Serological testing of blood donors to characterise the impact of COVID-19 in Melbourne, Australia, 2020
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Abstract
Rapidly identifying and isolating people with acute SARS-CoV-2 infection has been a core strategy to contain COVID-19 in Australia, but a proportion of infections go undetected. We estimated SARS-CoV-2 specific antibody prevalence (seroprevalence) among blood donors in metropolitan Melbourne following a COVID-19 outbreak in the city between June and September 2020. The aim was to determine the extent of infection spread and whether seroprevalence varied demographically in proportion to reported cases of infection. The design involved stratified sampling of residual specimens from blood donors (aged 20–69 years) in three postcode groups defined by low (<3 cases/1,000 population), medium (3–7 cases/1,000 population) and high (>7 cases/1,000 population) COVID-19 incidence based on case notification data. All specimens were tested using the Wantai SARS-CoV-2 total antibody assay. Seroprevalence was estimated with adjustment for test sensitivity and specificity for the Melbourne metropolitan blood donor and residential populations, using multilevel regression and poststratification. Overall, 4,799 specimens were collected between 23 November and 17 December 2020. Seroprevalence for blood donors was 0.87% (90% credible interval: 0.25–1.49%). The highest estimates, of 1.13% (0.25–2.15%) and 1.11% (0.28–1.95%), respectively, were observed among donors living in the lowest socioeconomic areas (Quintiles 1 and 2) and lowest at 0.69% (0.14–1.39%) among donors living in the highest socioeconomic areas (Quintile 5). When extrapolated to the Melbourne residential population, overall seroprevalence was 0.90% (0.26–1.51%), with estimates by demography groups similar to those for the blood donors. The results suggest a lack of extensive community transmission and good COVID-19 case ascertainment based on routine testing during Victoria’s second epidemic wave. Residual blood donor samples provide a practical epidemiological tool for estimating seroprevalence and information on population patterns of infection, against which the effectiveness of ongoing responses to the pandemic can be assessed.
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SciScore for 10.1101/2022.03.11.22272185: (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:However, it is also well recognised that blood donors are a selected population, a limitation of using these samples. Blood donors tend to be healthier, may generally have a higher average income and education, and may also be at lower risk of COVID-19 infection than the general population [18, 19]. To help address this bias, we …
SciScore for 10.1101/2022.03.11.22272185: (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:However, it is also well recognised that blood donors are a selected population, a limitation of using these samples. Blood donors tend to be healthier, may generally have a higher average income and education, and may also be at lower risk of COVID-19 infection than the general population [18, 19]. To help address this bias, we collected residual specimens using a sampling approach that stratified based on case notification data to provide broad representation across the metropolitan Melbourne populations at risk of COVID-19. While our seroprevalence estimates were broadly consistent with corresponding relationships observed for notified cases, the patterns were not as pronounced. Of note, the ratio between the high and low incidence strata was 5.9-fold based on notified cases but only 1.5-fold based on seroprevalence. Similarly, the ratio between the lowest and highest socioeconomic quintiles was 3.4-fold based on notified cases, but only 1.6-fold based on seroprevalence. A previous study that used routine notification data to inform sampling to estimate seroprevalence in a single urban area in Houston, Texas, found a much greater divergence in seroprevalence between areas with high (18%) and low (10%) case notifications and between demographic groups known to be disproportionately affected by the pandemic. Overall seroprevalence in the city was 14%, suggesting extensive community transmission. The Houston study employed a random sampling approach of the general population ...
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.
Results from scite Reference Check: We found no unreliable references.
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