Seroprevalence and correlates of SARS-CoV-2 neutralizing antibodies from a population-based study in Bonn, Germany

  1. N. Ahmad Aziz
  2. Victor M. Corman
  3. Antje K. C. Echterhoff
  4. Marcel A. Müller
  5. Anja Richter
  6. Antonio Schmandke
  7. Marie Luisa Schmidt
  8. Thomas H. Schmidt
  9. Folgerdiena M. de Vries
  10. Christian Drosten
  11. Monique M. B. Breteler

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Abstract

To estimate the seroprevalence and temporal course of SARS-CoV-2 neutralizing antibodies, we embedded a multi-tiered seroprevalence survey within an ongoing community-based cohort study in Bonn, Germany. We first assessed anti-SARS-CoV-2 immunoglobulin G levels with an immunoassay, followed by confirmatory testing of borderline and positive test results with a recombinant spike-based immunofluorescence assay and a plaque reduction neutralization test (PRNT). Those with a borderline or positive immunoassay result were retested after 4 to 5 months. At baseline, 4771 persons participated (88% response rate). Between April 24 th and June 30 th , 2020, seroprevalence was 0.97% (95% CI: 0.72−1.30) by immunoassay and 0.36% (95% CI: 0.21−0.61) when considering only those with two additional positive confirmatory tests. Importantly, about 20% of PRNT+ individuals lost their neutralizing antibodies within five months. Here, we show that neutralizing antibodies are detectable in only one third of those with a positive immunoassay result, and wane relatively quickly.

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  1. Version published to 10.1038/s41467-021-22351-5
  2. ScreenIT

    SciScore for 10.1101/2020.08.24.20181206: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: The sole exclusion criterion is insufficient command of the German language to provide informed consent.
    IRB: Approval to undertake the Rhineland Study was obtained from the ethics committee of the University of Bonn, Medical Faculty.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    First, the levels of IgG antibodies against SARS-CoV-2 were measured using a commercially available ELISA assay (Euroimmun, Lübeck, Germany).
    SARS-CoV-2
    suggested: None

    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:
    Our study has both strengths and limitations. By implementing this serosurvey in an ongoing community-based prospective cohort study, we were able to quickly reach and mobilize a large group of participants and achieve a very high response rate, thereby minimizing the risk of selection bias. This approach will also ensure systematic follow-up in the future, including serological reassessments, in a cohort of already deeply phenotyped individuals, allowing for the tracking of the evolution of the pandemic, identification of the determinants of susceptibility and resilience to SARS-CoV-2 infection, as well as elucidation of any long-term physical and mental health sequelae. The limitations of our study include the lack of a representative sample of the general population, since our study only enrolled individuals ≥ 30 years, and the fact that we did not assess SARS-CoV-2 specific T-cell response, another critical component of acquired immunity.27,28 Nevertheless, given the low (neutralizing antibody) seroprevalence, it is highly unlikely that the population seroprevalence in this region would materially differ from our estimates. Moreover, we are already planning to include indices of cellular immunity in follow-up serosurveys. In conclusion, we found a relatively low SARS-CoV-2 seroprevalence in participants of a large-scale community-based cohort study in Bonn, Germany (until June 30th, 2020), with neutralizing antibodies detectable in only one third of those with a positive ...

    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.

    About SciScore

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  3. Version published to 10.1101/2020.08.24.20181206v1 on medRxiv