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SARS-CoV-2 Antibody Prevalence in India: Findings from the Second Nationwide Household Serosurvey, August - September 2020

27 Pages Posted: 22 Oct 2020

See all articles by Manoj Murhekar

Manoj Murhekar

Indian Council of Medical Research (ICMR) - National Institute of Epidemiology

Tarun Bhatnagar

Indian Council of Medical Research (ICMR) - National Institute of Epidemiology

Sriram Selvaraju

Indian Council of Medical Research (ICMR) - National Institute for Research in Tuberculosis

V. Saravana Kumar

ICMR-National Institute of Epidemiology

Jeromie Wesley Vivian Thangaraj

ICMR-National Institute of Epidemiology

Naman Shah

Indian Council of Medical Research (ICMR) - National Institute of Epidemiology

Muthusamy Santhosh Kumar

ICMR-National Institute of Epidemiology

Kiran Rade

World Health Organization - India Country Office

R. Sabarinathan

ICMR-National Institute of Epidemiology

Smita Asthana

ICMR-National Institute of Cancer Prevention and Research

Rakesh Balachandar

ICMR-National Institute of Occupational Health

Sampada Dipak Bangar

ICMR-National AIDS Research Institute

Avi Kumar Bansal

ICMR – National JALMA Institute for Leprosy and Other Mycobacterial Diseases

Jyothi Bhat

ICMR-National Institute of Research in Tribal Health

Vishal Chopra

State TB Training and Demonstration centre (STDC)

Dasarathi Das

ICMR-Regional Medical Research Centre

Alok Kumar Deb

ICMR-National Institute of Cholera and Enteric Diseases

Kangjam Rekha Devi

ICMR-Regional Medical Research Centre

Gaurav Raj Dwivedi

ICMR-Regional Medical Research Centre

S. Muhammad Salim Khan

Government Medical College, Srinagar

CP Girish Kumar

ICMR-National Institute of Epidemiology

M. Sunil Kumar

State TB Training and Demonstration centre (STDC)

Avula Laxmaiah

ICMR-National Institute of Nutrition

Major Madhukar

ICMR-Rajendra Memorial Research Institute of Medical Sciences

Amarendra Mahapatra

ICMR-Regional Medical Research Centre

Suman Sundar Mohanty

ICMR-National Institute for Implementation Research on Non-Communicable Diseases

Chethana Rangaraju

National Tuberculosis Institute

Alka Turuk

Indian Council of Medical Research (ICMR)

Dinesh Kumar Baradwaj

ICMR-National Institute of Nutrition

Ashrafjit S. Chahal

State TB Training and Demonstration Centre (STDC)

Falguni Debnath

ICMR-National Institute of Cholera and Enteric Diseases

Inaamul Haq

Government Medical College, Srinagar

Arshad Kalliath

State TB Training and Demonstration Centre (STDC)

Srikanta Kanungo

Government of India - Department of Microbiology

Jaya Kshatri

Government of India - Department of Microbiology

Gangeti Gandhi Jayanthi Naga Lakshmi

Directorate of Public Health and Family Welfare - Office of Joint Director for Tuberculosis

Anindya Mitra

State TB Training and Demonstration centre (STDC)

AR Nirmala

Lady Willingdon State TB centre

Ganta Venkata Prasad

Directorate of Public Health and Family Welfare - Office of Joint Director for Tuberculosis

Mariya Amin Qurieshi

Government Medical College, Srinagar

Seema Sahay

ICMR-National AIDS Research Institute

Ramesh Kumar Sangwan

ICMR-National Institute for Implementation Research on Non-Communicable Diseases

Krithikaa Sekar

Indian Council of Medical Research (ICMR) - National Institute for Research in Tuberculosis

Vijay Kumar Shukla

Directorate Health Services

Prashant Kumar Singh

ICMR-National Institute of Cancer Prevention and Research

Pushpendra Singh

ICMR-National Institute of Research in Tribal Health

Rajeev Singh

ICMR-Regional Medical Research Centre

Dantuluri Sheethal Varma

Directorate of Public Health and Family Welfare - Office of Joint Director for Tuberculosis

Ankit Viramgami

ICMR – National Institute of Occupational Health

Samiran Panda

Indian Council of Medical Research (ICMR)

DCS Reddy

Independent

Balram Bhargava

Government of India - Department of Health Research

ICMR Serosurveillance Group

More...

Abstract

Background: The first round of national serosurvey in India was conducted in May-June 2020 among adults from 21 States. The second serosurvey was conducted in August-September 2020 to estimate the nationwide seroprevalence for SARS-CoV-2 infection in the general population aged ten years and above. 

