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High anti-SARS-CoV-2 antibody seroconversion rates before the second wave in Manaus, Brazil, and the protective effect of social behaviour measures: results from the prospective DETECTCoV-19 cohort.
Lalwani, Pritesh; Araujo-Castillo, Roger V; Ganoza, Christian A; Salgado, Bárbara Batista; Pereira Filho, Ivanildo Vieira; da Silva, Danielle Severino Sena; de Morais, Thiago Barros do Nascimento; Jordão, Maele Ferreira; Ortiz, Jessica Vanina; Barbosa, Aguyda Rayany Cavalcante; Sobrinho, Wlademir Braga Salgado; Cordeiro, Isabelle Bezerra; de Souza Neto, Júlio Nino; de Assunção, Enedina Nogueira; da Costa, Cristiano Fernandes; de Souza, Pedro Elias; de Albuquerque, Bernardino Claudio; Astofi-Filho, Spartaco; Lalwani, Jaila Dias Borges.
Afiliação
  • Lalwani P; Instituto Leoônidas e Maria Deane, Fiocruz Amazoônia, Manaus, Brazil. Electronic address: pritesh.lalwani@fiocruz.br.
  • Araujo-Castillo RV; Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.
  • Ganoza CA; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.
  • Salgado BB; Instituto Leoônidas e Maria Deane, Fiocruz Amazoônia, Manaus, Brazil.
  • Pereira Filho IV; Instituto Leoônidas e Maria Deane, Fiocruz Amazoônia, Manaus, Brazil; Faculdade de Ciências Farmacêuticas, Universidade Federal do Amazonas, Manaus, Brazil.
  • da Silva DSS; Instituto Leoônidas e Maria Deane, Fiocruz Amazoônia, Manaus, Brazil.
  • de Morais TBDN; Instituto Leoônidas e Maria Deane, Fiocruz Amazoônia, Manaus, Brazil.
  • Jordão MF; Instituto Leoônidas e Maria Deane, Fiocruz Amazoônia, Manaus, Brazil.
  • Ortiz JV; Instituto Leoônidas e Maria Deane, Fiocruz Amazoônia, Manaus, Brazil.
  • Barbosa ARC; Instituto Leoônidas e Maria Deane, Fiocruz Amazoônia, Manaus, Brazil; Instituto de Ciências Biológicas, Universidade Federal do Amazonas, Manaus, Brazil.
  • Sobrinho WBS; Instituto Leoônidas e Maria Deane, Fiocruz Amazoônia, Manaus, Brazil.
  • Cordeiro IB; Instituto de Ciências Biológicas, Universidade Federal do Amazonas, Manaus, Brazil.
  • de Souza Neto JN; Centro de Apoio Multidisciplinar, Universidade Federal do Amazonas, Manaus, Brazil.
  • de Assunção EN; Centro de Apoio Multidisciplinar, Universidade Federal do Amazonas, Manaus, Brazil.
  • da Costa CF; Fundação de Vigilância em Saúde do Amazonas, Manaus, Brazil.
  • de Souza PE; Programa de Pós-Graduação em Cirurgia, Faculdade de Medicina, Universidade Federal do Amazonas, Manaus, Brazil.
  • de Albuquerque BC; Faculdade de Medicina, Universidade Federal do Amazonas, Manaus, Brazil.
  • Astofi-Filho S; Instituto de Ciências Biológicas, Universidade Federal do Amazonas, Manaus, Brazil; Centro de Apoio Multidisciplinar, Universidade Federal do Amazonas, Manaus, Brazil.
  • Lalwani JDB; Faculdade de Ciências Farmacêuticas, Universidade Federal do Amazonas, Manaus, Brazil. Electronic address: jaila@ufam.edu.br.
Lancet Glob Health ; 9(11): e1508-e1516, 2021 11.
