Abstract
There are no robust data on the real onset of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and spread in the prepandemic period worldwide. We investigated the presence of SARS-CoV-2 receptor-binding domain (RBD)–specific antibodies in blood samples of 959 asymptomatic individuals enrolled in a prospective lung cancer screening trial between September 2019 and March 2020 to track the date of onset, frequency, and temporal and geographic variations across the Italian regions. SARS-CoV-2 RBD-specific antibodies were detected in 111 of 959 (11.6%) individuals, starting from September 2019 (14%), with a cluster of positive cases (>30%) in the second week of February 2020 and the highest number (53.2%) in Lombardy. This study shows an unexpected very early circulation of SARS-CoV-2 among asymptomatic individuals in Italy several months before the first patient was identified, and clarifies the onset and spread of the coronavirus disease 2019 (COVID-19) pandemic. Finding SARS-CoV-2 antibodies in asymptomatic people before the COVID-19 outbreak in Italy may reshape the history of pandemic.
Highlights
There are no robust data on the real onset of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and spread in the prepandemic period worldwide
The national distribution of the 959 recruited patients and of the 111 who tested positive for receptor-binding domain (RBD)-SARS-CoV-2 antibodies in comparison with the allocation of the patients with COVID-19 identified in Italy up to March 10 is shown in Figure 2(A) and Supplementary Table S3
Evaluation of anti-SARS-CoV-2 functional neutralizing antibodies (NAbs) was performed for all 111 SARSCoV-2 RBD-positive samples using a cytopathic effect (CPE)–based live virus microneutralization assay in a high-containment biosafety level 2 laboratory
Summary
There are no robust data on the real onset of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and spread in the prepandemic period worldwide.
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