Monitoring the proportion of the population infected by SARS-CoV-2 using age-stratified hospitalisation and serological data: a modelling study
Year: 2021
Type: article
Abstract: BACKGROUND: Regional monitoring of the proportion of the population who have been infected by SARS-CoV-2 is important to guide local management of the epidemic, but is difficult in the absence of regular nationwide serosurveys. We aimed to estimate in near real time the proportion of adults who have been infected by SARS-CoV-2. METHODS: In this modelling study, we developed a method to reconstruct the proportion of adults who have been infected by SARS-CoV-2 and the proportion of infections being detected, using the joint analysis of age-stratified seroprevalence, hospitalisation, and case data, with deconvolution methods. We developed our method on a dataset consisting of seroprevalence estimates from 9782 participants (aged ≥20 years) in the two worst affected regions of France in May, 2020, and applied our approach to the 13 French metropolitan regions over the period March, 2020, to January, 2021. We validated our method externally using data from a national seroprevalence study done between May and June, 2020. FINDINGS: We estimate that 5·7% (95% CI 5·1-6·4) of adults in metropolitan France had been infected with SARS-CoV-2 by May 11, 2020. This proportion remained stable until August, 2020, and increased to 14·9% (13·2-16·9) by Jan 15, 2021. With 26·5% (23·4-29·8) of adult residents having been infected in Île-de-France (Paris region) compared with 5·1% (4·5-5·8) in Brittany by January, 2021, regional variations remained large (coefficient of variation [CV] 0·50) although less so than in May, 2020 (CV 0·74). The proportion infected was twice as high (20·4%, 15·6-26·3) in 20-49-year-olds than in individuals aged 50 years or older (9·7%, 6·9-14·1). 40·2% (34·3-46·3) of infections in adults were detected in June to August, 2020, compared with 49·3% (42·9-55·9) in November, 2020, to January, 2021. Our regional estimates of seroprevalence were strongly correlated with the external validation dataset (coefficient of correlation 0·89). INTERPRETATION: Our simple approach to estimate the proportion of adults that have been infected with SARS-CoV-2 can help to characterise the burden of SARS-CoV-2 infection, epidemic dynamics, and the performance of surveillance in different regions. FUNDING: EU RECOVER, Agence Nationale de la Recherche, Fondation pour la Recherche Médicale, Institut National de la Santé et de la Recherche Médicale (Inserm).
Source: The Lancet Public Health
Institutions: Centre National de la Recherche Scientifique, Institut Pasteur, Génomique évolutive, modélisation et santé, Santé Publique France, Inserm, Sorbonne Université, Institut Pierre Louis d‘Épidémiologie et de Santé Publique, University of Cambridge, Cambridge University Press, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay, Institut Gustave Roussy, Centre de recherche en Epidémiologie et Santé des Populations, University of Florence, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Université Sorbonne Paris Nord, Equipe de Recherche en Epidémiologie Nutritionnelle, Centre de Recherche Épidémiologie et Statistique, Université Paris Cité, Hôpital Paul-Brousse, Cohortes épidémiologiques en population, Aix-Marseille Université, Méditerranée Infection Foundation, Institut de Recherche pour le Développement, Unité des Virus Emergents
Language: English
Subfield: Modeling and Simulation
Field: Mathematics
Domain: Physical Sciences
Open Access status: gold
Estimated APC paid: $4,723
Funders: AstraZeneca, Ministère de l'Enseignement supérieur, de la Recherche et de l'Innovation, European Commission, Agence Nationale de la Recherche, Institut National de la Santé et de la Recherche Médicale, Fondation pour la Recherche Médicale, Institut Pasteur, Ligue Contre le Cancer, Ministère des Affaires Sociales et de la Santé, Institut National de la Recherche Agronomique, Université Paris-Saclay, Mutuelle Générale de l'Education Nationale, H. Lundbeck A/S, Merck Sharp and Dohme, Horizon 2020
Awards: G1241864088, G1418548345, G1848624916, G1947072214, G1979782309, G2100353928, Versatile Emerging infectious disease Observatory, G282427092, La cohorte CONSTANCES - Infrastructure épidémiologique ouverte pour la recherche et la surveillance, G4153445168, G434337789, G456987127, Rapid European SARS-CoV-2 Emergency research Response, Institut Convergences pour l’étude de l’Emergence des Pathologies au Travers des Individus et des populatiONs, Etude Epidémiologique des Enfants de femmes de l'Education Nationale, G6048378198, Institut français de bioinformatique, G6899110680, Santé, perception, pratiques, relations et inégalités sociales en population générale pendant la crise COVID-19 - Sérologie, Study of the levers to Maximize Vaccine uptake against Covid-19 in the adult population aged 18-64 years at low risk of severe infection, Health, Perception, Practices, Relationships and Social Inequalities in the General Population during the Crisis COVID-19, G7240651115, Integrative Biology of Emerging Infectious Diseases, G7838947372, G7916265299, G7984917001, G8670608220, G8863602888
OpenAlex ID: W3141259803