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Seroprevalence of IgG antibodies against SARS-CoV-2 – a serial prospective cross-sectional nationwide study of residual samples,Belgium, March to October 2020
Authors:Sereina Annik Herzog  Jessie De Bie  Steven Abrams  Ine Wouters  Esra Ekinci  Lisbeth Patteet  Astrid Coppens  Sandy De Spiegeleer  Philippe Beutels  Pierre Van Damme  Niel Hens  Heidi Theeten
Abstract:
BackgroundTo control epidemic waves, it is important to know the susceptibility to SARS-CoV-2 and its evolution over time in relation to the control measures taken.AimTo assess the evolving SARS-CoV-2 seroprevalence and seroincidence related to the first national lockdown in Belgium, we performed a nationwide seroprevalence study, stratified by age, sex and region using 3,000–4,000 residual samples during seven periods between 30 March and 17 October 2020.MethodsWe analysed residual sera from ambulatory patients for IgG antibodies against the SARS-CoV-2 S1 protein with a semiquantitative commercial ELISA. Weighted seroprevalence (overall and by age category and sex) and seroincidence during seven consecutive periods were estimated for the Belgian population while accommodating test-specific sensitivity and specificity.ResultsThe weighted overall seroprevalence initially increased from 1.8% (95% credible interval (CrI): 1.0–2.6) to 5.3% (95% CrI: 4.2–6.4), implying a seroincidence of 3.4% (95% CrI: 2.4–4.6) between the first and second collection period over a period of 3 weeks during lockdown (start lockdown mid-March 2020). Thereafter, seroprevalence stabilised, however, significant decreases were observed when comparing the third with the fifth, sixth and seventh period, resulting in negative seroincidence estimates after lockdown was lifted. We estimated for the last collection period mid-October 2020 a weighted overall seroprevalence of 4.2% (95% CrI: 3.1–5.2).ConclusionDuring lockdown, an initially small but increasing fraction of the Belgian population showed serologically detectable signs of exposure to SARS-CoV-2, which did not further increase when confinement measures eased and full lockdown was lifted.
Keywords:serial sero-survey   COVID-19   seroprevalence seroincidence   ELISA   SARS-CoV-2 S1 epitope   humoral immunity
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