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. 2021 Apr 1;11(4):e045425.
doi: 10.1136/bmjopen-2020-045425.

SARS-CoV-2 population-based seroprevalence studies in Europe: a scoping review

Rebecca Grant  1   2 , Timothée Dub  3 , Xanthi Andrianou  4   5 , Hanna Nohynek  3 , Annelies Wilder-Smith  6   7 , Patrizio Pezzotti  4 , Arnaud Fontanet  8   9
Affiliations

SARS-CoV-2 population-based seroprevalence studies in Europe: a scoping review

Rebecca Grant et al. BMJ Open. .

Abstract

Objectives: We aimed to review SARS-CoV-2 seroprevalence studies conducted in Europe to understand how they may be used to inform ongoing control strategies for COVID-19.

Design: Scoping review of peer-reviewed publications and manuscripts on preprint servers from January 2020 to 15 September 2020.

Primary measure: Seroprevalence estimate (and lower and upper CIs). For studies conducted across a country or territory, we used the seroprevalence estimate and the upper and lower CIs and compared them to the total number of reported infections to calculate the ratio of reported to expected infections.

Results: We identified 23 population-based seroprevalence studies conducted in Europe. Among 12 general population studies, seroprevalence ranged from 0.42% among residual clinical samples in Greece to 13.6% in an area of high transmission in Gangelt, Germany. Of the eight studies in blood donors, seroprevalence ranged from 0.91% in North-Western Germany to 23.3% in a high-transmission area in Lombardy region, Italy. In three studies which recruited individuals through employment, seroprevalence ranged from 0.5% among factory workers in Frankfurt, Germany, to 10.2% among university employees in Milan, Italy. In comparison to nationally reported cases, the extent of infection, as derived from these seroprevalence estimates, is manyfold higher and largely heterogeneous.

Conclusion: Exposure to the virus in Europe has not reached a level of infection that would prevent further circulation of the virus. Effective vaccine candidates are urgently required to deliver the level of immunity in the population.

Keywords: epidemiology; public health.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Inclusion of studies in review.
Figure 2
Figure 2
Study seroprevalence (point estimate and CI, when reported) (For studies that used serial sampling, the most recent seroprevalence estimate was selected).
Figure 3
Figure 3
Blood sample collection periods of studies with respect to reported national epidemic curves of reported cases for those studies conducted nationwide/territory-wide (n=7).
See this image and copyright information in PMC

References

    1. Alter G, Seder R. The power of antibody-based surveillance. N Engl J Med 2020;383:1782–4. 10.1056/NEJMe2028079 - DOI - PMC - PubMed
    1. Koopmans M, Haagmans B. Assessing the extent of SARS-CoV-2 circulation through serological studies. Nat Med 2020;26:1171–2. 10.1038/s41591-020-1018-x - DOI - PubMed
    1. Flaxman S, Mishra S, Gandy A, et al. . Estimating the effects of non-pharmaceutical interventions on COVID-19 in Europe. Nature 2020;584:257–61. 10.1038/s41586-020-2405-7 - DOI - PubMed
    1. Clapham H, Hay J, Routledge I, et al. . Seroepidemiologic study designs for determining SARS-COV-2 transmission and immunity. Emerg Infect Dis 2020;26:1978–86. 10.3201/eid2609.201840 - DOI - PMC - PubMed
    1. Bobrovitz N, Arora RK, Yan T. Lessons from a rapid systematic review of early SARS-CoV-2 serosurveys. MedRxiv 2020.

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