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Testing Denmark: a Danish Nationwide Surveillance Study of COVID-19.
Fogh, Kamille; Strange, Jarl E; Scharff, Bibi F S S; Eriksen, Alexandra R R; Hasselbalch, Rasmus B; Bundgaard, Henning; Nielsen, Susanne D; Jørgensen, Charlotte S; Erikstrup, Christian; Norsk, Jakob; Nielsen, Pernille Brok; Kristensen, Jonas H; Østergaard, Lars; Ellermann-Eriksen, Svend; Andersen, Berit; Nielsen, Henrik; Johansen, Isik S; Wiese, Lothar; Simonsen, Lone; Fischer, Thea K; Folke, Fredrik; Lippert, Freddy; Ostrowski, Sisse R; Benfield, Thomas; Mølbak, Kåre; Ethelberg, Steen; Koch, Anders; Sönksen, Ute Wolff; Vangsted, Anne-Marie; Krause, Tyra Grove; Fomsgaard, Anders; Ullum, Henrik; Skov, Robert; Iversen, Kasper.
  • Fogh K; Department of Cardiology, Copenhagen University Hospitalgrid.4973.9, Herlev and Gentofte, Denmark.
  • Strange JE; Department of Emergency Medicine, Copenhagen University Hospitalgrid.4973.9, Herlev and Gentofte, Denmark.
  • Scharff BFSS; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
  • Eriksen ARR; Department of Cardiology, Copenhagen University Hospitalgrid.4973.9, Herlev and Gentofte, Denmark.
  • Hasselbalch RB; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
  • Bundgaard H; Department of Clinical Immunology, Copenhagen University Hospitalgrid.4973.9, Rigshospitalet, Denmark.
  • Nielsen SD; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
  • Jørgensen CS; Department of Cardiology, Copenhagen University Hospitalgrid.4973.9, Herlev and Gentofte, Denmark.
  • Erikstrup C; Department of Emergency Medicine, Copenhagen University Hospitalgrid.4973.9, Herlev and Gentofte, Denmark.
  • Norsk J; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
  • Nielsen PB; Department of Cardiology, Copenhagen University Hospitalgrid.4973.9, Herlev and Gentofte, Denmark.
  • Kristensen JH; Department of Emergency Medicine, Copenhagen University Hospitalgrid.4973.9, Herlev and Gentofte, Denmark.
  • Østergaard L; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
  • Ellermann-Eriksen S; Department of Cardiology, Copenhagen University Hospitalgrid.4973.9, Rigshospitalet, Denmark.
  • Andersen B; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
  • Nielsen H; Department of Infectious Diseases, Copenhagen University Hospitalgrid.4973.9, Rigshospitalet, Denmark.
  • Johansen IS; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
  • Wiese L; Statens Serum Institutgrid.6203.7, Copenhagen, Denmark.
  • Simonsen L; Statens Serum Institutgrid.6203.7, Copenhagen, Denmark.
  • Fischer TK; Department of Infectious Diseases, Aarhus University Hospitalgrid.154185.c, Aarhus, Denmark.
  • Folke F; Department of Cardiology, Copenhagen University Hospitalgrid.4973.9, Herlev and Gentofte, Denmark.
  • Lippert F; Department of Emergency Medicine, Copenhagen University Hospitalgrid.4973.9, Herlev and Gentofte, Denmark.
  • Ostrowski SR; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
  • Benfield T; Department of Cardiology, Copenhagen University Hospitalgrid.4973.9, Herlev and Gentofte, Denmark.
  • Mølbak K; Department of Emergency Medicine, Copenhagen University Hospitalgrid.4973.9, Herlev and Gentofte, Denmark.
  • Ethelberg S; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
  • Koch A; Department of Cardiology, Copenhagen University Hospitalgrid.4973.9, Herlev and Gentofte, Denmark.
  • Sönksen UW; Department of Emergency Medicine, Copenhagen University Hospitalgrid.4973.9, Herlev and Gentofte, Denmark.
  • Vangsted AM; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
  • Krause TG; Statens Serum Institutgrid.6203.7, Copenhagen, Denmark.
  • Fomsgaard A; Department of Infectious Diseases, Aarhus University Hospitalgrid.154185.c, Aarhus, Denmark.
  • Ullum H; Statens Serum Institutgrid.6203.7, Copenhagen, Denmark.
  • Skov R; Department of Clinical Microbiology, Aarhus University Hospitalgrid.154185.c, Aarhus, Denmark.
  • Iversen K; Statens Serum Institutgrid.6203.7, Copenhagen, Denmark.
Microbiol Spectr ; 9(3): e0133021, 2021 12 22.
Article in English | MEDLINE | ID: covidwho-1583201
Preprint
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ABSTRACT
"Testing Denmark" is a national, large-scale, epidemiological surveillance study of SARS-CoV-2 in the Danish population. Between September and October 2020, approximately 1.3 million people (age >15 years) were randomly invited to fill in an electronic questionnaire covering COVID-19 exposures and symptoms. The prevalence of SARS-CoV-2 antibodies was determined by point-of care rapid test (POCT) distributed to participants' home addresses. In total, 318,552 participants (24.5% invitees) completed the study and 2,519 (0.79%) were seropositive. Of the participants with a prior positive PCR test (n = 1,828), 29.1% were seropositive in the POCT. Although seropositivity increased with age, participants 61 years and over reported fewer symptoms and were tested less frequently. Seropositivity was associated with physical contact with SARS-CoV-2 infected individuals (risk ratio [RR] 7.43, 95% CI 6.57-8.41), particular in household members (RR 17.70, 95% CI 15.60-20.10). A greater risk of seropositivity was seen in home care workers (RR 2.09, 95% CI 1.58-2.78) compared to office workers. A high degree of adherence with national preventive recommendations was reported (e.g., >80% use of face masks), but no difference were found between seropositive and seronegative participants. The seroprevalence result was somewhat hampered by a lower-than-expected performance of the POCT. This is likely due to a low sensitivity of the POCT or problems reading the test results, and the main findings therefore relate to risk associations. More emphasis should be placed on age, occupation, and exposure in local communities. IMPORTANCE To date, including 318,522 participants, this is the largest population-based study with broad national participation where tests and questionnaires have been sent to participants' homes. We found that more emphasis from national and local authorities toward the risk of infection should be placed on age of tested individuals, type of occupation, as well as exposure in local communities and households. To meet the challenge that broad nationwide information can be difficult to gather. This study design sets the stage for a novel way of conducting studies. Additionally, this study design can be used as a supplementary model in future general test strategy for ongoing monitoring of COVID-19 immunity in the population, both from past infection and from vaccination against SARS-CoV-2, however, with attention to the complexity of performing and reading the POCT at home.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Vaccines Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Microbiol Spectr Year: 2021 Document Type: Article Affiliation country: SPECTRUM.01330-21

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Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Vaccines Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Microbiol Spectr Year: 2021 Document Type: Article Affiliation country: SPECTRUM.01330-21