Seroprevalence of IgG antibodies against SARS-CoV-2 – a serial prospective cross-sectional nationwide study of residual samples, Belgium, March to October 2020

Sereina Annik Herzog, Jessie De Bie, Steven Abrams, Ine Wouters, Esra Ekinci , Lisbeth Patteet, Astrid Coppens, Sandy De Spiegeleer, Philippe Beutels, Pierre Van Damme, Niel Hens, Heidi Theeten
 Eurosurveillance, Volume 27, Issue 9

Abstract

Background

To control epidemic waves, it is important to know the susceptibility to SARS-CoV-2 and its evolution over time in relation to the control measures taken.

Aim

To assess the evolving SARS-CoV-2 seroprevalence and seroincidence related to the first national lockdown in Belgium, we performed a nationwide seroprevalence study, stratified by age, sex and region using 3,000–4,000 residual samples during seven periods between 30 March and 17 October 2020.

Methods

We analysed residual sera from ambulatory patients for IgG antibodies against the SARS-CoV-2 S1 protein with a semiquantitative commercial ELISA. Weighted seroprevalence (overall and by age category and sex) and seroincidence during seven consecutive periods were estimated for the Belgian population while accommodating test-specific sensitivity and specificity.

Results

The weighted overall seroprevalence initially increased from 1.8% (95% credible interval (CrI): 1.0–2.6) to 5.3% (95% CrI: 4.2–6.4), implying a seroincidence of 3.4% (95% CrI: 2.4–4.6) between the first and second collection period over a period of 3 weeks during lockdown (start lockdown mid-March 2020). Thereafter, seroprevalence stabilised, however, significant decreases were observed when comparing the third with the fifth, sixth and seventh period, resulting in negative seroincidence estimates after lockdown was lifted. We estimated for the last collection period mid-October 2020 a weighted overall seroprevalence of 4.2% (95% CrI: 3.1–5.2).

Conclusion

During lockdown, an initially small but increasing fraction of the Belgian population showed serologically detectable signs of exposure to SARS-CoV-2, which did not further increase when confinement measures eased and full lockdown was lifted.

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Seroprevalence of IgG antibodies against SARS-CoV-2 – a serial prospective cross-sectional nationwide study of residual samples, Belgium, March to October 2020