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Prevalence of SARS-CoV-2 in Spain (ENE-COVID): a nationwide, population-based seroepidemiological study.
Pollán, Marina; Pérez-Gómez, Beatriz; Pastor-Barriuso, Roberto; Oteo, Jesús; Hernán, Miguel A; Pérez-Olmeda, Mayte; Sanmartín, Jose L; Fernández-García, Aurora; Cruz, Israel; Fernández de Larrea, Nerea; Molina, Marta; Rodríguez-Cabrera, Francisco; Martín, Mariano; Merino-Amador, Paloma; León Paniagua, Jose; Muñoz-Montalvo, Juan F; Blanco, Faustino; Yotti, Raquel.
  • Pollán M; National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain. Electronic address: mpollan@isciii.es.
  • Pérez-Gómez B; National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain.
  • Pastor-Barriuso R; National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain.
  • Oteo J; National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain; Spanish Network for Research in Infectious Diseases (REIPI), Institute of Health Carlos III, Madrid, Spain.
  • Hernán MA; Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA; Department of Biostatistics, Harvard T H Chan School of Public Health, Boston, MA, USA; Harvard-MIT Division of Health Sciences and Technology, Boston, MA, USA.
  • Pérez-Olmeda M; National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain.
  • Sanmartín JL; Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain.
  • Fernández-García A; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain; Department of Clinical Microbiology, Hospital Clínico San Carlos, Madrid, Spain.
  • Cruz I; National School of Public Health, Institute of Health Carlos III, Madrid, Spain.
  • Fernández de Larrea N; National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain.
  • Molina M; General Secretary of Health, Ministry of Health, Madrid, Spain.
  • Rodríguez-Cabrera F; National School of Public Health, Institute of Health Carlos III, Madrid, Spain.
  • Martín M; Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain.
  • Merino-Amador P; Department of Clinical Microbiology, Hospital Clínico San Carlos, Madrid, Spain.
  • León Paniagua J; General Secretariat, Institute of Health Carlos III, Madrid, Spain.
  • Muñoz-Montalvo JF; Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain.
  • Blanco F; General Secretary of Health, Ministry of Health, Madrid, Spain.
  • Yotti R; Directorate, Institute of Health Carlos III, Madrid, Spain.
Lancet ; 396(10250): 535-544, 2020 08 22.
Статья в английский | MEDLINE | ID: covidwho-2106188
ABSTRACT

BACKGROUND:

Spain is one of the European countries most affected by the COVID-19 pandemic. Serological surveys are a valuable tool to assess the extent of the epidemic, given the existence of asymptomatic cases and little access to diagnostic tests. This nationwide population-based study aims to estimate the seroprevalence of SARS-CoV-2 infection in Spain at national and regional level.

METHODS:

35 883 households were selected from municipal rolls using two-stage random sampling stratified by province and municipality size, with all residents invited to participate. From April 27 to May 11, 2020, 61 075 participants (75·1% of all contacted individuals within selected households) answered a questionnaire on history of symptoms compatible with COVID-19 and risk factors, received a point-of-care antibody test, and, if agreed, donated a blood sample for additional testing with a chemiluminescent microparticle immunoassay. Prevalences of IgG antibodies were adjusted using sampling weights and post-stratification to allow for differences in non-response rates based on age group, sex, and census-tract income. Using results for both tests, we calculated a seroprevalence range maximising either specificity (positive for both tests) or sensitivity (positive for either test).

FINDINGS:

Seroprevalence was 5·0% (95% CI 4·7-5·4) by the point-of-care test and 4·6% (4·3-5·0) by immunoassay, with a specificity-sensitivity range of 3·7% (3·3-4·0; both tests positive) to 6·2% (5·8-6·6; either test positive), with no differences by sex and lower seroprevalence in children younger than 10 years (<3·1% by the point-of-care test). There was substantial geographical variability, with higher prevalence around Madrid (>10%) and lower in coastal areas (<3%). Seroprevalence among 195 participants with positive PCR more than 14 days before the study visit ranged from 87·6% (81·1-92·1; both tests positive) to 91·8% (86·3-95·3; either test positive). In 7273 individuals with anosmia or at least three symptoms, seroprevalence ranged from 15·3% (13·8-16·8) to 19·3% (17·7-21·0). Around a third of seropositive participants were asymptomatic, ranging from 21·9% (19·1-24·9) to 35·8% (33·1-38·5). Only 19·5% (16·3-23·2) of symptomatic participants who were seropositive by both the point-of-care test and immunoassay reported a previous PCR test.

INTERPRETATION:

The majority of the Spanish population is seronegative to SARS-CoV-2 infection, even in hotspot areas. Most PCR-confirmed cases have detectable antibodies, but a substantial proportion of people with symptoms compatible with COVID-19 did not have a PCR test and at least a third of infections determined by serology were asymptomatic. These results emphasise the need for maintaining public health measures to avoid a new epidemic wave.

FUNDING:

Spanish Ministry of Health, Institute of Health Carlos III, and Spanish National Health System.
Тема - темы

Полный текст: Имеется в наличии Коллекция: Международные базы данных база данных: MEDLINE Основная тема: Pneumonia, Viral / Coronavirus Infections Тип исследования: Диагностическое исследование / Наблюдательное исследование / Прогностическое исследование / Рандомизированные контролируемые испытания Пределы темы: Подростки / Взрослые / Пожилые / Дети / Детский дошкольный / Женщины / Люди / Грудные дети / Мужчины / Middle aged Страна как тема: Европа Язык: английский Журнал: Lancet Год: 2020 Тип: Статья

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Полный текст: Имеется в наличии Коллекция: Международные базы данных база данных: MEDLINE Основная тема: Pneumonia, Viral / Coronavirus Infections Тип исследования: Диагностическое исследование / Наблюдательное исследование / Прогностическое исследование / Рандомизированные контролируемые испытания Пределы темы: Подростки / Взрослые / Пожилые / Дети / Детский дошкольный / Женщины / Люди / Грудные дети / Мужчины / Middle aged Страна как тема: Европа Язык: английский Журнал: Lancet Год: 2020 Тип: Статья