Role of SARS-CoV-2 seroprevalence studies in disease surveillance

The coronavirus disease 2019 (COVID-19) pandemic highlighted the importance of timely information on public health immunity for effective and efficient public health decision-making processes.

Seroprevalence studies that estimate the prevalence of antibodies are considered important sources of this information. However, during the COVID-19 pandemic, seroprevalence estimates have been obtained from research studies rather than part of ongoing public health surveillance efforts, which could raise questions regarding their public health impact.

Study: Timeliness of reporting of SARS-CoV-2 seroprevalence results and their utility for infectious disease surveillance. Image Credit: SergeyBitos / Shutterstock.com

Effective seroprevalence studies that can be used for public health surveillance must have the attributes of effective surveillance systems, which include timelessness, validity, and representativeness. Many of these attributes are challenging when the findings are distributed in shared research manuscripts published as peer-reviewed articles.

Some researchers have turned to more rapid and accessible platforms such as preprints, government reports, and news to obtain quicker results. However, it remains unclear whether these alternative platforms lead to faster reporting as compared to scientific journals and if bypassing peer-review can result in the prolific publication of weaker evidence.

A new study posted to the preprint server medRxiv* aimed to determine the timelessness of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence studies in providing information that is useful in public health surveillance, as well as further analysis.

About the study

The current study involved a living systematic review that was registered with PROSPERO. News media, electronic databases, and grey literature were searched for cohort and cross-sectional studies that reported seroprevalence estimates published between January 1, 2020, and December 31, 2021.

Inclusion criteria included sample size, geographic location of sampling, sampling end date, and seroprevalence estimate. Furthermore, a risk of bias (RoB) assessment was carried out by two independent reviewers.

For each study, the publication venue was categorized into peer-reviewed journal articles, institutional reports, preprint, media, or presentation or conference materials. In addition, the sample frame was categorized into healthcare workers, household or community samples, blood donors or residual sera, other special populations, and studies that sampled multiple populations.

After that, the timelessness of seroprevalence studies was determined in both the overall sample as well as those stratified by publication venue. Finally, the median timelessness was compared between preprints and institutional reports or media, along with peer-reviewed publications and preprints. The role of preprints in accelerating the release of data was also assessed.

The researchers also assessed the relationship between timelessness and study characteristics, as well as a comparison of timelessness between publication venues. Finally, the factors that were independently associated with timeliness were examined.

Study findings

Out of 1,844 studies included in the analysis, 59% were released as peer reviews, 24.2% as preprints, 6.24% as news articles, 7.81% as institutional reports, and 2.66% as presentations for presentations conference abstracts. The majority of the studies were cross-sectional.

The median time to publication was reported to be 154 days across all publication venues, with media reports requiring the shortest time and peer reviews the longest. The timelines were found to vary across publication venues. No significant difference in time to publication was observed in the case of 230 studies that were first published as preprints and later appeared as peer-reviewed journal articles.

A higher proportion of the low or moderate RoB was observed in preprint, peer-reviewed, and institutional reports as compared to media reports and conference materials. In addition, a significant difference in timelessness was observed in several World Health Organization (WHO) regions compared to ‘Regions of the Americas’ (AMRO).

Faster timelessness was also observed in studies with unclear RoB as compared to low RoB. A significant difference in timelessness was observed in the case of sample frames, where analyses of household/community samples took less time to be released as compared to the other sample frames. Studies that did not report antibody test sensitivity and specificity and those that were not representative of the target population had a high probability of being published in a short time.

Taken together, the current study demonstrates that seroprevalence studies have often released results slowly through venues that are more suitable for research studies, thus limiting their utility as surveillance tools. The surveillance system could be supported by well-sourced public health surveillance or close government-academic partnerships. However, more timely and robust reporting and the distribution of standardized seroprevalence results can help increase their usefulness for surveillance, which, in turn, leads to effective public health responses.

Limitations

The current study could not detect the duration of each step in the reporting process for each article. Second, only the first public report of seroprevalence studies was included in the analysis, and its subsequent publications were not.

Furthermore, some news and conference articles did not report the end date for sampling. Studies that reported directly to public health agencies could not be included in this analysis.

*Important notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Journal reference:
Suchandrima Bhowmik

Written by

Suchandrima Bhowmik

Suchandrima has a Bachelor of Science (B.Sc.) degree in Microbiology and a Master of Science (M.Sc.) degree in Microbiology from the University of Calcutta, India. The study of health and diseases was always very important to her. In addition to Microbiology, she also gained extensive knowledge in Biochemistry, Immunology, Medical Microbiology, Metabolism, and Biotechnology as part of her master's degree.

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