抗体状况和法国三个地区成年人在首次封锁后的 SARS-CoV-2 感染累积发生率及相关危险因素：一项多队列研究。
Antibody status and cumulative incidence of SARS-CoV-2 infection among adults in three regions of France following the first lockdown and associated risk factors: a multicohort study.
机构信息
Sorbonne Université, Inserm, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, Paris, France.
Département de Santé Publique, APHP.Sorbonne Université, Paris, France.
出版信息
Int J Epidemiol. 2021 Nov 10;50(5):1458-1472. doi: 10.1093/ije/dyab110.
BACKGROUND
We aimed to estimate the seropositivity to anti-SARS-CoV-2 antibodies in May-June 2020 after the first lockdown period in adults living in three regions in France and to identify the associated risk factors.
METHODS
Between 4 May 2020 and 23 June 2020, 16 000 participants in a survey on COVID-19 from an existing consortium of three general adult population cohorts living in the Ile-de-France (IDF) or Grand Est (GE) (two regions with high rate of COVID-19) or in the Nouvelle-Aquitaine (NA) (with a low rate) were randomly selected to take a dried-blood spot for anti-SARS-CoV-2 antibodies assessment with three different serological methods (ClinicalTrial Identifier #NCT04392388). The primary outcome was a positive anti-SARS-CoV-2 ELISA IgG result against the spike protein of the virus (ELISA-S). Estimates were adjusted using sampling weights and post-stratification methods. Multiple imputation was used to infer the cumulative incidence of SARS-CoV-2 infection with adjustments for imperfect tests accuracies.
RESULTS
The analysis included 14 628 participants, 983 with a positive ELISA-S. The weighted estimates of seropositivity and cumulative incidence were 10.0% [95% confidence interval (CI): 9.1%, 10.9%] and 11.4% (95% CI: 10.1%, 12.8%) in IDF, 9.0% (95% CI: 7.7%, 10.2%) and 9.8% (95% CI: 8.1%, 11.8%) in GE and 3.1% (95% CI: 2.4%, 3.7%) and 2.9% (95% CI: 2.1%, 3.8%) in NA, respectively. Seropositivity was higher in younger participants [odds ratio (OR) = 1.84 (95% CI: 1.79, 6.09) in <40 vs 50-60 years old and OR = 0.56 (95% CI: 0.42, 0.74) in ≥70 vs 50-60 years old)] and when at least one child or adolescent lived in the same household [OR = 1.30 (95% CI: 1.11, 1.53)] and was lower in smokers compared with non-smokers [OR = 0.71 (95% CI: 0.57, 0.89)].
CONCLUSIONS
Seropositivity to anti-SARS-CoV-2 antibodies in the French adult population was ≤10% after the first wave. Modifiable and non-modifiable risk factors were identified.
背景
本研究旨在 2020 年 5 月至 6 月第一次封锁期后，评估法国三个地区成年人对 SARS-CoV-2 抗体的血清阳性率，并确定相关的危险因素。
方法
2020 年 5 月 4 日至 6 月 23 日，对来自三个普通成年人群队列的现有联盟中对 COVID-19 进行调查的 16000 名参与者进行了随机抽样，以抽取干血斑用于评估 SARS-CoV-2 抗体，使用三种不同的血清学方法（临床试验标识符 #NCT04392388）。主要结局是针对病毒的刺突蛋白产生 SARS-CoV-2 抗体的 ELISA IgG 结果呈阳性（ELISA-S）。使用采样权重和后分层方法对估计值进行调整。采用多重插补法推断 SARS-CoV-2 感染的累积发病率，并对不完美检测的准确性进行调整。
结果
分析纳入了 14628 名参与者，其中 983 名 ELISA-S 阳性。在 IDF、GE 和 NA 地区，血清阳性率和累积发病率的加权估计值分别为 10.0%（95%置信区间：9.1%，10.9%）和 11.4%（95%置信区间：10.1%，12.8%）、9.0%（95%置信区间：7.7%，10.2%）和 9.8%（95%置信区间：8.1%，11.8%）、3.1%（95%置信区间：2.4%，3.7%）和 2.9%（95%置信区间：2.1%，3.8%）。年龄较小的参与者血清阳性率更高[<40 岁与 50-60 岁比较的比值比（OR）为 1.84（95%置信区间：1.79，6.09），≥70 岁与 50-60 岁比较的 OR 为 0.56（95%置信区间：0.42，0.74）]，且家中至少有一名儿童或青少年时血清阳性率更高[比值比（OR）为 1.30（95%置信区间：1.11，1.53）]，与非吸烟者相比，吸烟者的血清阳性率更低[OR 为 0.71（95%置信区间：0.57，0.89）]。
结论
在法国成年人群中，第一次疫情浪潮后对 SARS-CoV-2 抗体的血清阳性率≤10%。确定了可改变和不可改变的危险因素。
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