SARS-CoV-2 antibody dynamics in blood donors and COVID-19 epidemiology in eight Brazilian state capitals: A serial cross-sectional study
- University of São Paulo, Brazil
- Imperial College London, United Kingdom
- Faculdade de Ciências Médicas de Minas Gerais, Brazil
- Universidade Federal do ABC, Brazil
- Institute for Applied Economic Research, Brazil
- Fundação Oswaldo Cruz, Brazil
- Fundacao Oswaldo Cruz, Brazil
- Fundação Pró-Sangue Hemocentro de São Paulo, Brazil
- Fundação Pró Sangue Hemocentro de São Paulo, Brazil
- Centro de Hematologia e Hemoterapia do Paraná, Brazil
- Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas, Brazil
- Fundação de Hematologia e Hemoterapia da Bahia, Brazil
- Centro de Hematologia e Hemoterapia do Ceará, Brazil
- Fundação Centro de Hematologia e Hemoterapia de Minas Gerais, Brazil
- Fundação de Hematologia e Hemoterapia de Pernambuco, Brazil
- Instituto Estadual de Hematologia Arthur de Siqueira Cavalcanti, Brazil
- Vitalant Research Institute, United States
- Harvard TH Chan School of Public Health, United States
- University of Oxford, United Kingdom
- Universidade de São Paulo, Brazil
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 eight of Brazil’s most populous cities. Residential postal codes were used to obtain representative samples. Weekly age- and sex- specific seroprevalence was 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 VOC was dominant, ranged from 19.3% (95% 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 (IHR) 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.
Funding: This work was supported by Itaú Unibanco 'Todos pela Saude' program; FAPESP (grants 18/14389-0, 2019/21585-0); Wellcome Trust and Royal Society Sir Henry Dale Fellowship 204311/Z/16/Z; the Gates Foundation (INV- 034540 and INV-034652); REDS-IV-P (grant HHSN268201100007I); the UK Medical Research Council (MR/S0195/1, MR/V038109/1); CAPES; CNPq (304714/2018-6); Fundação Faculdade de Medicina; Programa Inova Fiocruz-CE/Funcap - Edital 01/2020 Number: FIO-0167-00065.01.00/20 SPU Nº06531047/2020; JBS - Fazer o bem faz bem.
Data availability
All serological data required to reproduce the analyses are available at Data Dryad (doi:10.5061/dryad.dz08kps08) and can be downloaded at https://datadryad.org/stash/dataset/doi:10.5061/dryad.dz08kps08. The codes used for the main analyses are available at https://github.com/CADDE-CENTRE/seroprevalence_eight_cities.
-
Data from: SARS-CoV-2 antibody dynamics in blood donors and COVID-19 epidemiology in eight Brazilian state capitalsDryad Digital Repository, doi:10.5061/dryad.dz08kps08.
Article and author information
Author details
Carlos A Prete Junior Jr.
Manoel Barral-Netto
Cesar de Almeida-Neto
Vítor H Nascimento
Funding
Itau Unibanco (Todos pela Saúde)
- Nuno R Faria
- Ester C Sabino
CNPq (304714/2018-6)
- Vítor H Nascimento
FAPESP
- Suzete C Ferreira
Programa Inova FIOCRUZ-CE/Funcap (Edital 01/2020 Number: FIO-0167-00065.01.00/20 SPU Nº 06531047/2020)
- Fabio Miyajima
CNPq
- Manoel Barral-Netto
JBS - Fazer o bem faz bem
- Rafael FO Franca
Medical Research Council (MR/V038109/1)
- Oliver Ratmann
FAPESP (18/14389-0)
- Nuno R Faria
- Ester C Sabino
Medical Research Council (MR/S0195/1)
- Nuno R Faria
- Ester C Sabino
Wellcome Trust and Royal Society (Sir Henry Dale Fellowship 204311/Z/16/Z)
- Nuno R Faria
Gates Foundation (INV- 034540 and INV-034652)
- Nuno R Faria
- Ester C Sabino
National Heart, Lung, and Blood Institute Recipient Epidemiology and Donor Evaluation Study (HHSN268201100007I)
- Nuno R Faria
- Ester C Sabino
FAPESP (2019/21858-0)
- Carlos A Prete Junior Jr.
Fundacao Faculdade de Medicina
- Carlos A Prete Junior Jr.
