Systematic review of seroprevalence of SARS-CoV-2 antibodies and appraisal of evidence, prior to the widespread introduction of vaccine programmes in the WHO European Region, January–December 2020

Objectives Systematic review of SARS-CoV-2 seroprevalence studies undertaken in the WHO European Region to measure pre-existing and cumulative seropositivity prior to the roll out of vaccination programmes.Design A systematic review of the literature.Data sources We searched MEDLINE, EMBASE and the...

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Main Authors: Anthony Nardone, Richard Pebody, Lorenzo Subissi, Isabel Bergeri, Aisling Vaughan, Erika Duffell, Gudrun S Freidl, Diogo Simão Lemos, M Valenciano, Eeva K Broberg, Pasi Penttinen, Maria Keramarou
Format: Article
Language:English
Published: BMJ Publishing Group 2023-11-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/13/11/e064240.full
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author Anthony Nardone
Richard Pebody
Lorenzo Subissi
Isabel Bergeri
Aisling Vaughan
Erika Duffell
Gudrun S Freidl
Diogo Simão Lemos
M Valenciano
Eeva K Broberg
Pasi Penttinen
Maria Keramarou
author_facet Anthony Nardone
Richard Pebody
Lorenzo Subissi
Isabel Bergeri
Aisling Vaughan
Erika Duffell
Gudrun S Freidl
Diogo Simão Lemos
M Valenciano
Eeva K Broberg
Pasi Penttinen
Maria Keramarou
author_sort Anthony Nardone
collection DOAJ
description Objectives Systematic review of SARS-CoV-2 seroprevalence studies undertaken in the WHO European Region to measure pre-existing and cumulative seropositivity prior to the roll out of vaccination programmes.Design A systematic review of the literature.Data sources We searched MEDLINE, EMBASE and the preprint servers MedRxiv and BioRxiv in the WHO ‘COVID-19 Global literature on coronavirus disease’ database using a predefined search strategy. Articles were supplemented with unpublished WHO-supported Unity-aligned seroprevalence studies and other studies reported directly to WHO Regional Office for Europe and European Centre for Disease Prevention and Control.Eligibility criteria Studies published before the widespread implementation of COVID-19 vaccination programmes in January 2021 among the general population and blood donors, at national and regional levels.Data extraction and synthesis At least two independent researchers extracted the eligible studies; a third researcher resolved any disagreements. Study risk of bias was assessed using a quality scoring system based on sample size, sampling and testing methodologies.Results In total, 111 studies from 26 countries published or conducted between 1 January 2020 and 31 December 2020 across the WHO European Region were included. A significant heterogeneity in implementation was noted across the studies, with a paucity of studies from the east of the Region. Sixty-four (58%) studies were assessed to be of medium to high risk of bias. Overall, SARS-CoV-2 seropositivity prior to widespread community circulation was very low. National seroprevalence estimates after circulation started ranged from 0% to 51.3% (median 2.2% (IQR 0.7–5.2%); n=124), while subnational estimates ranged from 0% to 52% (median 5.8% (IQR 2.3%–12%); n=101), with the highest estimates in areas following widespread local transmission.Conclusions The low levels of SARS-CoV-2 antibody in most populations prior to the start of vaccine programmes underlines the critical importance of targeted vaccination of priority groups at risk of severe disease, while maintaining reduced levels of transmission to minimise population morbidity and mortality.
