Heliyon (Nov 2022)
Cross-sectional analysis of students and school workers reveals a high number of asymptomatic SARS-CoV-2 infections during school reopening in Brazilian cities
- Lysandro P. Borges,
- Adriana G. Guimarães,
- Dennyson Leandro M. Fonseca,
- Paula P. Freire,
- Íkaro D.C. Barreto,
- Daniela R.V. Souza,
- Ricardo Q. Gurgel,
- Aline S.A. Lopes,
- José Melquiades de Rezende Neto,
- Kezia A. dos Santos,
- Igor L.S. Matos,
- Grazielly B. da Invenção,
- Brenda M. Oliveira,
- Aryanne A. Santos,
- Daniele Almeida Soares,
- Pamela C. de Jesus,
- Cliomar A. dos Santos,
- Marco A.O. Goes,
- Desirée Rodrigues Plaça,
- Igor Salerno Filgueiras,
- Alexandre H.C. Marques,
- Gabriela Crispim Baiocchi,
- William Cabral-Miranda,
- Gustavo Cabral de Miranda,
- Niels Olsen Saraiva Camara,
- Vera Lúcia Garcia Calich,
- Rodrigo Nalio Ramos,
- Helder I. Nakaya,
- Vanderson Rocha,
- Lasse M. Giil,
- Hans D. Ochs,
- Lena F. Schimke,
- Mércia S.F. de Souza,
- Luis E. Cuevas,
- Aline F. Martins,
- Otavio Cabral-Marques
Affiliations
- Lysandro P. Borges
- Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil; Corresponding author.
- Adriana G. Guimarães
- Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- Dennyson Leandro M. Fonseca
- Interunit Postgraduate Program on Bioinformatics, Institute of Mathematics and Statistics (IME), University of Sao Paulo (USP), Sao Paulo, SP, Brazil
- Paula P. Freire
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
- Íkaro D.C. Barreto
- Nuclear and Energy Technology Graduate Program (UFPE), Recife, Pernambuco, Brazil
- Daniela R.V. Souza
- Department of Education in Health, Lagarto and Post-graduate Program in Health Sciences, Federal University of Sergipe, Sergipe, Brazil
- Ricardo Q. Gurgel
- Department of Medicine and Post-Graduate Programs in Parasitic Biology and Health Sciences, Federal University of Sergipe, Aracaju, Sergipe, Brazil
- Aline S.A. Lopes
- Department of Education in Health, Lagarto and Post-graduate Program in Health Sciences, Federal University of Sergipe, Sergipe, Brazil
- José Melquiades de Rezende Neto
- Department of Education in Health, Lagarto and Post-graduate Program in Health Sciences, Federal University of Sergipe, Sergipe, Brazil
- Kezia A. dos Santos
- Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- Igor L.S. Matos
- Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- Grazielly B. da Invenção
- Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- Brenda M. Oliveira
- Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- Aryanne A. Santos
- Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- Daniele Almeida Soares
- Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- Pamela C. de Jesus
- Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- Cliomar A. dos Santos
- Sergipe Central Public Health Laboratory, Aracaju, Sergipe, Brazil
- Marco A.O. Goes
- Department of Medicine and Post-Graduate Programs in Parasitic Biology and Health Sciences, Federal University of Sergipe, Aracaju, Sergipe, Brazil; State Health Department, Sergipe, Brazil
- Desirée Rodrigues Plaça
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, SP, Brazil
- Igor Salerno Filgueiras
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
- Alexandre H.C. Marques
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
- Gabriela Crispim Baiocchi
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
- William Cabral-Miranda
- The Sabará Children´s Hospital and PENSI Institute, São Paulo, SP, Brazil
- Gustavo Cabral de Miranda
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
- Niels Olsen Saraiva Camara
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
- Vera Lúcia Garcia Calich
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
- Rodrigo Nalio Ramos
- Laboratory of Medical Investigation in Pathogenesis and Directed Therapy in Onco-Immuno-Hematology (LIM-31), Department of Hematology and Cell Therapy, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil; Instituto D'Or de Ensino e Pesquisa, São Paulo, Brazil
- Helder I. Nakaya
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, SP, Brazil; Hospital Israelita Albert Einstein, São Paulo 05652-900, Brazil; Scientific Platform Pasteur, University of São Paulo, São Paulo 05508-020, Brazil
- Vanderson Rocha
- Laboratory of Medical Investigation in Pathogenesis and Directed Therapy in Onco-Immuno-Hematology (LIM-31), Department of Hematology and Cell Therapy, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil; Instituto D'Or de Ensino e Pesquisa, São Paulo, Brazil; Fundação Pró-Sangue-Hemocentro de São Paulo, São Paulo, Brazil; Churchill Hospital, Department of Hematology, University of Oxford, Oxford, United Kingdom
- Lasse M. Giil
- Department of Internal Medicine, Haraldsplass Deaconess Hospital, Bergen, Norway
- Hans D. Ochs
- Department of Pediatrics, University of Washington School of Medicine, Seattle Children's Research Institute, Seattle, WA, USA
- Lena F. Schimke
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
- Mércia S.F. de Souza
- Department of Medicine and Post-Graduate Programs in Parasitic Biology and Health Sciences, Federal University of Sergipe, Aracaju, Sergipe, Brazil; State Health Department, Sergipe, Brazil
- Luis E. Cuevas
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- Aline F. Martins
- Department of Education in Health, Lagarto and Post-graduate Program in Health Sciences, Federal University of Sergipe, Sergipe, Brazil
- Otavio Cabral-Marques
- Interunit Postgraduate Program on Bioinformatics, Institute of Mathematics and Statistics (IME), University of Sao Paulo (USP), Sao Paulo, SP, Brazil; Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil; Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, SP, Brazil; Network of Immunity in Infection, Malignancy, and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Sao Paulo, Brazil; Department of Pharmacy and Postgraduate Program of Health and Science, Federal University of Rio Grande do Norte, Natal, Brazil; Corresponding author.
- Journal volume & issue
-
Vol. 8,
no. 11
p. e11368
Abstract
Brazil experienced one of the most prolonged periods of school closures, and reopening could have exposed students to high rates of SARS-CoV-2 infection. However, the infection status of students and school workers at the time of the reopening of schools located in Brazilian cities is unknown. Here we evaluated viral carriage by RT-PCR and seroprevalence of anti-SARS-CoV-2 antibodies (IgM and IgG) by immunochromatography in 2259 individuals (1139 students and 1120 school workers) from 28 schools in 28 Brazilian cities. We collected the samples within 30 days after public schools reopened and before the start of vaccination campaigns. Most students (n = 421) and school workers (n = 446) had active (qRT-PCR + IgM− IgG− or qRT-PCR + IgM + IgG−/+) SARS-CoV-2 infection. Regression analysis indicated a strong association between the infection status of students and school workers. Furthermore, while 45% (n = 515) of the students and 37% (n = 415) of the school workers were neither antigen nor antibody positive in laboratory tests, 16% of the participants (169 students and 193 school workers) were oligosymptomatic, including those reinfected. These individuals presented mild symptoms such as headache, sore throat, and cough. Notably, most of the individuals were asymptomatic (83.9%). These results indicate that many SARS-CoV-2 infections in Brazilian cities during school reopening were asymptomatic. Thus, our study highlights the need to promote a coordinated public health effort to guarantee a safe educational environment while avoiding exacerbating pre-existent social inequalities in Brazil, reducing social, mental, and economic losses for students, school workers, and their families.
