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Estimating the Cumulative Incidence of SARS-CoV-2 Infection and the Infection Fatality Ratio in Light of Waning Antibodies.
Shioda, Kayoko; Lau, Max S Y; Kraay, Alicia N M; Nelson, Kristin N; Siegler, Aaron J; Sullivan, Patrick S; Collins, Matthew H; Weitz, Joshua S; Lopman, Benjamin A.
  • Shioda K; From the Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA.
  • Lau MSY; Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA.
  • Kraay ANM; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA.
  • Nelson KN; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA.
  • Siegler AJ; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA.
  • Sullivan PS; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA.
  • Collins MH; Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA.
  • Weitz JS; School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA.
  • Lopman BA; School of Physics, Georgia Institute of Technology, Atlanta, GA.
Epidemiology ; 32(4): 518-524, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1211432
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ABSTRACT

BACKGROUND:

Serology tests can identify previous infections and facilitate estimation of the number of total infections. However, immunoglobulins targeting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been reported to wane below the detectable level of serologic assays (which is not necessarily equivalent to the duration of protective immunity). We estimate the cumulative incidence of SARS-CoV-2 infection from serology studies, accounting for expected levels of antibody acquisition (seroconversion) and waning (seroreversion), and apply this framework using data from New York City and Connecticut.

METHODS:

We estimated time from seroconversion to seroreversion and infection fatality ratio (IFR) using mortality data from March to October 2020 and population-level cross-sectional seroprevalence data from April to August 2020 in New York City and Connecticut. We then estimated the daily seroprevalence and cumulative incidence of SARS-CoV-2 infection.

RESULTS:

The estimated average time from seroconversion to seroreversion was 3-4 months. The estimated IFR was 1.1% (95% credible interval, 1.0%, 1.2%) in New York City and 1.4% (1.1, 1.7%) in Connecticut. The estimated daily seroprevalence declined after a peak in the spring. The estimated cumulative incidence reached 26.8% (24.2%, 29.7%) at the end of September in New York City and 8.8% (7.1%, 11.3%) in Connecticut, higher than maximum seroprevalence measures (22.1% and 6.1%), respectively.

CONCLUSIONS:

The cumulative incidence of SARS-CoV-2 infection is underestimated using cross-sectional serology data without adjustment for waning antibodies. Our approach can help quantify the magnitude of underestimation and adjust estimates for waning antibodies.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Observational study / Randomized controlled trials Limits: Humans Country/Region as subject: North America Language: English Journal: Epidemiology Journal subject: Epidemiology Year: 2021 Document Type: Article Affiliation country: EDE.0000000000001361

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Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Observational study / Randomized controlled trials Limits: Humans Country/Region as subject: North America Language: English Journal: Epidemiology Journal subject: Epidemiology Year: 2021 Document Type: Article Affiliation country: EDE.0000000000001361