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Prevalence and Risk Factors of Infection in the Representative COVID-19 Cohort Munich

51 Pages Posted: 6 Jan 2021

See all articles by Michael Pritsch

Michael Pritsch

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich

Katja Radon

Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich

Abhishek Bakuli

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich

Ronan Le Gleut

Institute of Computational Biology, Helmholtz Zentrum München - German Research Center for Environmental Health; Helmholtz Zentrum Muenchen

Laura Olbrich

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich

Jessica Michelle Guggenbuehl Noller

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich

Elmar Saathoff

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich

Noemi Castelletti

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich

Mercè Garí

Institute of Computational Biology, Helmholtz Zentrum München - German Research Center for Environmental Health

Peter Puetz

Institute of Computational Biology, Helmholtz Zentrum München - German Research Center for Environmental Health

Yannik Schaelte

Institute of Computational Biology, Helmholtz Zentrum München - German Research Center for Environmental Health

Turid Frahnow

Institute of Computational Biology, Helmholtz Zentrum München - German Research Center for Environmental Health

Roman Wölfel

Bundeswehr Institute of Microbiology

Camilla Rothe

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich

Michel Pletschette

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich

Dafni Metaxa

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich

Felix Forster

Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich

Verena Thiel

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich

Friedrich Riess

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich

Maximilian Nikolaus Diefenbach

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich

Guenter Froeschl

Ludwig Maximilian University of Munich (LMU) - CIHLMU Center for International Health

Jan Bruger

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich

Simon Winter

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich

Jonathan Frese

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich

Kerstin Puchinger

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich

Isabel Brand

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich

Inge Kroidl

LMU Munich - Division of Infectious Diseases and Tropical Medicine

Jan Hasenauer

University of Bonn - Interdisciplinary Research Unit of Mathematics and Life Sciences,

Christiane Fuchs

Institute of Computational Biology, Helmholtz Zentrum München - German Research Center for Environmental Health

Andreas Wieser

Ludwig Maximilian University of Munich (LMU) - Division of Infectious Diseases and Tropical Medicine

Michael Hoelscher

Ludwig Maximilian University of Munich (LMU) - CIHLMU Center for International Health

KoCo19 Study Group

Independent

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Abstract

Background: Population-based studies investigating the dynamics of the SARS-CoV-2 pandemic are needed. Here, we report on baseline findings from April through June 2020 of a prospective cohort study in Munich, Germany.

Methods: We drew a representative sample of 2994 private households. The 5313 participating household members 14 years and older completed questionnaires and provided blood samples. SARS-CoV-2 seropositivity was defined as Roche N pan-Ig ≥ 0·4218. We adjusted the prevalence for the sampling design, sensitivity, and specificity. We investigated risk factors for SARS-CoV-2 seropositivity and geospatial transmission patterns by generalized linear mixed models and permutation tests.

Findings: Seropositivity for SARS-CoV-2 specific antibodies was 1·82% (95% confidence interval (CI) 1·28-2·37%) as compared to 0·46% PCR-positive cases officially registered in Munich. Loss of the sense of smell or taste was associated with seropositivity (odds ratio (OR) 47·4; 95% CI 7·2-307·0) and infections clustered within households. Participants suffering from respiratory allergies (OR 2·7; 95% CI 0·9-8·6) and working in high-risk jobs (OR 2·0; 95% CI 0·5-6·7) showed non-significantly increased odds for SARS-CoV-2 seropositivity.

Interpretation: Applying a validated assay, we demonstrate a low SARS-CoV-2 seroprevalence in the Munich population 14 years and older towards the end of the first pandemic wave. However, we noted official sub-registration at this early stage of the pandemic.

Funding: Bavarian State Ministry of Science and the Arts, University Hospital of LMU Munich, Helmholtz Centre Munich, University of Bonn, and University of Bielefeld.

Declaration of Interests: FF, TF, DM, LO, and VT report grants from the Bavarian State Ministry of Science and the Arts during the conduct oft he study. TF reports grants from the University Hospital of LMU Munich, Helmholtz Center Munich, University of Bonn, University of Bielefeld, and German Ministry for Education and Research during the conduct of the study. JH reports grants from the German Federal Ministry of Education and Research during the conduct of the study. MH and AW report personal fees and non-financial support, LO and MP report non-financial support from Roche Diagnostics. MH, LO, MP, and AW report non-financial support from Euroimmun, Viramed, and Mikrogen. MH, MP, and AW report grants, non-financial support, and other from German Center for Infection Research (DZIF). FF, MH, LO, MP, VT, and AW report grants and non-financial support from the Government of Bavaria. MH, LO, MP, and AW report non-financial support from BMW, Mercedes Benz, Munich Police, and Accenture. MH and AW report personal fees and non-financial support from Dr. