SARS-CoV-2 antibody prevalence in England following the first peak of the pandemic
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Abstract
England has experienced a large outbreak of SARS-CoV-2, disproportionately affecting people from disadvantaged and ethnic minority communities. It is unclear how much of this excess is due to differences in exposure associated with structural inequalities. Here, we report from the REal-time Assessment of Community Transmission-2 (REACT-2) national study of over 100,000 people. After adjusting for test characteristics and re-weighting to the population, overall antibody prevalence is 6.0% (95% CI: 5.8-6.1). An estimated 3.4 million people had developed antibodies to SARS-CoV-2 by mid-July 2020. Prevalence is two- to three-fold higher among health and care workers compared with non-essential workers, and in people of Black or South Asian than white ethnicity, while age- and sex-specific infection fatality ratios are similar across ethnicities. Our results indicate that higher hospitalisation and mortality from COVID-19 in minority ethnic groups may reflect higher rates of infection rather than differential experience of disease or care.
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SciScore for 10.1101/2020.08.12.20173690: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:An important limitation was the exclusion of children for regulatory reasons as the tests were approved for research use in adults only. We used self-administered home LFIA tests as opposed to “gold standard” laboratory tests based on a blood draw. However, we carried out extensive evaluation of the selected LFIA whch showed it to have …
SciScore for 10.1101/2020.08.12.20173690: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:An important limitation was the exclusion of children for regulatory reasons as the tests were approved for research use in adults only. We used self-administered home LFIA tests as opposed to “gold standard” laboratory tests based on a blood draw. However, we carried out extensive evaluation of the selected LFIA whch showed it to have acceptable performance in terms of both sensitivity and specificity in comparison with the confirmatory laboratory tests.(21) We also took steps to measure and improve usability, including ability to perform and read an LFIA test, through public involvement and evaluation in a national study of 14,000 people.(22) Use of the LFIA enabled us to obtain antibody tests on large numbers over an 18-day period, without the need for laboratory or health care personnel. Antibodies were strongly associated with clinical history of confirmed or suspected COVID-19, providing face validity. Although there was a theoretical potential for reporting bias as respondents were not blinded to their test results, there was high concordance of self-reported with clinician-read results from the uploaded photographs. Our results closely tracked other indicators of the epidemic curve and we believe that use of home-based self-tests is a sustainable model for community-based prevalence studies in other populations. These could provide reliable estimates of the timing and extent of the epidemic, the groups most at risk, whilst avoiding the biases of surveillance that reli...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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SciScore for 10.1101/2020.08.12.20173690: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement We obtained research ethics approval from the South Central-Berkshire B Research Ethics Committee (IRAS ID: 283787), and received MHRA approval for use of the LFIA for research purposes only. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
An important limitation was the exclusion of …
SciScore for 10.1101/2020.08.12.20173690: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement We obtained research ethics approval from the South Central-Berkshire B Research Ethics Committee (IRAS ID: 283787), and received MHRA approval for use of the LFIA for research purposes only. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
An important limitation was the exclusion of children for regulatory reasons as the tests were approved for research use in adults only. We used selfadministered home LFIA tests as opposed to “gold standard” laboratory tests based on a blood draw. However, we carried out extensive evaluation of the selected LFIA whch showed it to have acceptable performance in terms of both sensitivity and specificity in comparison with the confirmatory laboratory tests (21). We also took steps to measure and improve usability, including ability to perform and read an LFIA test, through public involvement and evaluation in a national study of 14,000 people. (22). Use of the LFIA enabled us to obtain antibody tests on large numbers, without the need for laboratory or health care personnel, over an 18-day period. Antibodies were strongly associated with clinical history of confirmed or suspected COVID-19, providing face validity; although there was a theoretical potential for reporting bias as respondents were not blinded to their test results, there was high concordance of self-reported with clinician-read results from the uploaded photos. Our results closely tracked other indicators of the epidemic curve and we believe that use of home-based self-tests is a sustainable model for community-based seroprevalence studies in other populations – to provide reliable estimates of the timing, extent and at risk groups of the epidemic, avoiding the biases of studies carried out in e.g. health care or work settings. In conclusion, our finding of substantial inequalities in SARS-CoV-2 prevalence by ethnicity and social deprivation shows the underlying importance of excess risk of exposure in these groups, and counters suggestions that the excess risk is due predominantly to comorbidities or other biological factors. The higher risk of infection in these groups may explain, at least in part, their increased risk of hospitalisation and mortality from COVID-19.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
About SciScore
SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.
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