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.
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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
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 Jr
Fundacao Faculdade de Medicina
- Carlos A Prete Jr
CAPES (Finance Code 001)
- Carlos A Prete 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.
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.
Copyright
© 2022, Prete 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.
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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
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- Epidemiology and Global Health
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Biological aging exhibits heterogeneity across multi-organ systems. However, it remains unclear how is lifestyle associated with overall and organ-specific aging and which factors contribute most in Southwest China.
Methods:
This study involved 8396 participants who completed two surveys from the China Multi-Ethnic Cohort (CMEC) study. The healthy lifestyle index (HLI) was developed using five lifestyle factors: smoking, alcohol, diet, exercise, and sleep. The comprehensive and organ-specific biological ages (BAs) were calculated using the Klemera–Doubal method based on longitudinal clinical laboratory measurements, and validation were conducted to select BA reflecting related diseases. Fixed effects model was used to examine the associations between HLI or its components and the acceleration of validated BAs. We further evaluated the relative contribution of lifestyle components to comprehension and organ systems BAs using quantile G-computation.
Results:
About two-thirds of participants changed HLI scores between surveys. After validation, three organ-specific BAs (the cardiopulmonary, metabolic, and liver BAs) were identified as reflective of specific diseases and included in further analyses with the comprehensive BA. The health alterations in HLI showed a protective association with the acceleration of all BAs, with a mean shift of –0.19 (95% CI −0.34, –0.03) in the comprehensive BA acceleration. Diet and smoking were the major contributors to overall negative associations of five lifestyle factors, with the comprehensive BA and metabolic BA accounting for 24% and 55% respectively.
Conclusions:
Healthy lifestyle changes were inversely related to comprehensive and organ-specific biological aging in Southwest China, with diet and smoking contributing most to comprehensive and metabolic BA separately. Our findings highlight the potential of lifestyle interventions to decelerate aging and identify intervention targets to limit organ-specific aging in less-developed regions.
Funding:
This work was primarily supported by the National Natural Science Foundation of China (Grant No. 82273740) and Sichuan Science and Technology Program (Natural Science Foundation of Sichuan Province, Grant No. 2024NSFSC0552). The CMEC study was funded by the National Key Research and Development Program of China (Grant No. 2017YFC0907305, 2017YFC0907300). The sponsors had no role in the design, analysis, interpretation, or writing of this article.
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- Epidemiology and Global Health
- Microbiology and Infectious Disease
Background:
In many settings, a large fraction of the population has both been vaccinated against and infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Hence, quantifying the protection provided by post-infection vaccination has become critical for policy. We aimed to estimate the protective effect against SARS-CoV-2 reinfection of an additional vaccine dose after an initial Omicron variant infection.
Methods:
We report a retrospective, population-based cohort study performed in Shanghai, China, using electronic databases with information on SARS-CoV-2 infections and vaccination history. We compared reinfection incidence by post-infection vaccination status in individuals initially infected during the April–May 2022 Omicron variant surge in Shanghai and who had been vaccinated before that period. Cox models were fit to estimate adjusted hazard ratios (aHRs).
Results:
275,896 individuals were diagnosed with real-time polymerase chain reaction-confirmed SARS-CoV-2 infection in April–May 2022; 199,312/275,896 were included in analyses on the effect of a post-infection vaccine dose. Post-infection vaccination provided protection against reinfection (aHR 0.82; 95% confidence interval 0.79–0.85). For patients who had received one, two, or three vaccine doses before their first infection, hazard ratios for the post-infection vaccination effect were 0.84 (0.76–0.93), 0.87 (0.83–0.90), and 0.96 (0.74–1.23), respectively. Post-infection vaccination within 30 and 90 days before the second Omicron wave provided different degrees of protection (in aHR): 0.51 (0.44–0.58) and 0.67 (0.61–0.74), respectively. Moreover, for all vaccine types, but to different extents, a post-infection dose given to individuals who were fully vaccinated before first infection was protective.
Conclusions:
In previously vaccinated and infected individuals, an additional vaccine dose provided protection against Omicron variant reinfection. These observations will inform future policy decisions on COVID-19 vaccination in China and other countries.
Funding:
This study was funded the Key Discipline Program of Pudong New Area Health System (PWZxk2022-25), the Development and Application of Intelligent Epidemic Surveillance and AI Analysis System (21002411400), the Shanghai Public Health System Construction (GWVI-11.2-XD08), the Shanghai Health Commission Key Disciplines (GWVI-11.1-02), the Shanghai Health Commission Clinical Research Program (20214Y0020), the Shanghai Natural Science Foundation (22ZR1414600), and the Shanghai Young Health Talents Program (2022YQ076).