Methods: The household serosurvey was conducted among individuals aged ten years and above in the same 700 villages and wards from 70 districts selected during the first serosurvey. Blood samples were tested using the Abbott SARS-CoV-2 IgG assay. Seroprevalence was estimated after applying the sampling weights and adjusting for clustering and assay characteristics. In order to compare the adult seroprevalence between the two surveys, we randomly selected one adult serum sample from each household. 

Findings: The weighted and adjusted prevalence of infection among 29,082 individuals aged ten years and above was 6·6% (95% CI: 5·8% - 7·4%). The seroprevalence among adults was 7·1% (95% CI: 6·2% – 8·2%). Seroprevalence was similar across age groups, sex, and occupation. Seroprevalence was highest in urban slum areas followed by urban non-slum and rural areas. We estimated a cumulative 74·3 million infections in the country, with 26 – 32 infections for every reported COVID-19 case by August 2020.

Interpretation: Nearly one in 15 individuals aged ten years and above had SARS-CoV-2 infection by August 2020. The adult seroprevalence increased ten times between May and August 2020. Lower infection to case ratio in August compared to May reflects a substantial increase in testing across the country.

Funding: The study was funded by the Indian Council of Medical Research, New Delhi, India. The study sponsor was involved in reviewing the study design, writing of the manuscript and the decision to submit the paper for publication.

Declaration of Interests: The authors declare no competing interests.

Ethics Approval Statement: The authors obtained written informed consent from individuals aged 18 years and older. We obtained assent from children aged between 10–17 years, and written informed consent from their parents or guardians prior to the survey. The Central Ethics Committee of Health Research of Indian Council of Medical Research and the Institutional Human Ethics Committee of ICMR-National Institute of Epidemiology, Chennai approved the study protocol.

Suggested Citation

Murhekar, Manoj and Bhatnagar, Tarun and Selvaraju, Sriram and Kumar, V. Saravana and Thangaraj, Jeromie Wesley Vivian and Shah, Naman and Santhosh Kumar, Muthusamy and Rade, Kiran and Sabarinathan, R. and Asthana, Smita and Balachandar, Rakesh and Bangar, Sampada Dipak and Bansal, Avi Kumar and Bhat, Jyothi and Chopra, Vishal and Das, Dasarathi and Deb, Alok Kumar and Devi, Kangjam Rekha and Dwivedi, Gaurav Raj and Khan, S. Muhammad Salim and Kumar, CP Girish and Kumar, M. Sunil and Laxmaiah, Avula and Madhukar, Major and Mahapatra, Amarendra and Mohanty, Suman Sundar and Rangaraju, Chethana and Turuk, Alka and Baradwaj, Dinesh Kumar and Chahal, Ashrafjit S. and Debnath, Falguni and Haq, Inaamul and Kalliath, Arshad and Kanungo, Srikanta and Kshatri, Jaya and Naga Lakshmi, Gangeti Gandhi Jayanthi and Mitra, Anindya and Nirmala, AR and Prasad, Ganta Venkata and Qurieshi, Mariya Amin and Sahay, Seema and Sangwan, Ramesh Kumar and Sekar, Krithikaa and Shukla, Vijay Kumar and Singh, Prashant Kumar and Singh, Pushpendra and Singh, Rajeev and Varma, Dantuluri Sheethal and Viramgami, Ankit and Panda, Samiran and Reddy, DCS and Bhargava, Balram and Group, ICMR Serosurveillance, SARS-CoV-2 Antibody Prevalence in India: Findings from the Second Nationwide Household Serosurvey, August - September 2020. Available at SSRN: https://ssrn.com/abstract=3715460 or http://dx.doi.org/10.2139/ssrn.3715460

Manoj Murhekar (Contact Author)

Indian Council of Medical Research (ICMR) - National Institute of Epidemiology

Tarun Bhatnagar

Indian Council of Medical Research (ICMR) - National Institute of Epidemiology ( email )

Chennai, Tamil Nadu
India

Sriram Selvaraju

Indian Council of Medical Research (ICMR) - National Institute for Research in Tuberculosis ( email )

Chennai
India

V. Saravana Kumar

ICMR-National Institute of Epidemiology

Jeromie Wesley Vivian Thangaraj

ICMR-National Institute of Epidemiology

Ayapakkam
Ayapakkam
Chennai, 600077
India

Naman Shah

Indian Council of Medical Research (ICMR) - National Institute of Epidemiology

Chennai, Tamil Nadu
India

Muthusamy Santhosh Kumar

ICMR-National Institute of Epidemiology

Ayapakkam
Ayapakkam
Chennai, 600077
India

Kiran Rade

World Health Organization - India Country Office

India

R. Sabarinathan

ICMR-National Institute of Epidemiology

Smita Asthana

ICMR-National Institute of Cancer Prevention and Research ( email )

