SARS-CoV-2 antibody prevalence and correlates of six ethnic groups living in Amsterdam, the Netherlands: a population-based cross-sectional study, June–October 2020

  1. Liza Coyer
  2. Anders Boyd
  3. Janke Schinkel
  4. Charles Agyemang
  5. Henrike Galenkamp
  6. Anitra D M Koopman
  7. Tjalling Leenstra
  8. Eric P Moll van Charante
  9. Bert-Jan H van den Born
  10. Anja Lok
  11. Arnoud Verhoeff
  12. Aeilko H Zwinderman
  13. Suzanne Jurriaans
  14. Lonneke A van Vught
  15. Karien Stronks
  16. Maria Prins

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Abstract

It has been suggested that ethnic minorities have been disproportionally affected by the COVID-19. We aimed to determine whether prevalence and correlates of past SARS-CoV-2 exposure varied between six ethnic groups in Amsterdam, the Netherlands.

Design, setting, participants

Participants aged 25–79 years enrolled in the Healthy Life in an Urban Setting population-based prospective cohort (n=16 889) were randomly selected within ethnic groups and invited to participate in a cross-sectional COVID-19 seroprevalence substudy.

Outcome measures

We tested participants for SARS-CoV-2-specific antibodies and collected information on SARS-CoV-2 exposures. We estimated prevalence and correlates of SARS-CoV-2 exposure within ethnic groups using survey-weighted logistic regression adjusting for age, sex and calendar time.

Results

Between 24 June and 9 October 2020, we included 2497 participants. Adjusted SARS-CoV-2 seroprevalence was comparable between ethnic Dutch (24/498; 5.1%, 95% CI 2.8% to 7.4%), South-Asian Surinamese (22/451; 4.9%, 95% CI 2.2% to 7.7%), African Surinamese (22/400; 8.3%, 95% CI 3.1% to 13.6%), Turkish (30/408; 7.9%, 95% CI 4.4% to 11.4%) and Moroccan (32/391; 7.2%, 95% CI 4.2% to 10.1%) participants, but higher among Ghanaians (95/327; 26.3%, 95% CI 18.5% to 34.0%). 57.1% of SARS-CoV-2-positive participants did not suspect or were unsure of being infected, which was lowest in African Surinamese (18.2%) and highest in Ghanaians (90.5%). Correlates of SARS-CoV-2 exposure varied across ethnic groups, while the most common correlate was having a household member suspected of infection. In Ghanaians, seropositivity was associated with older age, larger household sizes, living with small children, leaving home to work and attending religious services.

Conclusions

No remarkable differences in SARS-CoV-2 seroprevalence were observed between the largest ethnic groups in Amsterdam after the first wave of infections. The higher infection seroprevalence observed among Ghanaians, which passed mostly unnoticed, warrants wider prevention efforts and opportunities for non-symptom-based testing.

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  1. Version published to 10.1136/bmjopen-2021-052752
  2. ScreenIT

    SciScore for 10.1101/2021.03.08.21252788: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementIRB: Ethical approval for the HELIUS study was obtained from the Academic Medical Center Ethical Review Board.
    Consent: All participants provided written informed consent.
    RandomizationParticipants were randomly selected within each ethnic group and asked to participate in the substudy.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variableFor post-stratification, a weight was assigned corresponding to the proportion representing the Amsterdam population of each stratum of age (20-44, 45-54, 55-59, 60-79 years), sex (male, female) and ethnicity (Surinamese, Ghanaian, Moroccan, Turkish, Dutch).

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Given the weighting scheme of this study, variance was calculated with the designed-based Taylor series linearization method using the ‘svy’ commands in STATA.
    STATA
    suggested: (Stata, RRID:SCR_012763)
    All analyses were conducted using Stata 15.1 (StataCorp, College Station, TX, USA).
    StataCorp
    suggested: (Stata, RRID:SCR_012763)

    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:
    Nonetheless, there are several limitations. First, our study includes a random subsample of HELIUS participants and there may be selection bias. Undocumented people and other ethnic groups living in Amsterdam were not included in the parent study. Second, participants in our substudy may have been more concerned about their health compared to non-participants. Notwithstanding the differential response rate between ethnicities in this substudy, the distribution of characteristics was largely similar between included and non-included HELIUS participants. Our estimates, corrected for sampling and post-stratification, were also close to those from a nationwide study that included mainly people of Dutch origin and revealed a 6% seroprevalence among the Amsterdam population in June 2020.[35] Data were also collected over a span of 4 months, which reflects different points of the epidemic, and thus the timing of testing could bias estimates. We attempted to mitigate this issue by adjusting for calendar time. Furthermore, prevention measures remained mostly the same and nationwide incidence was quite stable during this period, thereby limiting the effect of this bias.[8,36] Third, as this study was cross-sectional and infection occurred in the past, it is difficult to make any causal inference with respect to determinants. Fourth, fear of stigmatization or consequences for work might have led to an underreporting of suspected past infection and symptoms, particularly among Ghanaians....

    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 10.1101/2021.03.08.21252788v1 on medRxiv