2020 年 1 月 2 日至 3 月 18 日，所有美国人研究计划参与者中严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）的抗体。
Antibodies to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in All of Us Research Program Participants, 2 January to 18 March 2020.
机构信息
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
All of Us Research Program, National Institutes of Health, Bethesda, Maryland, USA.
出版信息
Clin Infect Dis. 2022 Mar 1;74(4):584-590. doi: 10.1093/cid/ciab519.
BACKGROUND
With limited severe acute respiratory syndrome coronavirus (SARS-CoV-2) testing capacity in the United States at the start of the epidemic (January-March 2020), testing was focused on symptomatic patients with a travel history throughout February, obscuring the picture of SARS-CoV-2 seeding and community transmission. We sought to identify individuals with SARS-CoV-2 antibodies in the early weeks of the US epidemic.
METHODS
All of Us study participants in all 50 US states provided blood specimens during study visits from 2 January to 18 March 2020. Participants were considered seropositive if they tested positive for SARS-CoV-2 immunoglobulin G (IgG) antibodies with the Abbott Architect SARS-CoV-2 IgG enzyme-linked immunosorbent assay (ELISA) and the EUROIMMUN SARS-CoV-2 ELISA in a sequential testing algorithm. The sensitivity and specificity of these ELISAs and the net sensitivity and specificity of the sequential testing algorithm were estimated, along with 95% confidence intervals (CIs).
RESULTS
The estimated sensitivities of the Abbott and EUROIMMUN assays were 100% (107 of 107 [95% CI: 96.6%-100%]) and 90.7% (97 of 107 [83.5%-95.4%]), respectively, and the estimated specificities were 99.5% (995 of 1000 [98.8%-99.8%]) and 99.7% (997 of 1000 [99.1%-99.9%]), respectively. The net sensitivity and specificity of our sequential testing algorithm were 90.7% (97 of 107 [95% CI: 83.5%-95.4%]) and 100.0% (1000 of 1000 [99.6%-100%]), respectively. Of the 24 079 study participants with blood specimens from 2 January to 18 March 2020, 9 were seropositive, 7 before the first confirmed case in the states of Illinois, Massachusetts, Wisconsin, Pennsylvania, and Mississippi.
CONCLUSIONS
Our findings identified SARS-CoV-2 infections weeks before the first recognized cases in 5 US states.
背景
在美国疫情初期（2020 年 1 月至 3 月），严重急性呼吸系统综合征冠状病毒（SARS-CoV-2）检测能力有限，因此检测重点一直是 2 月期间有旅行史且出现症状的患者，这掩盖了 SARS-CoV-2 传播和社区传播的情况。我们试图在疫情早期确定美国有 SARS-CoV-2 抗体的个体。
方法
在 2020 年 1 月 2 日至 3 月 18 日期间，所有美国研究参与者在参加研究访问时提供了血液样本。如果 Abbott Architect SARS-CoV-2 IgG 酶联免疫吸附测定（ELISA）和 EUROIMMUN SARS-CoV-2 ELISA 连续检测算法检测到 SARS-CoV-2 免疫球蛋白 G（IgG）抗体呈阳性，则认为参与者呈血清阳性。我们估计了这些 ELISA 的敏感性和特异性，以及连续检测算法的净敏感性和特异性，置信区间（CI）为 95%。
结果
Abbott 和 EUROIMMUN 检测的估计敏感性分别为 100%（107 例中的 107 例[95%CI：96.6%-100%]）和 90.7%（107 例中的 97 例[83.5%-95.4%]），估计特异性分别为 99.5%（1000 例中的 995 例[98.8%-99.8%]）和 99.7%（1000 例中的 997 例[99.1%-99.9%]）。我们连续检测算法的净敏感性和特异性分别为 90.7%（107 例中的 97 例[95%CI：83.5%-95.4%]）和 100.0%（1000 例中的 1000 例[99.6%-100%]）。在 2020 年 1 月 2 日至 18 日期间有血液样本的 24079 名研究参与者中，有 9 人血清阳性，其中 7 人在伊利诺伊州、马萨诸塞州、威斯康星州、宾夕法尼亚州和密西西比州的首个确诊病例之前呈阳性。
结论
我们的研究结果在 5 个美国州首次发现确诊病例前数周发现了 SARS-CoV-2 感染病例。
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