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spelling doaj.art-5f985260661f4f17b05d52cc72c7438e2023-11-14T17:25:07ZengBMJ Publishing GroupBMJ Open2044-60552023-11-01131110.1136/bmjopen-2022-064240Systematic review of seroprevalence of SARS-CoV-2 antibodies and appraisal of evidence, prior to the widespread introduction of vaccine programmes in the WHO European Region, January–December 2020Anthony Nardone0Richard Pebody1Lorenzo Subissi2Isabel Bergeri3Aisling Vaughan4Erika Duffell5Gudrun S Freidl6Diogo Simão Lemos7M Valenciano8Eeva K Broberg9Pasi Penttinen10Maria Keramarou112 HIV/STI Department, National Infection Service, Public Health England, London, UKWorld Health Organization Regional Office for Europe, Copenhagen, DenmarkWorld Health Organization, Geneva, SwitzerlandWHO Health Emergencies Programme, World Health Organization, Geneva, SwitzerlandWorld Health Organization Regional Office for Europe, Copenhagen, DenmarkEuropean Centre for Disease Prevention and Control, Solna, SwedenWorld Health Organization Regional Office for Europe, Copenhagen, DenmarkWorld Health Organization Regional Office for Europe, Copenhagen, DenmarkEpiconcept SAS, Paris, FranceEuropean Centre for Disease Prevention and Control, Solna, SwedenEuropean Centre for Disease Prevention and Control, Solna, SwedenEuropean Centre for Disease Prevention and Control, Solna, SwedenObjectives Systematic review of SARS-CoV-2 seroprevalence studies undertaken in the WHO European Region to measure pre-existing and cumulative seropositivity prior to the roll out of vaccination programmes.Design A systematic review of the literature.Data sources We searched MEDLINE, EMBASE and the preprint servers MedRxiv and BioRxiv in the WHO ‘COVID-19 Global literature on coronavirus disease’ database using a predefined search strategy. Articles were supplemented with unpublished WHO-supported Unity-aligned seroprevalence studies and other studies reported directly to WHO Regional Office for Europe and European Centre for Disease Prevention and Control.Eligibility criteria Studies published before the widespread implementation of COVID-19 vaccination programmes in January 2021 among the general population and blood donors, at national and regional levels.Data extraction and synthesis At least two independent researchers extracted the eligible studies; a third researcher resolved any disagreements. Study risk of bias was assessed using a quality scoring system based on sample size, sampling and testing methodologies.Results In total, 111 studies from 26 countries published or conducted between 1 January 2020 and 31 December 2020 across the WHO European Region were included. A significant heterogeneity in implementation was noted across the studies, with a paucity of studies from the east of the Region. Sixty-four (58%) studies were assessed to be of medium to high risk of bias. Overall, SARS-CoV-2 seropositivity prior to widespread community circulation was very low. National seroprevalence estimates after circulation started ranged from 0% to 51.3% (median 2.2% (IQR 0.7–5.2%); n=124), while subnational estimates ranged from 0% to 52% (median 5.8% (IQR 2.3%–12%); n=101), with the highest estimates in areas following widespread local transmission.Conclusions The low levels of SARS-CoV-2 antibody in most populations prior to the start of vaccine programmes underlines the critical importance of targeted vaccination of priority groups at risk of severe disease, while maintaining reduced levels of transmission to minimise population morbidity and mortality.https://bmjopen.bmj.com/content/13/11/e064240.full
spellingShingle Anthony Nardone
Richard Pebody
Lorenzo Subissi
Isabel Bergeri
Aisling Vaughan
Erika Duffell
Gudrun S Freidl
Diogo Simão Lemos
M Valenciano
Eeva K Broberg
Pasi Penttinen
Maria Keramarou
Systematic review of seroprevalence of SARS-CoV-2 antibodies and appraisal of evidence, prior to the widespread introduction of vaccine programmes in the WHO European Region, January–December 2020
BMJ Open
title Systematic review of seroprevalence of SARS-CoV-2 antibodies and appraisal of evidence, prior to the widespread introduction of vaccine programmes in the WHO European Region, January–December 2020
title_full Systematic review of seroprevalence of SARS-CoV-2 antibodies and appraisal of evidence, prior to the widespread introduction of vaccine programmes in the WHO European Region, January–December 2020
title_fullStr Systematic review of seroprevalence of SARS-CoV-2 antibodies and appraisal of evidence, prior to the widespread introduction of vaccine programmes in the WHO European Region, January–December 2020
title_full_unstemmed Systematic review of seroprevalence of SARS-CoV-2 antibodies and appraisal of evidence, prior to the widespread introduction of vaccine programmes in the WHO European Region, January–December 2020
title_short Systematic review of seroprevalence of SARS-CoV-2 antibodies and appraisal of evidence, prior to the widespread introduction of vaccine programmes in the WHO European Region, January–December 2020
title_sort systematic review of seroprevalence of sars cov 2 antibodies and appraisal of evidence prior to the widespread introduction of vaccine programmes in the who european region january december 2020
url https://bmjopen.bmj.com/content/13/11/e064240.full
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