SARS-CoV-2 seroprevalence among people living with HIV in Guinea-Bissau.

OBJECTIVES: In low-income countries with poor SARS-CoV-2 monitoring and high HIV burden, the prevalence of SARS-CoV-2 is scarcely studied in people living with HIV (PLWH). We set out to measure SARS-CoV-2 seroprevalence in this group. STUDY DESIGN: Serosurvey of SARS-CoV-2 in PLWH. METHODS: We measured IgG/IgM antibodies using point-of-care rapid tests in 294 PLWH with HIV-1, HIV-2 or HIV-1/2 dual infection at an HIV clinic in Guinea-Bissau between June 1, 2021, and October 1, 2021. RESULTS: Unvaccinated PLWH (n = 195), constituting 66% of the total study population, had a seroprevalence of SARS-CoV-2 antibodies of 27.7%. Of SARS-CoV-2 seropositive unvaccinated PLWH, 71.2% reported no symptoms of COVID-19 since the start of the epidemic up to the inclusion date. Among all participants, 90.1% reported never having been tested for SARS-CoV-2 by any test (n = 292). Six participants reported a household death, corresponding to a crude annual death rate of 3.3 per 1000 people. CONCLUSIONS: Despite a low number of officially registered cases of SARS-CoV-2 in Bissau, we found a high seroprevalence of SARS-CoV-2 of 27.7% in unvaccinated PLWH. Coupled with few ever tested for SARS-CoV-2, it indicates that official PCR testing likely underestimates prevalence and that SARS-CoV-2 monitoring is challenged for PLWH. The low number of symptoms from seropositives may stem from survival bias, some effect of herd immunity or, coupled with a low crude annual death rate, that disease symptomatology and severity could be lower than expected.

First wave of COVID-19 did not reach the homeless population in Aarhus

INTRODUCTION: The deadly coronavirus disease 2019 (COVID-19) has rapidly become a pandemic affecting the whole world. Lower health literacy and higher mortality rates in the homeless and vulnerable population compared with the background population potentially leaves this group or people more exposed to COVID-19. This study assessed the vulnerable population of Aarhus in relation to COVID-19 infection. METHODS: Participants were tested during a six-day period in April and a four-day period in June at drop-in centres, injection rooms and homeless shelters in Aarhus. Oropharyngeal swab tests were performed and analysed with real-time quantitative polymerase chain reaction. Test days in June were supplemented with lateral flow tests for immunoglobulin (Ig) G and IgM. Prevalence and corresponding Wilson 95% confidence intervals were computed. RESULTS: We tested 295 individuals in April and 141 individuals in June. All oropharyngeal swabs were COVID-19 negative. The lateral flow tests were IgM-positive in six of 129 individuals (4.7%) and IgG-positive less than five of 129 (<3.9%) individuals. On the day of testing, COVID-19 symptoms such as fever, coughing and/or sore throat were found in 63 of 240 (26.3%) of the participants in April and in 26 of 123 (21.1%) in June. In the April testing round, 175 of 291 (59.9%) reported to be born in Denmark. The corresponding number for the June testing round was 84 of 138 (60.9%). CONCLUSIONS: Despite their vulnerable profile, the vulnerable citizens tested in Aarhus were not infected with COVID-19 at the testing day and very few participants carried antibodies.