SARS-CoV-2 antibody dynamics in blood donors and COVID-19 epidemiology in eight Brazilian state capitals: A serial cross-sectional study

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Prete, Carlos A., Jr. ; Buss, Lewis F. ; Whittaker, Charles ; Salomon, Tassila ; Oikawa, Marcio K. ; Pereira, Rafael H. M. ; Moura, Isabel C. G. ; Delerino, Lucas ; Barral-Netto, Manoel ; Tavares, Natalia M. ; Franca, Rafael F. O. ; Boaventura, Viviane S. ; Miyajima, Fabio ; Mendrone-Junior, Alfredo ; De Almeida-Neto, Cesar ; Salles, Nanci A. ; Ferreira, Suzete C. ; Fladzinski, Karine A. ; de Souza, Luana M. ; Schier, Luciane K. ; Inoue, Patricia M. ; Xabregas, Lilyane A. ; Crispim, Myuki A. E. ; Fraiji, Nelson ; Araujo, Fernando L., V ; Carlos, Luciana M. B. ; Pessoa, Veridiana ; Ribeiro, Maisa A. ; de Souza, Rosenvaldo E. ; da Silva, Sonia M. N. ; Cavalcante, Anna F. ; Valenca, Maria I. B. ; da Silva, Maria, V ; Lopes, Esther ; Filho, Luiz A. ; Mateos, Sheila O. G. ; Nunes, Gabrielle T. ; Silva-Junior, Alexander L. ; Busch, Michael P. ; Castro, Marcia C. ; Dye, Christopher ; Ratmann, Oliver ; Faria, Nuno R. ; Nascimento, Vitor H. ; Sabino, Ester C.

• Document type: Journal article
• Source: eLIFE; v. 11, p. 53-pg., 2022-09-22.

Abstract

Background: The COVID-19 situation in Brazil is complex due to large differences in the shape and size of regional epidemics. Understanding these patterns is crucial to understand future outbreaks of SARS-CoV-2 or other respiratory pathogens in the country. Methods: We tested 97,950 blood donation samples for IgG antibodies from March 2020 to March 2021 in 8 of Brazil's most populous cities. Residential postal codes were used to obtain representative samples. Weekly age- and sex-specific seroprevalence were estimated by correcting the crude seroprevalence by test sensitivity, specificity, and antibody waning. Results: The inferred attack rate of SARS-CoV-2 in December 2020, before the Gamma variant of concern (VOC) was dominant, ranged from 19.3% (95% credible interval [CrI] 17.5-21.2%) in Curitiba to 75.0% (95% CrI 70.8-80.3%) in Manaus. Seroprevalence was consistently smaller in women and donors older than 55 years. The age-specific infection fatality rate (IFR) differed between cities and consistently increased with age. The infection hospitalisation rate increased significantly during the Gamma-dominated second wave in Manaus, suggesting increased morbidity of the Gamma VOC compared to previous variants circulating in Manaus. The higher disease penetrance associated with the health system's collapse increased the overall IFR by a minimum factor of 2.91 (95% CrI 2.43-3.53). Conclusions: These results highlight the utility of blood donor serosurveillance to track epidemic maturity and demonstrate demographic and spatial heterogeneity in SARS-CoV-2 spread. (AU)

• FAPESP's process: 18/14389-0 - Brazil-UK Centre for Arbovirus Discovery, Diagnosis, Genomics and Epidemiology (CADDE)
• Grantee: Ester Cerdeira Sabino
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 19/21858-0 - Bayesian models for estimating the attack rate of epidemics
• Grantee: Carlos Augusto Prete Junior
• Support Opportunities: Scholarships in Brazil - Doctorate