Seroprevalence of anti-SARS-CoV-2 antibodies in Colombia, 2020: A population-based study

Abstract

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to cause very high morbidity and mortality throughout Latin American countries. However, few population-based seroprevalence surveys have been conducted to quantify attack rates and characterize drivers of transmission.

Methods: We conducted a population-based cross-sectional study to assess the seroprevalence of antibodies against SARS-CoV-2 in ten cities in Colombia between September and December 2020. The study involved multi-stage cluster sampling at each city. Participants provided a serum sample and answered a demographic and risk factor questionnaire. Prior infection by SARS-CoV-2 was ascertained using the "SARS-CoV-2 Total (COV2T) Advia Centaur - Siemens" chemiluminescence assay.

Findings: A total of 17863 participants from 7320 households participated in the study. Seroprevalence varied substantially between cities, ranging from 26% (95%CI 23-29 %) in Medellín to 68% (95%CI 62-74 %) in Guapi. There were no differences in seroprevalence by sex, but seropositivity was higher in certain ethnic groups. There was substantial heterogeneity in seroprevalence within cities, driven to a large extent by a strong association between socioeconomic stratum and seropositivity.

Interpretation: Colombia has been one of the Latin American countries most affected by the COVID-19 pandemic. This study documented very high attack rates in several Colombian cities by the end of 2020 and identified key drivers of heterogeneities including ethnicity and socioeconomic stratum. Few studies of seroprevalence of SARS-CoV-2 have been conducted in Latin America, and therefore this study contributes to the fundamental understanding of the pandemic in the region.

Funding: The study was sponsored by, Ministerio de Ciencia y Tecnología e Innovación -CT361/2020, Ministerio de Salud y Protección Social, Fundación Universitaria del Norte, Imperial College of London, Universidad Nacional de Colombia (Sede Medellín), Universidad de Córdoba, California University, Unidad Nacional de Gestión del Riesgo, Centro de Atención y Diagnóstico de Enfermedades Infecciosas -CDI-, Centro Internacional de Entrenamiento e Investigaciones Médicas -CIDEIM-, Departamento Administrativo Nacional de Estadística - DANE, Fondo Nacional de Turismo -FONTUR-, Secretarías de Salud Departamentales, Distritales y Municipales and Instituto Nacional de Salud.

Keywords: COVID-19; Colombia; Population; Public health; SARS-CoV-2; Seroprevalence.

Figure. 1

Map of study locations and epidemiological curves. Map of Colombia showing the locations of the 10 cities where the serosurveys were conducted. Panels surrounding the map show the epidemic curves at each city (weekly number of reported cases). The colored lines and polygons (red, orange, blue, yellow, green, cyan, purple, lilac and light yellow) indicate the period of sample collection for each city relative to the ongoing epidemic.

Figure. 2

Risk factors for seropositivity. Association between individual and household risk factors and seropositivity to SARS-CoV-2. Black symbols show the unadjusted mean associations (prevalence ratios) and 95% confidence intervals estimated using data from the 10 cities. Colored symbols show the mean association estimated for each city independently.