Dataset Information

Seroprevalence of IgG antibodies against SARS-CoV-2 in India, March 2020-August 2021: a systematic review and meta-analysis.

ABSTRACT:

Introduction

India experienced two waves of Coronavirus disease 2019 (COVID-19) pandemic caused by Severe Acute Respiratory Syndrome Coronavirus 2 [SARS-CoV-2] and reported second highest caseload globally. Seroepidemiological studies were done to track the course of the pandemic. We systematically reviewed and synthesized seroprevalence of SARS-CoV-2 among Indian population.

Methods

We included studies reporting seroprevalence of IgG antibodies against SARS-CoV-2 from March 1, 2020, to August 11, 2021 and excluded studies done only among COVID-19 patients, and vaccinated individuals. We searched published databases, preprint servers and government documents using a combination of keywords and Medical subheading (MeSH) terms of "Seroprevalence AND SARS-CoV-2 AND India". We assessed risk of bias using the Newcastle Ottawa scale, the Appraisal tool for cross-sectional studies (AXIS), the Joanna Briggs Institute (JBI) critical appraisal tool and WHO's statement on the Reporting of Seroepidemiological Studies for SARS-CoV-2 (ROSES-S). We calculated pooled seroprevalence along with 95% Confidence Intervals (CI) during the first (March 2020 to February 2021) and second wave (March to August 2021). We also estimated seroprevalence by selected demographic characteristics.

Results

We identified 3821 studies and included 53 studies with 905,379 participants after excluding duplicates, screening of titles and abstracts and full-text screening. Of the 53, 20 studies were of good quality. Some of the reviewed studies did not report adequate information on study methods [sampling=24% (13/53); laboratory=83% (44/53)]. Studies of 'poor' quality had more than one of the following issues: unjustified sample size, non-representative sample, non-classification of non-respondents, results unadjusted for demographics and methods insufficiently explained to enable replication. Overall pooled seroprevalence was 20.7% in the first (95% CI=16.1 to 25.3) and 69.2% (95% CI=64.5 to 73.8) in the second wave. Seroprevalence did not differ by age in first wave, whereas in second, it increased with age. Seroprevalence was slightly higher among females in second wave. In both the waves, the estimate was higher in urban than in rural areas.

Conclusion

Seroprevalence increased by threefold between the two waves of the pandemic in India. Our review highlights the need for designing and reporting studies using standard protocols.

SUBMITTER: Jahan N

PROVIDER: S-EPMC8712428 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundThe first national severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serosurvey in India, done in May-June, 2020, among adults aged 18 years or older from 21 states, found a SARS-CoV-2 IgG antibody seroprevalence of 0·73% (95% CI 0·34-1·13). We aimed to assess the more recent nationwide seroprevalence in the general population in India.MethodsWe 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.FindingsBetween 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.InterpretationApproximately 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.FundingIndian Council of Medical Research.