Robert Koch Institute, Berlin, Germany.
Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str. 62-66, 12101, Berlin, Germany.
Sci Rep. 2022 Nov 14;12(1):19492. doi: 10.1038/s41598-022-23821-6.
Pre-vaccine SARS-CoV-2 seroprevalence data from Germany are scarce outside hotspots, and socioeconomic disparities remained largely unexplored. The nationwide representative RKI-SOEP study (15,122 participants, 18-99 years, 54% women) investigated seroprevalence and testing in a supplementary wave of the Socio-Economic-Panel conducted predominantly in October-November 2020. Self-collected oral-nasal swabs were PCR-positive in 0.4% and Euroimmun anti-SARS-CoV-2-S1-IgG ELISA from dry-capillary-blood antibody-positive in 1.3% (95% CI 0.9-1.7%, population-weighted, corrected for sensitivity = 0.811, specificity = 0.997). Seroprevalence was 1.7% (95% CI 1.2-2.3%) when additionally correcting for antibody decay. Overall infection prevalence including self-reports was 2.1%. We estimate 45% (95% CI 21-60%) undetected cases and lower detection in socioeconomically deprived districts. Prior SARS-CoV-2 testing was reported by 18% from the lower educational group vs. 25% and 26% from the medium and high educational group (p < 0.001, global test over three categories). Symptom-triggered test frequency was similar across educational groups. Routine testing was more common in low-educated adults, whereas travel-related testing and testing after contact with infected persons was more common in highly educated groups. This countrywide very low pre-vaccine seroprevalence in Germany at the end of 2020 can serve to evaluate the containment strategy. Our findings on social disparities indicate improvement potential in pandemic planning for people in socially disadvantaged circumstances.
德国的疫苗接种前 SARS-CoV-2 血清流行率数据在热点地区以外很少见,社会经济差异在很大程度上仍未得到充分探索。这项全国性的 RKI-SOEP 研究(共有 15122 名参与者,年龄在 18-99 岁之间,女性占 54%)在 2020 年 10 月至 11 月进行的社会经济面板补充调查中,调查了血清流行率和检测情况。自我采集的口腔鼻拭子 PCR 检测阳性率为 0.4%,Euroimmun 抗 SARS-CoV-2-S1-IgG ELISA 检测阳性率为 1.3%(95%置信区间为 0.9-1.7%,人群加权,校正后的敏感性为 0.811,特异性为 0.997)。另外,在抗体衰减的情况下,血清流行率为 1.7%(95%置信区间为 1.2-2.3%)。包括自我报告在内的总体感染流行率为 2.1%。我们估计有 45%(95%置信区间为 21-60%)的病例未被发现,而且在社会经济贫困地区的检测率较低。低教育群体中报告进行过 SARS-CoV-2 检测的比例为 18%,而中等和高教育群体的比例分别为 25%和 26%(p<0.001,对三个类别进行整体检验)。不同教育程度组的症状触发检测频率相似。低教育程度成年人更常进行常规检测,而高教育程度群体更常进行与旅行相关的检测和与感染者接触后的检测。2020 年底德国的疫苗接种前血清流行率非常低,这可以用来评估防控策略。我们关于社会差异的发现表明,在社会弱势群体的大流行规划方面有改进的潜力。
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