Estimates of the rate of infection and asymptomatic COVID-19 disease in a population sample from SE England

TY - JOUR

T1 - Estimates of the rate of infection and asymptomatic COVID-19 disease in a population sample from SE England

AU - Wells, Philippa M.

AU - Doores, Katie J.

AU - Couvreur, Simon

AU - Nunez, Rocio Martinez

AU - Seow, Jeffrey

AU - Graham, Carl

AU - Acors, Sam

AU - Kouphou, Neophytos

AU - Neil, Stuart J.D.

AU - Tedder, Richard S.

AU - Matos, Pedro M.

AU - Poulton, Kate

AU - Lista, Maria Jose

AU - Dickenson, Ruth E.

AU - Sertkaya, Helin

AU - Maguire, Thomas J.A.

AU - Scourfield, Edward J.

AU - Bowyer, Ruth C.E.

AU - Hart, Deborah

AU - O'Byrne, Aoife

AU - Steel, Kathryn J.A.

AU - Hemmings, Oliver

AU - Rosadas, Carolina

AU - McClure, Myra O.

AU - Capedevilla-pujol, Joan

AU - Wolf, Jonathan

AU - Ourselin, Sebastien

AU - Brown, Matthew A.

AU - Malim, Michael H.

AU - Spector, Tim

AU - Steves, Claire J.

PY - 2020/12

Y1 - 2020/12

N2 - Background: Understanding of the true asymptomatic rate of infection of SARS-CoV-2 is currently limited, as is understanding of the population-based seroprevalence after the first wave of COVID-19 within the UK. The majority of data thus far come from hospitalised patients, with little focus on general population cases, or their symptoms. Methods: We undertook enzyme linked immunosorbent assay characterisation of IgM and IgG responses against SARS-CoV-2 spike glycoprotein and nucleocapsid protein of 431 unselected general-population participants of the TwinsUK cohort from South-East England, aged 19–86 (median age 48; 85% female). 382 participants completed prospective logging of 14 COVID-19 related symptoms via the COVID Symptom Study App, allowing consideration of serology alongside individual symptoms, and a predictive algorithm for estimated COVID-19 previously modelled on PCR positive individuals from a dataset of over 2 million. Findings: We demonstrated a seroprevalence of 12% (51 participants of 431). Of 48 seropositive individuals with full symptom data, nine (19%) were fully asymptomatic, and 16 (27%) were asymptomatic for core COVID-19 symptoms: fever, cough or anosmia. Specificity of anosmia for seropositivity was 95%, compared to 88% for fever cough and anosmia combined. 34 individuals in the cohort were predicted to be Covid-19 positive using the App algorithm, and of those, 18 (52%) were seropositive. Interpretation: Seroprevalence amongst adults from London and South-East England was 12%, and 19% of seropositive individuals with prospective symptom logging were fully asymptomatic throughout the study. Anosmia demonstrated the highest symptom specificity for SARS-CoV-2 antibody response. Funding: NIHR BRC, CDRF, ZOE global LTD, RST-UKRI/MRC.

AB - Background: Understanding of the true asymptomatic rate of infection of SARS-CoV-2 is currently limited, as is understanding of the population-based seroprevalence after the first wave of COVID-19 within the UK. The majority of data thus far come from hospitalised patients, with little focus on general population cases, or their symptoms. Methods: We undertook enzyme linked immunosorbent assay characterisation of IgM and IgG responses against SARS-CoV-2 spike glycoprotein and nucleocapsid protein of 431 unselected general-population participants of the TwinsUK cohort from South-East England, aged 19–86 (median age 48; 85% female). 382 participants completed prospective logging of 14 COVID-19 related symptoms via the COVID Symptom Study App, allowing consideration of serology alongside individual symptoms, and a predictive algorithm for estimated COVID-19 previously modelled on PCR positive individuals from a dataset of over 2 million. Findings: We demonstrated a seroprevalence of 12% (51 participants of 431). Of 48 seropositive individuals with full symptom data, nine (19%) were fully asymptomatic, and 16 (27%) were asymptomatic for core COVID-19 symptoms: fever, cough or anosmia. Specificity of anosmia for seropositivity was 95%, compared to 88% for fever cough and anosmia combined. 34 individuals in the cohort were predicted to be Covid-19 positive using the App algorithm, and of those, 18 (52%) were seropositive. Interpretation: Seroprevalence amongst adults from London and South-East England was 12%, and 19% of seropositive individuals with prospective symptom logging were fully asymptomatic throughout the study. Anosmia demonstrated the highest symptom specificity for SARS-CoV-2 antibody response. Funding: NIHR BRC, CDRF, ZOE global LTD, RST-UKRI/MRC.

KW - Anosmia

KW - Antibody

KW - Asymptomatic

KW - COVID-19

KW - Immunity

KW - Population

KW - SARS-CoV-2

KW - Seropoprevalence

KW - UK

UR - http://www.scopus.com/inward/record.url?scp=85094123297&partnerID=8YFLogxK

U2 - 10.1016/j.jinf.2020.10.011

DO - 10.1016/j.jinf.2020.10.011

M3 - Article

C2 - 33068628

AN - SCOPUS:85094123297

SN - 0163-4453

VL - 81

SP - 931

EP - 936

JO - Journal of Infection

JF - Journal of Infection

IS - 6

ER -