CAPES (Finance Code 001)
- Carlos A Prete Junior Jr.
- Vítor H Nascimento
The National Heart, Lung, and Blood Institute Recipient Epidemiology and Donor Evaluation Study (REDS-IV-P) provided blood donor demographic and zip code data for analysis. The other funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.
Reviewing Editor
- James M McCaw, The University of Melbourne, Australia
Ethics
Human subjects: This project was approved by the Brazilian national research ethics committee, CONEP CAAE - 30178220.3.1001.0068. The Brazilian national research committee (CONEP) waived for informed consent. All methods were performed in accordance with relevant guidelines and regulations.
Version history
- Preprint posted: February 22, 2022 (view preprint)
- Received: February 28, 2022
- Accepted: September 17, 2022
- Accepted Manuscript published: September 22, 2022 (version 1)
- Accepted Manuscript updated: September 23, 2022 (version 2)
- Version of Record published: October 7, 2022 (version 3)
Copyright
© 2022, Prete Junior et al.
This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.
Metrics
-
- 1,181
- Page views
-
- 252
- Downloads
-
- 5
- Citations
Article citation count generated by polling the highest count across the following sources: PubMed Central, Crossref, Scopus.
Download links
A two-part list of links to download the article, or parts of the article, in various formats.
Downloads (link to download the article as PDF)
Open citations (links to open the citations from this article in various online reference manager services)
Cite this article (links to download the citations from this article in formats compatible with various reference manager tools)
SARS-CoV-2 antibody dynamics in blood donors and COVID-19 epidemiology in eight Brazilian state capitals: A serial cross-sectional study
eLife 11:e78233.
https://doi.org/10.7554/eLife.78233
Further reading
-
- Epidemiology and Global Health
Paxlovid, a SARS-CoV-2 antiviral, not only prevents severe illness but also curtails viral shedding, lowering transmission risks from treated patients. By fitting a mathematical model of within-host Omicron viral dynamics to electronic health records data from 208 hospitalized patients in Hong Kong, we estimate that Paxlovid can inhibit over 90% of viral replication. However, its effectiveness critically depends on the timing of treatment. If treatment is initiated three days after symptoms first appear, we estimate a 17% chance of a post-treatment viral rebound and a 12% (95% CI: 0%-16%) reduction in overall infectiousness for non-rebound cases. Earlier treatment significantly elevates the risk of rebound without further reducing infectiousness, whereas starting beyond five days reduces its efficacy in curbing peak viral shedding. Among the 104 patients who received Paxlovid, 62% began treatment within an optimal three-to-five-day day window after symptoms appeared. Our findings indicate that broader global access to Paxlovid, coupled with appropriately timed treatment, can mitigate the severity and transmission of SARS-Cov-2.
-
- Epidemiology and Global Health
Background:
Circulating omega-3 and omega-6 polyunsaturated fatty acids (PUFAs) have been associated with various chronic diseases and mortality, but results are conflicting. Few studies examined the role of omega-6/omega-3 ratio in mortality.
Methods:
We investigated plasma omega-3 and omega-6 PUFAs and their ratio in relation to all-cause and cause-specific mortality in a large prospective cohort, the UK Biobank. Of 85,425 participants who had complete information on circulating PUFAs, 6461 died during follow-up, including 2794 from cancer and 1668 from cardiovascular disease (CVD). Associations were estimated by multivariable Cox proportional hazards regression with adjustment for relevant risk factors.
Results:
Risk for all three mortality outcomes increased as the ratio of omega-6/omega-3 PUFAs increased (all Ptrend <0.05). Comparing the highest to the lowest quintiles, individuals had 26% (95% CI, 15–38%) higher total mortality, 14% (95% CI, 0–31%) higher cancer mortality, and 31% (95% CI, 10–55%) higher CVD mortality. Moreover, omega-3 and omega-6 PUFAs in plasma were all inversely associated with all-cause, cancer, and CVD mortality, with omega-3 showing stronger effects.
Conclusions:
Using a population-based cohort in UK Biobank, our study revealed a strong association between the ratio of circulating omega-6/omega-3 PUFAs and the risk of all-cause, cancer, and CVD mortality.
Funding:
Research reported in this publication was supported by the National Institute of General Medical Sciences of the National Institute of Health under the award number R35GM143060 (KY). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
