Seroepidemiological Study of Novel Coronavirus Disease (COVID-19) in Tehran, Iran

Document Type : Original Research

Authors
Z. Tabanejad 1
S. Darvish 2
Z. Borjian Boroujeni 3
S. S. Asadi 3
M. Mesri 1
O. Raiesi 4
M. E. Getso 5
M. Zareei 3
1 Nursing Care Research Center, Iran University of Medical Sciences, Tehran, IR. Iran.
2 Department of Medical Laboratory Sciences, Faculty of Medicine, Babol University of Medical Sciences, Babol, IR. Iran.
3 Department of Medical Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, IR. Iran.
4 Department of Parasitology, School of Allied Medical Sciences. Ilam University of Medical Sciences, Ilam, Iran.
5 Department of Medical Microbiology and Parasitology, Faculty of Clinical Sciences, College of Health Sciences, Bayero University, PMB 3011, Kano-Nigeria
10.52547/iem.7.2.121
Abstract
Backgrounds: A novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has now spread to all countries of the world, including Iran. Although anti-SARS-CoV-2 antibodies may be identified in patients using immunological methods with sufficient sensitivity and specificity, the conclusive diagnosis of the disease is made using the molecular RT-PCR method. A population-based seroepidemiological survey was conducted to quantify the proportion of the exposed population with SARS-CoV-2 antibodies and evaluate whether the antibodies are a marker of total or partial immunity compared to the population that remains susceptible to the virus.

Material & Methods: This cross-sectional study was conducted to investigate the seroprevalence of COVID-19 in Valiasr, Sajad, and Ghaem hospitals in Tehran, the capital of Iran, from April to the end of October 2020. Clotted and heparinized blood specimens (2mL) were collected from the patients. The serum and plasma were separated and stored at −80 °C until use. Anti-SARS-CoV-2 IgG and IgM antibodies were examined in the serum samples of 1375 in-patients admitted to the hospitals using ELISA kits. The obtained data were analyzed using SPSS software Ver.22.0 by employing statistical tests such as Chi-square and Fisher’s exact tests. A p-value <.05 was considered as significant.

Findings: In total, 1375 participants were enrolled in this study, and SARS‐CoV‐2 antibodies were detected in 291 patients using IgM‐IgG antibody assay. Among the seropositive patients studied, 187 were male (64.3%), and 104 were female (35.7%) (p<.05). The mean age of the patients was 49±8.4 years; the majority of whom (27%) were in the age group of 31-40 years. Also, the lowest frequency of infected cases was related to the age group of 1-10 years (p <.05). The seroprevalence of SARS‐CoV‐2 IgM or IgG antibodies was determined to be 21.2%. Diabetes mellitus was the most common underlying disease among SARS‐CoV‐2 patients [p=.05; Odd Ratio=1.61(0.90-2.91)].

Conclusion: The use of conventional serological assays, such as the enzyme-linked immunoassay (ELISA), for detecting specific IgM and IgG antibodies in SARS‐CoV‐2 patients has a high-throughput advantage while minimizing false-negative results obtained using the RT-PCR method. In this study, the seroprevalence of SARS-CoV-2 antibodies was determined to be 21%. Control of diabetes, among other influential factors, plays an important role in the management and control of COVID-19.

Keywords

1. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. New England Journal of Medicine. 2020.
2. Dadar M, Fakhri Y, Bjørklund G, Shahali Y. The association between the incidence of COVID-19 and the distance from the virus epicenter in Iran. Archives of virology. 2020;165(11):2555-60.
3. Kronbichler A, Kresse D, Yoon S, Lee KH, Effenberger M, Shin JI. Asymptomatic patients as a source of COVID-19 infections: A systematic review and meta-analysis. International journal of infectious diseases. 2020;98:180-6.
4. Shakiba M, Nazari SSH, Mehrabian F, Rezvani SM, Ghasempour Z, Heidarzadeh A. Seroprevalence of COVID-19 virus infection in Guilan province, Iran. medRxiv. 2020.
5. den Hartog G, Schepp RM, Kuijer M, GeurtsvanKessel C, van Beek J, Rots N, et al. SARS-CoV-2–specific antibody detection for seroepidemiology: a multiplex analysis approach accounting for accurate seroprevalence. The Journal of infectious diseases. 2020;222(9):1452-61.
6. Organization WH. Population-based age-stratified seroepidemiological investigation protocol for COVID-19 virus infection, 17 March 2020. World Health Organization, 2020.
7. Infantino M, Damiani A, Gobbi FL, Grossi V, Lari B, Macchia D, et al. Serological assays for SARS-CoV-2 infectious disease: benefits, limitations and perspectives. Isr Med Assoc J. 2020;22(4):203-10.
8. Long Q-X, Liu B-Z, Deng H-J, Wu G-C, Deng K, Chen Y-K, et al. Antibody responses to SARS-CoV-2 in patients with COVID-19. Nature medicine. 2020:1-4.
9. Hemati S. Antibodies testing, Immunity and immunity passport in Covid-19. Laboratory & Diagnosis. 2020;12(47):8-22.
10. Pollán M, Pérez-Gómez B, Pastor-Barriuso R, Oteo J, Hernán MA, Pérez-Olmeda M, et al. Prevalence of SARS-CoV-2 in Spain (ENE-COVID): a nationwide, population-based seroepidemiological study. The Lancet. 2020;396(10250):535-44.
11. Byambasuren O, Cardona M, Bell K, Clark J, McLaws M-L, Glasziou P. Estimating the extent of true asymptomatic COVID-19 and its potential for community transmission: systematic review and meta-analysis. Available at SSRN 3586675. 2020.
12. Bendavid E, Mulaney B, Sood N, Shah S, Ling E, Bromley-Dulfano R, et al. COVID-19 Antibody Seroprevalence in Santa Clara County, California. MedRxiv. 2020.
13. Amir-Behghadami M, Janati A. Iranian national COVID-19 electronic screening system: experience to share. Emergency Medicine Journal. 2020.
14. Sethuraman N, Jeremiah SS, Ryo A. Interpreting diagnostic tests for SARS-CoV-2. Jama. 2020.
15. Chen X, Zhou B, Li M, Liang X, Wang H, Yang G, et al. Serology of severe acute respiratory syndrome: implications for surveillance and outcome. Journal of Infectious Diseases. 2004;189(7):1158-63.
16. Farnoosh G, Alishiri G, Hosseini Zijoud SR, Dorostkar R, Jalali Farahani A. Understanding the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and Coronavirus Disease (COVID-19) Based on Available Evidence-A Narrative Review. J Mil Med. 2020;22(1):1-11.
17. Haybar H, Kazemnia K, Rahim F. Underlying Chronic Disease and COVID-19 Infection: A State-of-the-Art Review. Jundishapur Journal of Chronic Disease Care. 2020;9(2).
18. Lewis T. Smoking or vaping may increase the risk of a severe coronavirus infection. Scientific American. 2020;17.
19. Tavakoli A, Vahdat K, Keshavarz M. Novel coronavirus disease 2019 (COVID-19): an emerging infectious disease in the 21st century. ISMJ. 2020;22(6):432-50.
Infection Epidemiology and Microbiology
Volume 7, Issue 2
May 2021
Pages 121-128