Abstract
BackgroundThere are several ecological studies, but few studies of the prevalence of SARS-COV-2 at high altitude. We aimed to estimate the population-based seroprevalence of SARS-COV-2 in three settings of Cusco at the end of the first wave among adults.MethodsA population-based survey was conducted in September 2020, in three settings in the region of Cusco: (1) Cusco city at 3,300 meters above the sea level (m.a.s.l.), (2) the periphery of Cusco (Santiago, San Jerónimo, San Sebastián, and Wanchaq) at 3,300 m.a.s.l., and (3) Quillabamba city, located at 1,050 m.a.s.l. People aged ≥ 18 years within a family unit were included. The diagnosis of SARS-CoV-2 infection was based on identifying anti- SARS-CoV-2 total antibodies (IgM and IgG) in serum using the Elecsys Anti-SARS-CoV-2 chemiluminescence test.ResultsWe enrolled 1924 participants from 712 families. Of the total, 637 participants were anti-SARS-CoV-2 seropositive. Seroprevalence was 38.8% (95% CI [33.4%–44.9%]) in Cusco city, 34.9% (95% CI [30.4%–40.1%]) in the periphery of Cusco, and 20.3% (95% CI [16.2%–25.6%]) in Quillabamba. In 141 families (19.8%; 95% CI [17.0%–22.8%]) the whole members were positive to the test. Living with more than three persons in the same house, a positive COVID-19 case at home, and a member who died in the last five months were factors associated with SARS-COV-2 seropositivity. Dysgeusia/dysosmia was the symptom most associated with seropositivity (aPR = 2.74, 95% CI [2.41–3.12]); whereas always wearing a face shield (aPR = 0. 73; 95% CI [0.60–0.89]) or a facial mask (aPR = 0.76, 95% CI [0.63–0. 92) reduced that probability.ConclusionsA great proportion of Cusco’s city inhabitants presented anti-SARS-CoV-2 antibodies at the end of the first wave, with significant differences between settings. Wearing masks and face shields were associated with lower rate of seropositivity; however, efforts must be made to sustain them over time since there is still a high proportion of susceptible people.
Highlights
Worldwide, the Coronavirus Disease 19 (COVID-19) pandemic, caused by SARSCoV-2 virus, has been evaluated in real-time through the official notifications of the affected countries (World Health Organization, 2020b), which usually come from passive surveillance systems
A great proportion of individuals infected by SARS-CoV-2 virus remains undetected, especially in resource-constrained settings, as they usually are asymptomatic (Gandhi, Yokoe & Havlir, 2020), and there is a lack of appropriate access to diagnosis in the health care system, generating a gap in the information for appropriate decisions (Byambasuren et al, 2020; Eckerle & Meyer, 2020)
On average, a third of the population of Cusco had antibodies against SARS-CoV-2 virus, expanding our knowledge about the epidemiology of COVID19 pandemic in high-altitude settings, which is a very high result compared to other seroprevalence studies in different settings and countries
Summary
The Coronavirus Disease 19 (COVID-19) pandemic, caused by SARSCoV-2 virus, has been evaluated in real-time through the official notifications of the affected countries (World Health Organization, 2020b), which usually come from passive surveillance systems. A great proportion of individuals infected by SARS-CoV-2 virus remains undetected, especially in resource-constrained settings, as they usually are asymptomatic (Gandhi, Yokoe & Havlir, 2020), and there is a lack of appropriate access to diagnosis in the health care system, generating a gap in the information for appropriate decisions (Byambasuren et al, 2020; Eckerle & Meyer, 2020) To deal with these issues, multiple population-based surveys have been conducted around the world (Franceschi et al, 2020; Lai, Wang & Hsueh, 2020; Rostami et al, 2020), with divergent results as countries are in different epidemiological scenarios, i.e., beginning or end of the first pandemic wave, urban/rural areas, national/regional representation, or different diagnostic test used (molecular, antibody, or antigen detection tests). Wearing masks and face shields were associated with lower rate of seropositivity; efforts must be made to sustain them over time since there is still a high proportion of susceptible people
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