Continuous population-level monitoring of SARS-CoV-2 seroprevalence in a large metropolitan region
Emmenegger M., Cecco ED., Lamparter D., Jacquat RPB., Riou J., Menges D., Ballouz T., Ebner D., Schneider MM., Morales IC., Doğançay B., Guo J., Wiedmer A., Domange J., Imeri M., Moos R., Zografou C., Batkitar L., Madrigal L., Schneider D., Trevisan C., Gonzalez-Guerra A., Carrella A., Dubach IL., Xu CK., Meisl G., Kosmoliaptsis V., Malinauskas T., Burgess-Brown N., Owens R., Hatch S., Mongkolsapaya J., Screaton GR., Schubert K., Huck JD., Liu F., Pojer F., Lau K., Hacker D., Probst-Müller E., Cervia C., Nilsson J., Boyman O., Saleh L., Spanaus K., von Eckardstein A., Schaer DJ., Ban N., Tsai C-J., Marino J., Schertler GFX., Ebert N., Thiel V., Gottschalk J., Frey BM., Reimann R., Hornemann S., Ring AM., Knowles TPJ., Puhan MA., Althaus CL., Xenarios I., Stuart DI., Aguzzi A.
AbstractEffective public-health measures and vaccination campaigns against SARS-CoV-2 require granular knowledge of population-level immune responses. We developed a Tripartite Automated Blood Immunoassay (TRABI) to assess the IgG response against the ectodomain and the receptor-binding domain of the spike protein as well as the nucleocapsid protein of SARS-CoV-2. We used TRABI for continuous seromonitoring of hospital patients and healthy blood donors (n=72’222) in the canton of Zurich from December 2019 to December 2020 (pre-vaccine period). Seroprevalence peaked in May 2020 and rose again in November 2020 in both cohorts. Validations of results included antibody diffusional sizing and Western Blotting. Using an extended Susceptible-Exposed-Infectious-Removed model, we found that antibodies waned with a half-life of 75 days, whereas the cumulative incidence rose from 2.3% in June 2020 to 12.2% in mid-December 2020 in the population of the canton of Zurich. A follow-up health survey indicated that about 10% of patients infected with wildtype SARS-CoV-2 sustained some symptoms at least twelve months post COVID-19 and up to the timepoint of survey participation. Crucially, we found no evidence for a difference in long-term complications between those whose infection was symptomatic and those with asymptomatic acute infection. The cohort of asymptomatic SARS-CoV-2- infected subjects represents a resource for the study of chronic and possibly unexpected sequelae.