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    SARS-CoV-2 seroprevalence worldwide: a systematic review and meta-analysis.

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    Author
    Rostami, A; Sepidarkish, M; Leeflang, MMG; Riahi, SM; Nourollahpour Shiadeh, M; Esfandyari, S; Mokdad, AH; Hotez, PJ; Gasser, RB
    Date
    2021-03
    Source Title
    Clinical Microbiology and Infection
    Publisher
    Elsevier BV
    University of Melbourne Author/s
    Gasser, Robin
    Affiliation
    Veterinary Biosciences
    Metadata
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    Document Type
    Journal Article
    Citations
    Rostami, A., Sepidarkish, M., Leeflang, M. M. G., Riahi, S. M., Nourollahpour Shiadeh, M., Esfandyari, S., Mokdad, A. H., Hotez, P. J. & Gasser, R. B. (2021). SARS-CoV-2 seroprevalence worldwide: a systematic review and meta-analysis.. Clin Microbiol Infect, 27 (3), pp.331-340. https://doi.org/10.1016/j.cmi.2020.10.020.
    Access Status
    Access this item via the Open Access location
    URI
    http://hdl.handle.net/11343/254622
    DOI
    10.1016/j.cmi.2020.10.020
    Open Access URL
    https://europepmc.org/articles/PMC7584920?pdf=render
    Open Access at PMC
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7584920
    Abstract
    OBJECTIVES: COVID-19 has been arguably the most important public health concern worldwide in 2020, and efforts are now escalating to suppress or eliminate its spread. In this study we undertook a meta-analysis to estimate the global and regional seroprevalence rates in humans of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and to assess whether seroprevalence is associated with geographical, climatic and/or sociodemographic factors. METHODS: We systematically reviewed PubMed, Scopus, Embase, medRxiv and bioRxiv databases for preprints or peer-reviewed articles (up to 14 August 2020). Study eligibility criteria were population-based studies describing the prevalence of anti-SARS-CoV-2 (IgG and/or IgM) serum antibodies. Participants were people from different socioeconomic and ethnic backgrounds (from the general population), whose prior COVID-19 status was unknown and who were tested for the presence of anti-SARS-CoV-2 serum antibodies. We used a random-effects model to estimate pooled seroprevalence, and then extrapolated the findings to the global population (for 2020). Subgroup and meta-regression analyses explored potential sources of heterogeneity in the data, and relationships between seroprevalence and sociodemographic, geographical and/or climatic factors. RESULTS: In total, 47 studies involving 399 265 people from 23 countries met the inclusion criteria. Heterogeneity (I2 = 99.4%, p < 0.001) was seen among studies; SARS-CoV-2 seroprevalence in the general population varied from 0.37% to 22.1%, with a pooled estimate of 3.38% (95%CI 3.05-3.72%; 15 879/399 265). On a regional level, seroprevalence varied from 1.45% (0.95-1.94%, South America) to 5.27% (3.97-6.57%, Northern Europe), although some variation appeared to relate to the serological assay used. The findings suggested an association of seroprevalence with income levels, human development indices, geographic latitudes and/or climate. Extrapolating to the 2020 world population, we estimated that 263.5 million individuals had been exposed or infected at the time of this study. CONCLUSIONS: This study showed that SARS-CoV-2 seroprevalence varied markedly among geographic regions, as might be expected early in a pandemic. Longitudinal surveys to continually monitor seroprevalence around the globe will be critical to support prevention and control efforts, and might indicate levels of endemic stability or instability in particular countries and regions.

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