Infection and Drug Resistance (Jan 2023)
Seroprevalence of SARS-CoV-2 Antibodies in Denmark: Results of Two Nationwide Population-Based Surveys, February and May 2021
Abstract
Lene Wulff Krogsgaard,1 Laura Espenhain,1 Siri Tribler,1 Charlotte Sværke Jørgensen,2 Christian Holm Hansen,1 Frederik Trier Møller,1 Ida Glode Helmuth,1 Ute Wolff Sönksen,3,4 Anne-Marie Vangsted,4 Henrik Ullum,5 Steen Ethelberg1,6 1Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark; 2Department of Virus & Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark; 3Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark; 4TestCentre Denmark, Statens Serum Institut, Copenhagen, Denmark; 5Division of Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark; 6Department of Public Health, University of Copenhagen, Copenhagen, DenmarkCorrespondence: Steen Ethelberg, Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, 5 Artillerivej, 2300 Copenhagen, Denmark, Tel +45 3268 3545, Email [email protected]: Seroprevalence studies can be used to measure the progression of national COVID-19 epidemics. The Danish National Seroprevalence Survey of SARS-CoV-2 infections (DSS) was conducted as five separate surveys between May 2020 and May 2021. Here, we present results from the two last surveys conducted in February and May 2021.Methods: Persons aged 12 or older were randomly selected from the Danish Population Register and those having received COVID-19 vaccination subsequently excluded. Invitations to have blood drawn in local test centers were sent by mail. Samples were analyzed for whole Immunoglobulin by ELISA. Seroprevalence was estimated by sex, age and geography. Comparisons to vaccination uptake and RT-PCR test results were made.Results: In February 2021, we found detectable antibodies in 7.2% (95% CI: 6.3– 7.9%) of the invited participants (participation rate 25%) and in May 2021 in 8.6% (95% CI: 7.6– 9.5%) of the invited (participation rate: 14%). Seroprevalence did not differ by sex, but by age group, generally being higher among the < 50 than 50+ year-olds. In May 2021, levels of seroprevalence varied from an estimated 13% (95% CI: 12– 15%) in the capital to 5.2% (95% CI: 3.4– 7.4%) in rural areas. Combining seroprevalence results with vaccine coverage, estimates of protection against infection in May 2021 varied from 95% among 65+ year-olds down to 10– 20% among 12– 40 year-olds. In March–May 2021, an estimated 80% of all community SARS-CoV-2 infections were diagnosed by RT-PCR and captured by surveillance.Conclusion: Seroprevalence estimates doubled during the 2020– 21 winter wave of SARS-CoV-2 infections and then stabilized as vaccinations were rolled out. The epidemic affected large cities and younger people the most. Denmark saw comparatively low infections rates, but high test coverage; an estimated four out of five infections were detected by RT-PCR in March–May 2021.Keywords: seroepidemiological studies, COVID-19 serological testing, SARS-CoV-2, population register, questionnaire, ELISA
