SARS-CoV-2 seroprevalence among the general population and healthcare workers in India, December 2020–January 2021
Open accessAbstract
BACKGROUND: Earlier serosurveys in India revealed seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) of 0.73% in May-June 2020 and 7.1% in August-September 2020. A third serosurvey was conducted between December 2020 and January 2021 to estimate the seroprevalence of SARS-CoV-2 infection among the general population and healthcare workers (HCWs) in India. METHODS: The third serosurvey was conducted in the same 70 districts as the first and second serosurveys. For each district, at least 400 individuals aged ≥10 years from the general population and 100 HCWs from subdistrict-level health facilities were enrolled. Serum samples from the general population were tested for the presence of immunoglobulin G (IgG) antibodies against the nucleocapsid (N) and spike (S1-RBD) proteins of SARS-CoV-2, whereas serum samples from HCWs were tested for anti-S1-RBD. Weighted seroprevalence adjusted for assay characteristics was estimated. RESULTS: Of the 28,598 serum samples from the general population, 4585 (16%) had IgG antibodies against the N protein, 6647 (23.2%) had IgG antibodies against the S1-RBD protein, and 7436 (26%) had IgG antibodies against either the N protein or the S1-RBD protein. Weighted and assay-characteristic-adjusted seroprevalence against either of the antibodies was 24.1% [95% confidence interval (CI) 23.0-25.3%]. Among 7385 HCWs, the seroprevalence of anti-S1-RBD IgG antibodies was 25.6% (95% CI 23.5-27.8%). CONCLUSIONS: Nearly one in four individuals aged ≥10 years from the general population as well as HCWs in India had been exposed to SARS-CoV-2 by December 2020.
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Reported COVID-19 cases generally capture a small fraction of total infections, and deaths in these systems are undercounts.
“it is widely recognized that reported cases generally capture a small fraction of total infections, and that deaths in these systems are undercounts [8–10].”
From Estimates of pandemic excess mortality in India based on civil registration data (2022) · cites this paper as [10]
The third national serosurvey, carried out during December 2020-January 2021, estimated national seroprevalence of 24.1%, corresponding to approximately 325 million infections nationwide.
“The third national serosurvey carried out during December 2020–January 2021 estimated seroprevalence of 24.1% nationally, corresponding to approximately 325M infections nationwide [10].”
From Estimates of pandemic excess mortality in India based on civil registration data (2022) · cites this paper as [10]
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- Authors
- Murhekar, M. V., Bhatnagar, T., Thangaraj, J. W. V., Saravanakumar, V., Kumar, M. S., Selvaraju, S., Rade, K., Kumar, C. P. G., Sabarinathan, R., Turuk, A., Asthana, S., Balachandar, R., Bangar, S. D., Bansal, A. K., Chopra, V., Das, D., Deb, A. K., Devi, K. R., Dhikav, V., Dwivedi, G. R., Khan, S. M. S., Kumar, M. S., Laxmaiah, A., Madhukar, M., Mahapatra, A., Rangaraju, C., Turuk, J., Yadav, R., Andhalkar, R., Arunraj, K., Bharadwaj, D. K., Bharti, P., Bhattacharya, D., Bhat, J., Chahal, A. S., Chakraborty, D., Chaudhury, A., Deval, H., Dhatrak, S., Dayal, R., Elantamilan, D., Giridharan, P., Haq, I., Hudda, R. K., Jagjeevan, B., Kalliath, A., Kanungo, S., Krishnan, N. N., Kshatri, J. S., Kumar, A., Kumar, N., Kumar, V. G. V., Lakshmi, G. G. J. N., Mehta, G., Mishra, N. K., Mitra, A., Nagbhushanam, K., Nimmathota, A., Nirmala, A. R., Pandey, A. K., Prasad, G. V., Qurieshi, M. A., Reddy, S. D., Robinson, A., Sahay, S., Saxena, R., Sekar, K., Shukla, V. K., Singh, H. B., Singh, P. K., Singh, P., Singh, R., Srinivasan, N., Varma, D. S., Viramgami, A., Wilson, V. C., Yadav, S., Yadav, S., Zaman, K., Chakrabarti, A., Das, A., Dhaliwal, R. S., Dutta, S., Kant, R., Khan, A. M., Narain, K., Narasimhaiah, S., Padmapriyadarshini, C., Pandey, K., Pati, S., Patil, S., Rajkumar, H., Ramarao, T., Sharma, Y. K., Singh, S., Panda, S., Reddy, D. C. S., Bhargava, B., Anand, T., Babu, G. R., Chauhan, H., Dikid, T., Gangakhedkar, R. R., Kant, S., Kulkarni, S., Muliyil, J. P., Pandey, R. M., Sarkar, S., Shah, N., Shrivastava, A., Singh, S. K., Zodpe, S., Hindupur, A., Asish, P. R., Chellakumar, M., Chokkalingam, D., Dasgupta, S., Gowtham, M. M. E., Jose, A., Kalaiyarasi, K., Karthik, N. N., Karunakaran, T., Kiruthika, G., Dinesh Kumar, H., Sarath Kumar, S., Sarath Kumar, M. P., Michaelraj, E., Pradhan, J., Arun Prasath, E. B., Gladys Angelin Rachel, D., Rani, S., Rozario, A., Sivakumar, R., Gnana Soundari, P., Sujeetha, K., & Vinod, A.