Article em En | MEDLINE | ID: mdl-34678195
BACKGROUND: The city of Manaus, Brazil, has seen two collapses of the health system due to the COVID-19 pandemic. We report anti-SARS-CoV-2 nucleocapsid IgG antibody seroconversion rates and associated risk factors in Manaus residents before the second wave of the epidemic in Brazil. METHODS: A convenience sample of adult (aged ≥18 years) residents of Manaus was recruited through online and university website advertising into the DETECTCoV-19 study cohort. The current analysis of seroconversion included a subgroup of DETECTCoV-19 participants who had at least two serum sample collections separated by at least 4 weeks between Aug 19 and Oct 2, 2020 (visit 1), and Oct 19 and Nov 27, 2020 (visit 2). Those who reported (or had no data on) having a COVID-19 diagnosis before visit 1, and who were positive for anti-SARS-CoV-2 nucleocapsid IgG antibodies at visit 1 were excluded. Using an in-house ELISA, the reactivity index (RI; calculated as the optical density ratio of the sample to the negative control) for serum anti-SARS-CoV-2 nucleocapsid IgG antibodies was measured at both visits. We calculated the incidence of seroconversion (defined as RI values ≤1·5 at visit 1 and ≥1·5 at visit 2, and a ratio >2 between the visit 2 and visit 1 RI values) during the study period, as well as incidence rate ratios (IRRs) through cluster-corrected and adjusted Poisson regression models to analyse associations between seroconversion and variables related to sociodemographic characteristics, health access, comorbidities, COVID-19 exposure, protective behaviours, and symptoms. FINDINGS: 2496 DETECTCoV-19 cohort participants returned for a follow-up visit between Oct 19 and Nov 27, 2020, of whom 204 reported having COVID-19 before the first visit and 24 had no data regarding previous disease status. 559 participants were seropositive for anti-SARS-CoV-2 nucleocapsid IgG antibodies at baseline. Of the remaining 1709 participants who were seronegative at baseline, 71 did not meet the criteria for seroconversion and were excluded from the analyses. Among the remaining 1638 participants who were seronegative at baseline, 214 showed seroconversion at visit 2. The seroconversion incidence was 13·06% (95% CI 11·52-14·79) overall and 6·78% (5·61-8·10) for symptomatic seroconversion, over a median follow-up period of 57 days (IQR 54-61). 48·1% of seroconversion events were estimated to be asymptomatic. The sample had higher proportions of affluent and higher-educated people than those reported for the Manaus city population. In the fully adjusted and corrected model, risk factors for seroconversion before visit 2 were having a COVID-19 case in the household (IRR 1·49 [95% CI 1·21-1·83]), not wearing a mask during contact with a person with COVID-19 (1·25 [1·09-1·45]), relaxation of physical distancing (1·31 [1·05-1·64]), and having flu-like symptoms (1·79 [1·23-2·59]) or a COVID-19 diagnosis (3·57 [2·27-5·63]) between the first and second visits, whereas working remotely was associated with lower incidence (0·74 [0·56-0·97]). INTERPRETATION: An intense infection transmission period preceded the second wave of COVID-19 in Manaus. Several modifiable behaviours increased the risk of seroconversion, including non-compliance with non-pharmaceutical interventions measures such as not wearing a mask during contact, relaxation of protective measures, and non-remote working. Increased testing in high-transmission areas is needed to provide timely information about ongoing transmission and aid appropriate implementation of transmission mitigation measures. FUNDING: Ministry of Education, Brazil; Fundação de Amparo à Pesquisa do Estado do Amazonas; Pan American Health Organization (PAHO)/WHO.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Imunoglobulina G / Epidemias / Soroconversão / SARS-CoV-2 / COVID-19 Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: Lancet Glob Health Ano de publicação: 2021 Tipo de documento: Article País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Imunoglobulina G / Epidemias / Soroconversão / SARS-CoV-2 / COVID-19 Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: Lancet Glob Health Ano de publicação: 2021 Tipo de documento: Article País de publicação: Reino Unido