Our study estimates the overall national serological prevalence of COVID-19 in Saudi Arabia to be 11%, with an apparent disparity between regions. This indicates the prevalence of asymptomatic or mild unreported COVID-19 cases.
由严重急性呼吸系统综合症冠状病毒 2 型（SARS-CoV-2）引起的 2019 年冠状病毒病（COVID-19）的估计血清流行率是更好地评估病毒传播和监测人群中 COVID-19 大流行进展的关键证据。在沙特阿拉伯王国（KSA），已经在特定地区报告了 SARS-CoV-2 的血清流行率，但尚未报告广泛的全国性研究。在这里，我们报告了一项全国性研究，以确定大流行期间 KSA 人群中 SARS-CoV-2 的流行率，使用来自不同地区的健康献血者、非 COVID 患者和医护人员（HCWs）的血清样本，以及来自 COVID-19 患者的额外样本。
共收集了来自沙特阿拉伯不同地区的 11703 份血清样本，包括：5395 份来自剩余健康献血者的样本（D）；5877 份来自非 COVID 患者的样本，这些样本是通过临床生物化学实验室中来自非 COVID 患者的剩余血清收集的（P）；以及 400 份来自同意的 HCWs 的样本。为了确定 SARS-CoV-2 的血清流行率，除了来自经 RT-PCR 确认的 COVID-19 患者的阳性对照血清外，所有血清样本均采用内部 ELISA 进行检测，并采用样本混合策略进行检测，进一步通过测试组成部分的一些混合样本的个别样本进行验证，采用统计估计方法报告血清流行率估计值。
总体而言（合并 D 和 P 组），沙特阿拉伯的血清流行率估计约为 11%；利雅得为 5.1%，吉赞为 1.5%，卡西姆为 18.4%，哈伊勒为 20.8%，埃尔阿赫萨为 14.7%，麦加为 18.8%。麦加的样本仅来自 D 组，在麦加和吉达市的比例分别为 24.4%和 12.8%。沙特阿拉伯在采样地区的血清流行率将是报告的 COVID-19 感染率的 12 倍。在 HCWs 中，有 7.5%（95%置信区间 4.95-10.16）的人对 SARS-CoV-2 有反应性抗体，而没有报告任何先前确认的感染。在患有高血压的 HCWs 中，这一比例更高。该研究还介绍了 HCWs 和非 COVID-19 人群亚组的人口统计学和合并症患病率。
我们的研究估计，沙特阿拉伯的全国性 COVID-19 血清流行率总体为 11%，各地区之间存在明显差异。这表明存在无症状或轻度未报告的 COVID-19 病例。
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