SARS-CoV-2 seroprevalence trends in healthy blood donors during the COVID-19 outbreak in Milan

밀라노에서 COVID-19가 발생하는 동안 건강한 헌혈자의 SARS-CoV-2 혈청 유병률 추세

Published on
Journal: Blood transfusion = Trasfusione del sangue
[키워드]
[저자] Luca Valenti, Annalisa Bergna, Serena Pelusi, Federica Facciotti, Alessia Lai, Maciej Tarkowski, Angela Lombardi, Alessandra Berzuini, Flavio Caprioli, Luigi Santoro, Guido Baselli, Carla Della Ventura, Elisa Erba, Silvano Bosari, Massimo Galli, Gianguglielmo Zehender, Daniele Prati, Covid-19 Donors Study (CoDS) network (Appendix 1)
[Category] MERS, SARS, 진단, 치료법,
PMC URL    [DOI] 10.2450/2021.0324-20    
[Article Type] Article
[Source] PMC

Abstract
Background: The Milan metropolitan area in Northern Italy was among the most severely hit by the SARS-CoV-2 outbreak. The aim of this study was to examine the seroprevalence trends of SARS-CoV-2 in healthy asymptomatic adults, and the risk factors and laboratory correlates of positive tests.
Materials and methods: We conducted a cross-sectional study in a random sample of blood donors, who were asymptomatic at the time of evaluation, at the beginning of the first phase (February 24 th to April 8 th 2020; n=789). Presence of IgM/IgG antibodies against the SARS-CoV-2-Nucleocapsid protein was assessed by a lateral flow immunoassay.
Results: The test had a 100/98.3 sensitivity/specificity (n=32/120 positive/negative controls, respectively), and the IgG test was validated in a subset by an independent ELISA against the Spike protein (n=34, p<0.001). At the start of the outbreak, the overall adjusted seroprevalence of SARS-CoV-2 was 2.7% (95% CI: 0.3-6%; p<0.0001 vs 120 historical controls). During the study period, characterised by a gradual implementation of social distancing measures, there was a progressive increase in the adjusted seroprevalence to 5.2% (95% CI: 2.4-9.0; 4.5%, 95% CI: 0.9-9.2% according to a Bayesian estimate) due to a rise in IgG reactivity to 5% (95% CI: 2.8-8.2; p=0.004 for trend), but there was no increase in IgM + (p=not significant). At multivariate logistic regression analysis, IgG reactivity was more frequent in younger individuals (p=0.043), while IgM reactivity was more frequent in individuals aged >45 years (p=0.002).
Discussion: SARS-CoV-2 infection was already circulating in Milan at the start of the outbreak. The pattern of IgM/IgG reactivity was influenced by age: IgM was more frequently detected in participants aged >45 years. By the end of April, 2.4-9.0% of healthy adults had evidence of seroconversion.

All Keywords
【초록키워드】 SARS-CoV-2, IgG, IgM, Risk factors, Bayesian, antibody, cross-sectional, SARS-COV-2 infection, Italy, risk factor, ELISA, Spike protein, nucleocapsid protein, Laboratory, Protein, lateral flow immunoassay, Adults, Blood donors, Seroconversion, cross-sectional study, Random sample, Asymptomatic, IgG antibodies, outbreak, IgM/IgG, implementation, pattern, Evidence, Analysis, evidence of, historical controls), IgG test, Logistic regression analysis, 95% CI, individual, social distancing measures, study period, no increase, multivariate logistic regression, participant, circulating, multivariate logistic regression analysis, material, random, positive, controls, independent, healthy, conducted, adjusted, increase in, reactivity, subset, the Spike, Presence, the SARS-CoV-2, 【제목키워드】 Blood donors, SARS-CoV-2 seroprevalence, COVID-19 outbreak, healthy blood donor,
{{{ 추상적인 }}} {{ 배경: }} 이탈리아 북부의 밀라노 대도시 지역은 SARS-CoV-2 발병으로 가장 심각한 피해를 입은 지역 중 하나였습니다. 이 연구의 목적은 건강한 무증상 성인에서 SARS-CoV-2의 혈청 유병률 경향과 양성 검사의 위험 인자 및 실험실 상관 관계를 조사하는 것이었습니다. {{ 재료 및 방법: }} 우리는 1단계(2020년 2월 24일부터 4월 8일까지, n =789). SARS-CoV-2-뉴클레오캡시드 단백질에 대한 IgM/IgG 항체의 존재는 측방 유동 면역분석에 의해 평가되었습니다. {{ 결과: }} 테스트는 100/98.3 민감도/특이도(각각 n=32/120 양성/음성 대조군)를 가졌고, IgG 테스트는 스파이크 단백질(n= 34, p<0.001). 발병 초기에 SARS-CoV-2의 전체 조정된 혈청 유병률은 2.7%였습니다(95% CI: 0.3-6%; p<0.0001 대 120개의 과거 대조군). 사회적 거리두기 조치의 점진적인 시행을 특징으로 하는 연구 기간 동안 조정된 혈청 유병률이 5.2%로 점진적으로 증가했습니다(95% CI: 2.4-9.0; 4.5%, 95% CI: 0.9-9.2%에 따르면 베이지안 추정) IgG 반응성이 5%(95% CI: 2.8-8.2, 경향에 대해 p=0.004)로 증가했기 때문에 IgM +에는 증가가 없었습니다(p=유의하지 않음). 다변량 로지스틱 회귀 분석에서 IgG 반응성은 젊은 개체에서 더 빈번한 반면(p=0.043), IgM 반응성은 >45세 이상의 개체에서 더 빈번했습니다(p=0.002). {{ 토론: }} SARS-CoV-2 감염은 발병 초기에 밀라노에서 이미 돌고 있었습니다. IgM/IgG 반응성 패턴은 연령에 따라 영향을 받았습니다. IgM은 45세 이상의 참가자에서 더 자주 검출되었습니다. 4월 말까지 건강한 성인의 2.4-9.0%가 혈청 전환의 증거를 보였습니다.