Rakesh Balachandar

ICMR-National Institute of Occupational Health ( email )

Ahmedabad
India

Sampada Dipak Bangar

ICMR-National AIDS Research Institute ( email )

Avi Kumar Bansal

ICMR – National JALMA Institute for Leprosy and Other Mycobacterial Diseases ( email )

Jyothi Bhat

ICMR-National Institute of Research in Tribal Health

Vishal Chopra

State TB Training and Demonstration centre (STDC)

Dasarathi Das

ICMR-Regional Medical Research Centre ( email )

Alok Kumar Deb

ICMR-National Institute of Cholera and Enteric Diseases ( email )

Kangjam Rekha Devi

ICMR-Regional Medical Research Centre ( email )

Gaurav Raj Dwivedi

ICMR-Regional Medical Research Centre ( email )

S. Muhammad Salim Khan

Government Medical College, Srinagar

Srinagar
India

CP Girish Kumar

ICMR-National Institute of Epidemiology

Ayapakkam
Ayapakkam
Chennai, 600077
India

M. Sunil Kumar

State TB Training and Demonstration centre (STDC) ( email )

Avula Laxmaiah

ICMR-National Institute of Nutrition ( email )

Major Madhukar

ICMR-Rajendra Memorial Research Institute of Medical Sciences ( email )

Amarendra Mahapatra

ICMR-Regional Medical Research Centre ( email )

Suman Sundar Mohanty

ICMR-National Institute for Implementation Research on Non-Communicable Diseases ( email )

Chethana Rangaraju

National Tuberculosis Institute ( email )

Alka Turuk

Indian Council of Medical Research (ICMR) ( email )

National Institute of Occupational Health
NIOH, Meghani Nagar
Ahemdabad, Gujarat, Gujarat 380016
India

Dinesh Kumar Baradwaj

ICMR-National Institute of Nutrition ( email )

Ashrafjit S. Chahal

State TB Training and Demonstration Centre (STDC) ( email )

Falguni Debnath

ICMR-National Institute of Cholera and Enteric Diseases ( email )

Inaamul Haq

Government Medical College, Srinagar

Srinagar
India

Arshad Kalliath

State TB Training and Demonstration Centre (STDC) ( email )

Srikanta Kanungo

Government of India - Department of Microbiology ( email )

Chandrasekharpur
India

Jaya Kshatri

Government of India - Department of Microbiology ( email )

Chandrasekharpur
India

Gangeti Gandhi Jayanthi Naga Lakshmi

Directorate of Public Health and Family Welfare - Office of Joint Director for Tuberculosis ( email )

Anindya Mitra

State TB Training and Demonstration centre (STDC)

AR Nirmala

Lady Willingdon State TB centre ( email )

Ganta Venkata Prasad

Directorate of Public Health and Family Welfare - Office of Joint Director for Tuberculosis ( email )

Mariya Amin Qurieshi

Government Medical College, Srinagar

Srinagar
India

Seema Sahay

ICMR-National AIDS Research Institute ( email )

Ramesh Kumar Sangwan

ICMR-National Institute for Implementation Research on Non-Communicable Diseases ( email )

Krithikaa Sekar

Indian Council of Medical Research (ICMR) - National Institute for Research in Tuberculosis ( email )

Chennai
India

Vijay Kumar Shukla

Directorate Health Services

Prashant Kumar Singh

ICMR-National Institute of Cancer Prevention and Research

Pushpendra Singh

ICMR-National Institute of Research in Tribal Health

Rajeev Singh

ICMR-Regional Medical Research Centre

CHANDRASEKHARPUR
BHUBANESWAR, 751023
India

Dantuluri Sheethal Varma

Directorate of Public Health and Family Welfare - Office of Joint Director for Tuberculosis ( email )

Ankit Viramgami

ICMR – National Institute of Occupational Health ( email )

Samiran Panda

Indian Council of Medical Research (ICMR) ( email )

National Institute of Occupational Health
NIOH, Meghani Nagar
Ahemdabad, Gujarat, Gujarat 380016
India

DCS Reddy

Independent ( email )

Balram Bhargava

Government of India - Department of Health Research

India

No contact information is available for ICMR Serosurveillance Group

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