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. 2022 Jun:207:54-61.
doi: 10.1016/j.puhe.2022.03.009. Epub 2022 Mar 23.

SARS-CoV-2 seroprevalence and determinants of infection in young adults: a population-based seroepidemiological study

I Backhaus  1 , D Hermsen  2 , J Timm  3 , F Boege  2 , N Lübke  3 , T Degode  4 , K Göbels  4 , N Dragano  5
Affiliations

SARS-CoV-2 seroprevalence and determinants of infection in young adults: a population-based seroepidemiological study

I Backhaus et al. Public Health. 2022 Jun.

Abstract

Objectives: Most SARS-CoV-2 seroprevalence studies have focussed on adults and high-risk populations, and little is known about young adults. The objective of the present study was to provide evidence on the SARS-CoV-2 seroprevalence among young adults in Germany and to explore determinants associated with seropositivity in general and, specifically, with previously undetected infections.

Study design: This was a population-based SARS-CoV-2 seroprevalence study.

Methods: In November 2020, a population-based study on SARS-CoV-2 seroprevalence in young adults (aged 18-30 years) was conducted in a large German city. Serum samples were obtained to analyse the SARS-CoV-2 antibody status using the Elecsys Anti-SARS-CoV-2 immunoassay. Descriptive statistics and odds ratios (ORs) of seropositivity and of previously undetected infections in relation to different determinants were calculated.

Results: Among 2186 participants, SARS-CoV-2 antibodies were detected in 72 individuals, equalling a test performance-adjusted seroprevalence of 3.1% (95% confidence interval [CI]: 2.4-4.0). Based on reported COVID-19 cases to the public health authority, a moderate underascertainment rate of 1.7 was calculated. Seropositivity was higher among individuals who sought COVID-19-related information from social media (OR: 1.83, 95% CI: 1.2-3.1), and undetected COVID-19 infections were more prevalent among men and those not adhering to social distancing.

Conclusions: The results show a substantial underascertainment of SARS-CoV-2 infections among young adults and indicate that seroprevalence is likely to be much higher than the reported COVID-19 prevalence based on confirmed COVID-19 cases in Germany. Preventive efforts should consider the heterogeneity of risk profiles among the young adult population.

Keywords: COVID-19; SARS-CoV-2 antibodies; Seroprevalence; Young adults.

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Figures

Fig. 1
Fig. 1
Flow diagram of participant recruitment, enrolment, and study completion.
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