Sebastian Weis, Andre Scherag, Michael Baier, Michael Kiehntopf, Thomas Kamradt, Steffi Kolanos, Juliane Ankert, Stefan Gloeckner, Oliwia Makarewicz, Stefan Hagel, Christina Bahrs, Aurelia Kimmig, Hans Proquitte, Joel Guerra, Bettina Loeffler, Mathias W. Pletz
The primary objective was to determine the SARS-CoV-2 antibody status (sero-conversion rate) of the population of Neustadt-am-Rennsteig with a defined distance to the end of the quarantine period. SARS-CoV-2 antibody status was defined as ”positive” if participants had a positive test result in ≥ 2 of the six antibody tests (details below); otherwise participants were classified as “negative”. The secondary objectives of the study were i.) to determine the rate of seroconversion in children; ii.) to determine potential risk factors for symptomatic vs. asymptomatic Covid19 courses; iii.) to investigate the rate of virus persistence (as part of future follow-up assessments).
Due to the substantial proportion of asymptomatic and mild courses many SARS-CoV-2 infections remain unreported. Therefore, assessment of seroprevalence may detect the real burden of disease. We aimed at determining and characterizing the rate of SARS-CoV-2 infections and the resulting immunity in a defined population. Methods: CoNAN is a population-based cohort study in the previously quarantined community Neustadt-am-Rennsteig, Germany six weeks after a SARS-CoV-2 outbreak with 49 cases identified by PCR screening of all 883 inhabitants. The primary objective of the study was to assess SARS-CoV-2 antibody seroconversion rate using six different IgG detecting immunoassays. Secondary objectives of the study were: i.) to determine the rate of seroconversion in children; ii.) to determine potential risk factors for symptomatic vs. asymptomatic Covid19 courses; iii.) to investigate the rate of virus persistence. Findings: We enrolled 626 participants (71% of the community population). All actual SARS-CoV-2 PCR tests were negative; while a total of 8.4% (52 of 620 tested) had antibodies against SARS-CoV-2 in at least two independent tests. Twenty of the antibody positive participants had previously a positive SARS-CoV-2 PCR. On the contrary, of those 38 participants with SARS-CoV-2 infection, only 20 (52.6%) were antibody positive. Interpretation: Several antibody tests conducted six weeks after an outbreak of SARS-CoV-2 did not detect all previously PCR-positive tested individuals. Cautious evaluation of antibody testing strategies to assess immunity against the infection is warranted.
Competing Interest Statement SW received speakers fees from MSD and Infectopharm. SH received speakers fees from Pfizer, MSD and Astra Zeneca. TK speakers fees from Roche MP has participated in international advisory boards from Pfizer, Novartis, Basilea and Cubist and received speakers fees from the same companies. CB has participated in advisory boards from GSK and received speakers fees from Pfizer. All other authors do not report any conflict of interest
Clinical Trial: DRKS00022416 (submitted)
Funding Statement: CoNAN was funded by the Thuringian Ministry for Economic Affairs, Science and Digital Society (TMWWDG).