A H-UNCOVER vizsgálat eredményei és hatása a magyarországi járványkezelésre

Abstract

Összefoglaló. A HUNgarian COronaVirus disease-19 Epidemiological Research (H-UNCOVER) vizsgálat egy országos szintű reprezentatív felmérés volt, melyet az Innovációs és Technológiai Minisztérium (ITM) támogatásával végzett el a négy orvostudományi képzést folytató magyar egyetem a Központi Statisztikai Hivatallal (KSH) együttműködve. A vizsgálat célja az volt, hogy egy reprezentatív mintán keresztül felmérje a magyar lakosság SARS-CoV-2 átfertőzöttségét, és támaszul szolgáljon a koronavírus első hulláma kapcsán meghozott restriktív intézkedések utáni lazításra. A világszinten is jelentős méretű vizsgálat alacsony átfertőzöttségi arányt mutatott, így nemcsak a restriktív intézkedések hatékonyságát mutatta meg, de egy biztos járványügyi támaszt jelentett a gazdaság újranyitásának tervezéséhez. Summary. Close to the end of the first wave of the COVID-19 pandemic in Europe, many countries started to consider the possibility of reopening their economy, and lifting some of the containment measures introduced in the previous weeks. Such a decision is utterly complicated, as reopening might easily lead to an increase in active SARS-CoV-2 cases, but a delay puts an almost unbearable burden on the country’s economy. The objective of the HUNgarian COronaVirus disease-19 Epidemiological Research (H-UNCOVER) study was to conduct a cross-sectional survey among the Hungarian population to estimate the total number of infectious cases and the prevalence of prior SARS-CoV-2 exposure, and by using these data help to plan an exit strategy. The H-UNCOVER study was performed by the 4 medical universities in Hungary (Semmelweis University, University of Pécs, University of Debrecen and University of Szeged) with the help of the Central Statistical Office, Hungarian National Ambulance Service, Governmental offices and General Practitioners. The study was initiated 50 days after the Hungarian restrictions and performed between 1-16 May. With the help of the Central Statistical Office, 17,787 people were selected to represent the Hungarian population of 14 years or older living in private households (n=8,283,810). SARS-CoV-2 PCR and blood tests were performed to assess the prevalence of active infection and seropositivity. These tests were accompanied by a questionnaire about symptoms, comorbidities, and COVID-19 contacts. More specifically, questions included topics about home office, going abroad after the 1st of March, or possible contacts with COVID-19 positive, or quarantined individuals, as well as symptoms which might be due to COVID-19 infection. Altogether 67.7% of the selected individuals participated in some form in the study, which is an exceptionally high number compared to such studies. 10,502 individuals had SARS-CoV-2 PCR testing and 10,501 people had a blood test to assess SARS-CoV-2 IgG levels. Of the tested individuals, three had positive PCR and 69 had positive serological tests. Population estimates of the number of SARS-CoV-2 infections and seropositivity were 2,421 and 56,439, respectively, thus the active infection rate (2.9/10,000, 95% confidence interval: 0-6.7/10,000) and the prevalence of prior SARS-CoV-2 exposure (68/10,000, 95% confidence interval: 50-86/10,000) were low. A total of 10,474 individuals completed the questionnaire. Self-reported loss of smell or taste and body aches were significantly more frequent among those with SARS-CoV-2. Our study suggested that the early containment measures initiated by the Government of Hungary were effective in preventing the escalation of the first wave of COVID-19 in Hungary. We also found that the highest prevalence of the disease was in Budapest, and those who attended their workplace on a regular basis, travelled abroad after the 1st of March, or contacted with a COVID-19 positive or quarantined individual had a higher tendency to become infected. In conclusion, the H-UNCOVER study supported the exit strategy after the first wave of COVID-19 in Hungary.