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. 2024 Mar;119(3):242-251.
doi: 10.1111/vox.13571. Epub 2023 Dec 29.

The evolution and interpretation of seroprevalence of SARS-CoV-2 antibodies among South African blood donors from the Beta to Omicron variant-driven waves

Marion Vermeulen  1   2 , Laurette Mhlanga  3   4 , Wendy Sykes  1 , Russell Cable  5 , Charl Coleman  1 , Nadia Pietersen  5 , Ronel Swanevelder  1 , Tanya Nadia Glatt  1   6 , Jeremy Bingham  3 , Karin van den Berg  1   2   7 , Eduard Grebe  3   8   9 , Alex Welte  3
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The evolution and interpretation of seroprevalence of SARS-CoV-2 antibodies among South African blood donors from the Beta to Omicron variant-driven waves

Marion Vermeulen et al. Vox Sang. 2024 Mar.

Abstract

Background and objectives: Confirmed COVID-19 diagnoses underestimate the total number of infections. Blood donors can provide representative seroprevalence estimates, which can be leveraged into reasonable estimates of total infection counts and infection fatality rate (IFR).

Materials and methods: Blood donors who donated after each of three epidemic waves (Beta, Delta and first Omicron waves) were tested for anti-SARS-CoV-2 nucleocapsid antibodies using the Roche Elecsys anti-SARS-CoV-2 total immunoglobulin assay. Roche Elecsys anti-spike antibody testing was done for the post-Omicron sampling. Prevalence of antibodies was estimated by age, sex, race and province and compared to official case reporting. Province and age group-specific IFRs were estimated using external excess mortality estimates.

Results: The nationally weighted anti-nucleocapsid seroprevalence estimates after the Beta, Delta and Omicron waves were 47% (46.2%-48.6%), 71% (68.8%-73.5%) and 87% (85.5%-88.4%), respectively. There was no variation by age and sex, but there were statistically and epidemiologically significant differences by province (except at the latest time point) and race. There was a 13-fold higher seroprevalence than confirmed case counts at the first time point. Age-dependent IFR roughly doubled for every 10 years of age increase over 6 decades from 0.014% in children to 6.793% in octogenarians.

Conclusion: Discrepancies were found between seroprevalence and confirmed case counts. High seroprevalence rates found among Black African donors can be ascribed to historical inequities. Our IFR estimates were useful in refining previous large disagreements about the severity of the epidemic in South Africa. Blood donor-based serosurveys provided a valuable and efficient way to provide near real-time monitoring of the ongoing SARS-CoV-2 outbreak.

Keywords: SARS-CoV-2 antibodies; blood donors; infection fatality rate; seroprevalence.

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References

REFERENCES

    1. Department of Health SA. Department of Health COVID-19 Online Resource and News Portal. Available from: https://sacoronavirus.co.za/covid-19-daily-cases/. Last accessed 8 Dec 2022.
    1. Topol Eric J, Oran Daniel P. The proportion of SARS-CoV-2 infections that are asymptomatic. Ann Intern Med. 2021;174:655-662.
    1. Cheng MP, Papenburg J, Desjardins M, Kanjilal S, Quach C, Libman M, et al. Diagnostic testing for severe acute respiratory syndrome-related coronavirus 2: a narrative review. Ann Intern Med. 2020;172:726-734.
    1. Paton C. The huge gap between excess natural deaths and confirmed COVID-19 deaths may indicate that the latter is under-reported by up to 10 times. Available from: https://www.businesslive.co.za/bd/national/2020-07-23-sa-covid-19-deaths.... Last accessed 12 Dec 2023.
    1. Heever Avd. Lockdown restrictions are not responsible for massive increase in mortality. Ground Up. Available from: https://www.groundup.org.za/author/537/. Last accessed 1 Feb 2021.

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