COVID-19 antibody seroprevalence in Duhok, Kurdistan Region, Iraq: A population-based study

  1. Nawfal R Hussein
  2. Amer A Balatay
  3. Ibrahim A Naqid
  4. Shakir A Jamal
  5. Narin A Rasheed
  6. Alind N Ahmed
  7. Reving S Salih
  8. Ahmed S Mahdi
  9. Sabeeha A Mansour
  10. Shaveen Mahdi
  11. Nashwan Ibrahim
  12. Dildar H Musa
  13. Zana SM. Saleem

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Abstract

Objective

This population-based study aimed to evaluate the seroprevalence of antibodies to SARS-CoV-2 in Duhok City, Kurdistan Region of Iraq.

Methods

We analyzed the national COVID-19 database that contains data regarding COVID-19 testing, management, and clinical outcomes in Duhok. For this study, different subdistricts within each district of Duhok were considered distinct clusters. Blood samples were collected from and questionnaires were administered to eligible and consenting participants who were members of different families from the subdistricts. Immunoassays were conducted to detect antibodies against SARS-CoV-2, and the associations between certain variables were investigated.

Results

The average number cases of COVID-19 before November 2020 was 23141 ± 4364, which was significantly higher than the average number of cases between November 2020 and February 2021 (3737 ± 2634; P = 0.001). A total of 743 individuals agreed to participate and were enrolled in the study. Among the participants, 465/743 (62.58%) were found to have antibodies against severe acute respiratory syndrome coronavirus 2. Among the participants with antibodies, 262/465 (56.34%) denied having any history of COVID-19-related symptoms. The most common symptom was fever (81.77%), followed by myalgia (81.28%). We found that antibody levels increased steadily with age (Pearson correlation coefficient = 0.117; P = 0.012). A significant association was found between antibody levels and the presence of symptoms (P = 0.023; odds ratio = 1.0023; 95% confidence interval = 1.0002-1.0061).

Conclusions

A significant reduction in the number of COVID-19 cases was observed. This might be due to the high prevalence of SARS-CoV-2 antibodies in Duhok. However, infection-prevention measures should be followed as it remains unclear whether acquired immunity is protective against reinfection. It expected that the infection rates during the next wave will not be as high as the first wave due to the high infection rate in the society.

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  1. ScreenIT

    SciScore for 10.1101/2021.03.23.21254169: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementConsent: Ethics: The study protocol and method of obtaining consent were approved by the Ethics and Scientific Committee of the University of Zakho’s College of Medicine.
    RandomizationFinally, from each selected family, two people were randomly chosen to participate.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    SARS-CoV-2 antibody measurement: Elecsys Anti-SARS-CoV-2 (Roche Diagnostics International Ltd, Rotkreuz, Switzerland), which is an immunoassay for the in vitro qualitative detection of antibodies (including IgG) to SARS-CoV-2, was used to determine antibody levels.
    SARS-CoV-2
    suggested: None
    Software and Algorithms
    SentencesResources
    Statistical analysis was performed using Minitab 17.
    Minitab
    suggested: (Minitab, RRID:SCR_014483)

    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 had certain limitations. First, we could not ascertain the representativeness of SARS-CoV-2 antibodies in groups with possibly high prevalence, such as healthcare workers and nursing-home residents and workers. Additionally, we could not reach remote villages due to transportation difficulties, particularly those caused by the snowy winter weather. In conclusion, a significant reduction in the number of COVID-19 cases was observed. This may be due to the high prevalence of SARS-CoV-2 antibodies in Duhok. To control the spread of COVID-19, it is extremely important for members of society to follow social-distancing measures. It expected that the infection rates during the second wave will not be as high as the first wave due to the high infection rate in the society. Locally derived population prevalence estimates should be used to develop infection control plans.

    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

    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.

  2. Version published to 10.1101/2021.03.23.21254169v1 on medRxiv