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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Given the rapid cross-country spread of SARS-CoV-2 and the resulting difficulty in tracking lineage spread, we investigated the potential of combining mobile service data and fine-granular metadata (such as postal codes and genomic data) to advance integrated genomic surveillance of the pandemic in the federal state of Thuringia, Germany. We sequenced over 6500 SARS-CoV-2 Alpha genomes (B.1.1.7) across 7 months within Thuringia while collecting patients’ isolation dates and postal codes. Our dataset is complemented by over 66,000 publicly available German Alpha genomes and mobile service data for Thuringia. We identified the existence and spread of nine persistent mutation variants within the Alpha lineage, seven of which formed separate phylogenetic clusters with different spreading patterns in Thuringia. The remaining two are subclusters. Mobile service data can indicate these clusters’ spread and highlight a potential sampling bias, especially of low-prevalence variants. Thereby, mobile service data can be used either retrospectively to assess surveillance coverage and efficiency from already collected data or to actively guide part of a surveillance sampling process to districts where these variants are expected to emerge. The latter concept was successfully implemented as a proof-of-concept for a mobility-guided sampling strategy in response to the surveillance of Omicron sublineage BQ.1.1. The combination of mobile service data and SARS-CoV-2 surveillance by genome sequencing is a valuable tool for more targeted and responsive surveillance.
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- Epidemiology and Global Health
Background: The role of circulating metabolites on child development is understudied. We investigated associations between children's serum metabolome and early childhood development (ECD).
Methods: Untargeted metabolomics was performed on serum samples of 5,004 children aged 6-59 months, a subset of participants from the Brazilian National Survey on Child Nutrition (ENANI-2019). ECD was assessed using the Survey of Well-being of Young Children's milestones questionnaire. The graded response model was used to estimate developmental age. Developmental quotient (DQ) was calculated as the developmental age divided by chronological age. Partial least square regression selected metabolites with a variable importance projection ≥ 1. The interaction between significant metabolites and the child's age was tested.
Results: Twenty-eight top-ranked metabolites were included in linear regression models adjusted for the child's nutritional status, diet quality, and infant age. Cresol sulfate (β = -0.07; adjusted-p < 0.001), hippuric acid (β = -0.06; adjusted-p < 0.001), phenylacetylglutamine (β = -0.06; adjusted-p < 0.001), and trimethylamine-N-oxide (β = -0.05; adjusted-p = 0.002) showed inverse associations with DQ. We observed opposite directions in the association of DQ for creatinine (for children aged -1 SD: β = -0.05; p =0.01; +1 SD: β = 0.05; p =0.02) and methylhistidine (-1 SD: β = - 0.04; p =0.04; +1 SD: β = 0.04; p =0.03).
Conclusion: Serum biomarkers, including dietary and microbial-derived metabolites involved in the gut-brain axis, may potentially be used to track children at risk for developmental delays.
Funding: Supported by the Brazilian Ministry of Health and the Brazilian National Research Council.
