Prevalence of SARS-CoV-2 antibodies in France: results from nationwide serological surveillance

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Abstract

Assessment of the cumulative incidence of SARS-CoV-2 infections is critical for monitoring the course and extent of the COVID-19 epidemic. Here, we report estimated seroprevalence in the French population and the proportion of infected individuals who developed neutralising antibodies at three points throughout the first epidemic wave. Testing 11,000 residual specimens for anti-SARS-CoV-2 IgG and neutralising antibodies, we find nationwide seroprevalence of 0.41% (95% CI: 0.05–0.88) mid-March, 4.14% (95% CI: 3.31–4.99) mid-April and 4.93% (95% CI: 4.02–5.89) mid-May 2020. Approximately 70% of seropositive individuals have detectable neutralising antibodies. Infection fatality rate is 0.84% (95% CI: 0.70–1.03) and increases exponentially with age. These results confirm that the nationwide lockdown substantially curbed transmission and that the vast majority of the French population remained susceptible to SARS-CoV-2 in May 2020. Our study shows the progression of the first epidemic wave and provides a framework to inform the ongoing public health response as viral transmission continues globally.

Abstract

The percentage of national populations infected during the first stages of the COVID-19 pandemic are unclear owing to limited early testing. Here the authors provide a nation-wide prevalence study of SARS-CoV-2 antibodies in France from the first wave of COVID-19 in 2020, including stratification based on age, sex and region.

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Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

Chaolin Huang, Yeming Wang, Xingwang Li … (2020)

Summary Background A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. Methods All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. Findings By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0–58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0–13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. Interpretation The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. Funding Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.

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The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application

Stephen A. Lauer, Kyra Grantz, Qifang Bi … (2020)

Background: A novel human coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified in China in December 2019. There is limited support for many of its key epidemiologic features, including the incubation period for clinical disease (coronavirus disease 2019 [COVID-19]), which has important implications for surveillance and control activities. Objective: To estimate the length of the incubation period of COVID-19 and describe its public health implications. Design: Pooled analysis of confirmed COVID-19 cases reported between 4 January 2020 and 24 February 2020. Setting: News reports and press releases from 50 provinces, regions, and countries outside Wuhan, Hubei province, China. Participants: Persons with confirmed SARS-CoV-2 infection outside Hubei province, China. Measurements: Patient demographic characteristics and dates and times of possible exposure, symptom onset, fever onset, and hospitalization. Results: There were 181 confirmed cases with identifiable exposure and symptom onset windows to estimate the incubation period of COVID-19. The median incubation period was estimated to be 5.1 days (95% CI, 4.5 to 5.8 days), and 97.5% of those who develop symptoms will do so within 11.5 days (CI, 8.2 to 15.6 days) of infection. These estimates imply that, under conservative assumptions, 101 out of every 10 000 cases (99th percentile, 482) will develop symptoms after 14 days of active monitoring or quarantine. Limitation: Publicly reported cases may overrepresent severe cases, the incubation period for which may differ from that of mild cases. Conclusion: This work provides additional evidence for a median incubation period for COVID-19 of approximately 5 days, similar to SARS. Our results support current proposals for the length of quarantine or active monitoring of persons potentially exposed to SARS-CoV-2, although longer monitoring periods might be justified in extreme cases. Primary Funding Source: U.S. Centers for Disease Control and Prevention, National Institute of Allergy and Infectious Diseases, National Institute of General Medical Sciences, and Alexander von Humboldt Foundation.

