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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Lancet
2020 ; 396
(10250
): 535-544
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Prevalence of SARS-CoV-2 in Spain (ENE-COVID): a nationwide, population-based
seroepidemiological study
#MMPMID32645347
Pollán M
; Pérez-Gómez B
; Pastor-Barriuso R
; Oteo J
; Hernán MA
; Pérez-Olmeda M
; Sanmartín JL
; Fernández-García A
; Cruz I
; Fernández de Larrea N
; Molina M
; Rodríguez-Cabrera F
; Martín M
; Merino-Amador P
; León Paniagua J
; Muñoz-Montalvo JF
; Blanco F
; Yotti R
Lancet
2020[Aug]; 396
(10250
): 535-544
PMID32645347
show ga
BACKGROUND: Spain is one of the European countries most affected by the COVID-19
pandemic. Serological surveys are a valuable tool to assess the extent of the
epidemic, given the existence of asymptomatic cases and little access to
diagnostic tests. This nationwide population-based study aims to estimate the
seroprevalence of SARS-CoV-2 infection in Spain at national and regional level.
METHODS: 35?883 households were selected from municipal rolls using two-stage
random sampling stratified by province and municipality size, with all residents
invited to participate. From April 27 to May 11, 2020, 61?075 participants (75·1%
of all contacted individuals within selected households) answered a questionnaire
on history of symptoms compatible with COVID-19 and risk factors, received a
point-of-care antibody test, and, if agreed, donated a blood sample for
additional testing with a chemiluminescent microparticle immunoassay. Prevalences
of IgG antibodies were adjusted using sampling weights and post-stratification to
allow for differences in non-response rates based on age group, sex, and
census-tract income. Using results for both tests, we calculated a seroprevalence
range maximising either specificity (positive for both tests) or sensitivity
(positive for either test). FINDINGS: Seroprevalence was 5·0% (95% CI 4·7-5·4) by
the point-of-care test and 4·6% (4·3-5·0) by immunoassay, with a
specificity-sensitivity range of 3·7% (3·3-4·0; both tests positive) to 6·2%
(5·8-6·6; either test positive), with no differences by sex and lower
seroprevalence in children younger than 10 years (<3·1% by the point-of-care
test). There was substantial geographical variability, with higher prevalence
around Madrid (>10%) and lower in coastal areas (<3%). Seroprevalence among 195
participants with positive PCR more than 14 days before the study visit ranged
from 87·6% (81·1-92·1; both tests positive) to 91·8% (86·3-95·3; either test
positive). In 7273 individuals with anosmia or at least three symptoms,
seroprevalence ranged from 15·3% (13·8-16·8) to 19·3% (17·7-21·0). Around a third
of seropositive participants were asymptomatic, ranging from 21·9% (19·1-24·9) to
35·8% (33·1-38·5). Only 19·5% (16·3-23·2) of symptomatic participants who were
seropositive by both the point-of-care test and immunoassay reported a previous
PCR test. INTERPRETATION: The majority of the Spanish population is seronegative
to SARS-CoV-2 infection, even in hotspot areas. Most PCR-confirmed cases have
detectable antibodies, but a substantial proportion of people with symptoms
compatible with COVID-19 did not have a PCR test and at least a third of
infections determined by serology were asymptomatic. These results emphasise the
need for maintaining public health measures to avoid a new epidemic wave.
FUNDING: Spanish Ministry of Health, Institute of Health Carlos III, and Spanish
National Health System.
free
free
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