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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BMJ Publishing Group
2023-11-01
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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 Articles were supplemented with unpublished WHO-supported Unity-aligned seroprevalence studies and other studies reported directly to WHO Regional Office for Europe and European Centre for Disease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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institution | Directory Open Access Journal |
issn | 2044-6055 |
language | English |
last_indexed | 2024-03-11T10:31:39Z |
publishDate | 2023-11-01 |
publisher | BMJ Publishing Group |
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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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