- Affiliations
- National Institute of Epidemiology (IN)
- Government of Kerala (IN)
- National Institute of Research in Tuberculosis (IN)
- World Health Organization - India (IN)
- Indian Council of Medical Research (IN)
- National Institute of Cancer Prevention and Research (IN)
- National Institute of Occupational Health (IN)
- National AIDS Research Institute (IN)
- National JALMA Institute for Leprosy & Other Mycobacterial Diseases (IN)
- Regional Medical Research Center (IN)
- National Institute of Cholera and Enteric Diseases (IN)
- Regional Medical Research Centre (IN)
- National Institute for Implementation Research on Non-Communicable Diseases (IN)
- National Institute of Nutrition (IN)
- Rajendra Memorial National Institute of Health Research (IN)
- National Tuberculosis Institute (IN)
- Government Medical College (IN)
- Government of Andhra Pradesh (IN)
- Corresponding author
- Murhekar, Manoj V.
- ORCID
- Murhekar, Manoj V.
- Bhatnagar, Tarun
- Thangaraj, Jeromie Wesley Vivian
- Selvaraju, Sriram
- Rade, Kiran
- Kumar, C.P. Girish
- Sabarinathan, R.
- Asthana, Smita
- Balachandar, Rakesh
- Bangar, Sampada Dipak
- Bansal, Avi Kumar
- Chopra, Vishal
- Devi, Kangjam Rekha
- Dhikav, Vikas
- Dwivedi, Gaurav Raj
- Khan, S. Muhammad Salim
- Kumar, M. Sunil
- Laxmaiah, Avula
- Madhukar, Major
- Mahapatra, Amarendra
- Rangaraju, Chethana
- Turuk, Jyotirmayee
- Andhalkar, Rushikesh
- Bharti, Pravin
- Bhattacharya, Debdutta
- Bhat, Jyothi
- Chakraborty, Debjit
- Deval, Hirawati
- Dhatrak, Sarang
- Elantamilan, D.
- Giridharan, Prathiksha
- Haq, Inaamul
- Kalliath, Arshad
- Kanungo, Srikanta
- Krishnan, Nivethitha N.
- Kshatri, Jaya Singh
- Kumar, Alok
- Kumar, Niraj
- Pandey, Ashok Kumar
- Qurieshi, Mariya Amin
- Robinson, Aby
- Sahay, Seema
- Sekar, Krithikaa
- Shukla, Vijay Kumar
- Singh, Prashant Kumar
- Singh, Pushpendra
- Singh, Rajeev
- Srinivasan, Nivetha
- Viramgami, Ankit
- Wilson, Vimith Cheruvathoor
- Yadav, Suresh
- Zaman, Kamran
- Chakrabarti, Amit
- Das, Aparup
- Dhaliwal, R.S.
- Dutta, Shanta
- Kant, Rajni
- Khan, A.M.
- Narain, Kanwar
- Pandey, Krishna
- Pati, Sanghamitra
- Patil, Shripad
- Rajkumar, Hemalatha
- Singh, Shalini
- Panda, Samiran
- Reddy, D.C.S.
- Bhargava, Balram
- Anand, Tanu
- Babu, Giridhara R.
- Chauhan, Himanshu
- Dikid, Tanzin
- Gangakhedkar, Raman R.
- Kant, Shashi
- Kulkarni, Sanket
- Sarkar, Swarup
- Shah, Naman
- Shrivastava, Aakash
- Singh, Sujeet K.
- Asish, P.R.
- Dasgupta, Sauvik
- Jose, Annamma
- Karthik, N.N.
- Karunakaran, T.
- Kiruthika, G.
- Pradhan, Josephine
- Rani, Sudha
- Rozario, Amanda
- Venue
- International Journal of Infectious Diseases
- Publisher
- Elsevier BV
- Published
- 2021-07
- Volume
- 108
- Pages
- 145-155
- ISSN
- 1201-9712 (ISSN-L)
- PMC
- PMC8132496
- OpenAlex
- W3163246137
- Cited by
- 134
- References
- 21
- Citations by year
- 2026: 5 · 2025: 10 · 2024: 23 · 2023: 19 · 2022: 52 · 2021: 25
- FWCI
- 9.41
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Infectious Diseases (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Indian Council of Medical Research
- Topics
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 detection and testing
- Keywords
- SARS-CoV-2, COVID-19 pandemic, seroprevalence, IgG, healthcare workers, general population, nucleocapsid protein, India, serological survey, SARS-CoV-2 exposure
- MeSH terms
- COVID-19, SARS-CoV-2, Antibodies, Viral, Health Personnel, Humans, Seroepidemiologic Studies
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