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Defining the Epidemiology of Covid-19 — Studies Needed

Marc Lipsitch, David Swerdlow, Lyn Finelli (2020)

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Author and article information

Contributors

Stéphane Le Vu:

ORCID: http://orcid.org/0000-0002-1303-8281

stephane.levu@gmail.com

Journal

Journal ID (nlm-ta): Nat Commun

Journal ID (iso-abbrev): Nat Commun

Title: Nature Communications

Publisher: Nature Publishing Group UK (London )

ISSN (Electronic): 2041-1723

Publication date (Electronic): 21 May 2021

Publication date PMC-release: 21 May 2021

Publication date Collection: 2021

Volume: 12

Electronic Location Identifier: 3025

Affiliations

[1 ]GRID grid.493975.5, ISNI 0000 0004 5948 8741, Infectious Diseases Division, , Santé publique France, ; Saint-Maurice, France

[2 ]GRID grid.428999.7, ISNI 0000 0001 2353 6535, Unit of Molecular Virology and Vaccinology, Virology Department, , Theravectys, Institut Pasteur, ; Paris, France

[3 ]GRID grid.428999.7, ISNI 0000 0001 2353 6535, Unit of Lymphocyte Cell Biology, Immunology Department, , INSERM 1221, Institut Pasteur, ; Paris, France

[4 ]GRID grid.493975.5, ISNI 0000 0004 5948 8741, Data Sciences Division, , Santé publique France, ; Saint-Maurice, France

[5 ]Unit of Molecular Genetics of RNA Viruses, UMR 3569 CNRS, University of Paris-Diderot, Institut Pasteur, Paris, France

[6 ]GRID grid.428999.7, ISNI 0000 0001 2353 6535, Unit of Chemistry and Biocatalysis, UMR 3523 CNRS, Institut Pasteur, ; Paris, France

[7 ]GRID grid.428999.7, ISNI 0000 0001 2353 6535, Innovation Laboratory: Vaccines, Institut Pasteur, ; Paris, France

[8 ]GRID grid.428999.7, ISNI 0000 0001 2353 6535, Production and Purification of Recombinant Proteins Technological Platform, Institut Pasteur, ; Paris, France

[9 ]Cerba Healthcare Division, Cerba Xpert, St Ouen L’Aumone, France

[10 ]Eurofins Biomnis Sample Library, Eurofins Biomnis, Lyon, France

[11 ]GRID grid.428999.7, ISNI 0000 0001 2353 6535, ICAReB Biobanking Platform, Center for Translational Science, Institut Pasteur, ; Paris, France

[12 ]GRID grid.493975.5, ISNI 0000 0004 5948 8741, Regional Office—French Caribbean, Santé publique France, ; Gourbeyre, France

[13 ]GRID grid.493975.5, ISNI 0000 0004 5948 8741, Regional Office—Brittany, Santé publique France, ; Rennes, France

[14 ]GRID grid.493975.5, ISNI 0000 0004 5948 8741, Regional Office—Nouvelle Aquitaine, Santé publique France, ; Bordeaux, France

[15 ]GRID grid.428999.7, ISNI 0000 0001 2353 6535, National Reference Center for Respiratory Infections Viruses Including Influenza, Institut Pasteur, ; Paris, France

Author information

Stéphane Le Vu http://orcid.org/0000-0002-1303-8281

Gabrielle Jones http://orcid.org/0000-0001-9441-4172

Jean-Baptiste Richard http://orcid.org/0000-0002-4193-9159

Caroline Demeret http://orcid.org/0000-0002-1103-6805

Louise Perrin de Facci http://orcid.org/0000-0003-2821-4759

Sylvie van der Werf http://orcid.org/0000-0002-1148-4456

Harold Noel http://orcid.org/0000-0003-3011-9267

Article

Publisher ID: 23233

DOI: 10.1038/s41467-021-23233-6

PMC ID: 8140151

PubMed ID: 34021152

SO-VID: a35f750c-8519-4499-a096-bf2cbd003411

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Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 18 December 2020

Date accepted : 18 April 2021

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Keywords: viral infection,epidemiology

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ScienceOpen disciplines: Uncategorized

Keywords: viral infection, epidemiology

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Prevalence of SARS-CoV-2 antibodies in France: results from nationwide serological surveillance

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Novel Coronavirus Disease COVID-19

Most cited references 11

Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application

Defining the Epidemiology of Covid-19 — Studies Needed

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Cited by 28

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