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. 2021 Sep 23;11(9):e053791.
doi: 10.1136/bmjopen-2021-053791.

Seroprevalence of SARS-CoV-2-specific IgG antibodies in Kashmir, India, 7 months after the first reported local COVID-19 case: results of a population-based seroprevalence survey from October to November 2020

S Muhammad Salim Khan  1 , Mariya Amin Qurieshi  1 , Inaamul Haq  2 , Sabhiya Majid  3 , Javid Ahmad #  4 , Taha Ayub #  1 , Ashfaq Ahmad Bhat #  5 , Anjum Bashir Fazili #  4 , Abdul Majeed Ganai #  6 , Yasmeen Jan #  5 , Rauf-Ur-Rashid Kaul #  4 , Zahid Ali Khan #  6 , Muneer Ahmad Masoodi #  7 , Beenish Mushtaq #  5 , Fouzia Nazir #  7 , Muzamil Nazir #  6 , Malik Waseem Raja #  1 , Mahbooba Rasool #  7 , Anjum Asma #  1 , Shifana Ayoub #  1 , Munazza Aziz #  8 , Arif Akbar Bhat #  3 , Iqra Nisar Chowdri #  1 , Shaista Ismail #  1 , Misbah Ferooz Kawoosa #  1 , Mehvish Afzal Khan #  1 , Mosin Saleem Khan #  3 , Rafiya Kousar #  1 , Ab Aziz Lone #  1 , Shahroz Nabi #  1 , Mohammad Obaid #  3 , Tanzeela Bashir Qazi #  1 , Iram Sabah #  1 , Ishtiyaq Ahmad Sumji #  1
Affiliations

Seroprevalence of SARS-CoV-2-specific IgG antibodies in Kashmir, India, 7 months after the first reported local COVID-19 case: results of a population-based seroprevalence survey from October to November 2020

S Muhammad Salim Khan et al. BMJ Open. .

Abstract

Objectives: We designed a population-based survey in Kashmir to estimate the seroprevalence of SARS-CoV-2-specific IgG antibodies in the general population aged 18 years and above.

Setting: The survey was conducted among 110 villages and urban wards across 10 districts in Kashmir from 17 October 2020 to 4 November 2020.

Participants: Individuals aged 18 years and above were eligible to be included in the survey. Serum samples were tested for the presence of SARS-CoV-2-specific IgG antibodies using the Abbott SARS-CoV-2 IgG assay.

Primary and secondary outcome measures: We labelled assay results equal to or above the cut-off index value of 1.4 as positive for SARS-CoV-2-specific IgG antibodies. Seroprevalence estimates were adjusted for the sampling design and assay characteristics.

Results: Out of 6397 eligible individuals enumerated, 6315 (98.7%) agreed to participate. The final analysis was done on 6230 participants. Seroprevalence adjusted for the sampling design and assay characteristics was 36.7% (95% CI 34.3% to 39.2%). Seroprevalence was higher among the older population. Among seropositive individuals, 10.2% (247/2415) reported a history of COVID-19-like symptoms. Out of 474 symptomatic individuals, 233 (49.2%) reported having been tested. We estimated an infection fatality rate of 0.034%.

Conclusions: During the first 7 months of the COVID-19 epidemic in Kashmir Valley, approximately 37% of individuals were infected. The reported number of COVID-19 cases was only a small fraction of the estimated number of infections. A more efficient surveillance system with strengthened reporting of COVID-19 cases and deaths is warranted.

Keywords: COVID-19; epidemiology.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Location of the 10 districts and seroprevalence (%) by district. Numbers in parentheses indicate a 95% CI for seroprevalence.
Figure 2
Figure 2
Participant flow.
Figure 3
Figure 3
(A) Seropositivity by the history of COVID-19-like symptoms, RT-PCR testing and test result. (B) History of COVID-19-like symptoms by seropositivity, RT-PCR testing and test result.
Figure 4
Figure 4
(A) Daily cases and deaths in Kashmir since the start of the COVID-19 pandemic. (B) Cumulative number of cases and deaths in Kashmir.
See this image and copyright information in PMC

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