SARS-CoV-2 antibody seroprevalence in India, August-September, 2020: findings from the second nationwide household serosurvey.
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Murhekar Manoj V, Bhatnagar Tarun, Selvaraju Sriram, Saravanakumar V, Thangaraj Jeromie Wesley Vivian, Shah Naman, Kumar Muthusamy Santhosh, Rade Kiran, Sabarinathan R, Asthana Smita, Balachandar Rakesh, Bangar Sampada Dipak, Bansal Avi Kumar, Bhat Jyothi, Chopra Vishal, Das Dasarathi, Deb Alok Kumar, Devi Kangjam Rekha, Dwivedi Gaurav Raj, Khan S Muhammad Salim, Kumar C P Girish, Kumar M Sunil, Laxmaiah Avula, Madhukar Major, Mahapatra Amarendra, Mohanty Suman Sundar, Rangaraju Chethana, Turuk Alka, Baradwaj Dinesh Kumar, Chahal Ashrafjit S, Debnath Falguni, Haq Inaamul, Kalliath Arshad, Kanungo Srikanta, Kshatri Jaya Singh, Lakshmi G G J Naga, Mitra Anindya, Nirmala A R, Prasad Ganta Venkata, Qurieshi Mariya Amin, Sahay Seema, Sangwan Ramesh Kumar, Sekar Krithikaa, Shukla Vijay Kumar, Singh Prashant Kumar, Singh Pushpendra, Singh Rajeev, Varma Dantuluri Sheethal, Viramgami Ankit, Panda Samiran, Reddy D C S, Bhargava Balram, ICMR Serosurveillance Group
Аннотация
METHODS: We did a second household serosurvey among individuals aged 10 years or older in the same 700 villages or wards within 70 districts in India that were included in the first serosurvey. Individuals aged younger than 10 years and households that did not respond at the time of survey were excluded. Participants were interviewed to collect information on sociodemographics, symptoms suggestive of COVID-19, exposure history to laboratory-confirmed COVID-19 cases, and history of COVID-19 illness. 3-5 mL of venous blood was collected from each participant and blood samples were tested using the Abbott SARS-CoV-2 IgG assay. Seroprevalence was estimated after applying the sampling weights and adjusting for clustering and assay characteristics. We randomly selected one adult serum sample from each household to compare the seroprevalence among adults between the two serosurveys.
FINDINGS: Between Aug 18 and Sept 20, 2020, we enrolled and collected serum samples from 29 082 individuals from 15 613 households. The weighted and adjusted seroprevalence of SARS-CoV-2 IgG antibodies in individuals aged 10 years or older was 6·6% (95% CI 5·8-7·4). Among 15 084 randomly selected adults (one per household), the weighted and adjusted seroprevalence was 7·1% (6·2-8·2). Seroprevalence was similar across age groups, sexes, and occupations. Seroprevalence was highest in urban slum areas followed by urban non-slum and rural areas. We estimated a cumulative 74·3 million infections in the country by Aug 18, 2020, with 26-32 infections for every reported COVID-19 case.
INTERPRETATION: Approximately one in 15 individuals aged 10 years or older in India had SARS-CoV-2 infection by Aug 18, 2020. The adult seroprevalence increased approximately tenfold between May and August, 2020. Lower infection-to-case ratio in August than in May reflects a substantial increase in testing across the country.
FUNDING: Indian Council of Medical Research.