Abstract

We aimed to assess the prevalence of and factors associated with anti- severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) positivity in a large population of adult volunteers from five administrative departments of the Liguria and Lombardia regions. A total of 3609 individuals were included in this analysis. Participants were tested for anti-SARS-CoV-2 antibodies [Immunoglobulin G (IgG) and M (IgM) class antibodies] at three private laboratories (Istituto Diganostico Varelli, Medical Center, and Casa della Salute di Genova). Demographic data, occupational or private exposure to SARS-CoV-2-infected patients, and prior medical history consistent with SARS-CoV-2 infection were collected according to a preplanned analysis. The overall seroprevalence of anti-SARS-CoV-2 antibodies (IgG and/or IgM) was 11.0% [398/3609; confidence interval (CI) 10.0%–12.1%]. Seroprevalence was higher in female inmates than in male inmates (12.5% vs. 9.2%, respectively, p = 0.002), with the highest rate observed among adults aged >55 years (13.2%). A generalized estimating equations model showed that the main risk factors associated with SARS-CoV-2 seroprevalence were the following: an occupational exposure to the virus [Odd ratio (OR) = 2.36; 95% CI 1.59–3.50, p = 0.001], being a long-term care facility resident (OR = 4.53; 95% CI 3.19–6.45, p = 0.001), and reporting previous symptoms of influenza-like illness (OR = 4.86; 95% CI 3.75–6.30, p = 0.001) or loss of sense of smell or taste (OR = 41.00; 95% CI 18.94–88.71, p = 0.001). In conclusion, we found a high prevalence (11.0%) of SARS-CoV-2 infection that is significantly associated with residing in long-term care facilities or occupational exposure to the virus. These findings warrant further investigation into SARS-CoV-2 antibody prevalence among the Italian population.

Highlights

  • In Italy, the first case of pandemic severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection was reported on 20 February, 2020

  • The results showed values of sensitivity and specificity consistent with those reported by each manufacturer

  • All patients lived in the Lombardia and Liguria regions in the administrative departments of Varese (39.6%; n = 1430/3609), Pavia (24.1%; n = 871/3,609), Milano (21.2%; n = 764/3609), Genova (13.6%; n = 492/3609,) and Savona (1.4%; n = 52/3609;)

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Summary

Introduction

In Italy, the first case of pandemic severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection was reported on 20 February, 2020. By the end of April 2020, approximately 85,000 laboratory confirmed cases -of SARS-CoV-2 infection were reported in this geographical area of the country [2]. These data included only a fraction of the real number of SARS-CoV-2 infections, since not all infected patients were symptomatic [3,4,5], required hospitalizations, or provided specimens for laboratory testing. The secondary outcome was to evaluate possible factors associated with anti-SARS-CoV-2 positivity in a large population of individuals from five administrative departments of the Liguria and Lombardia regions

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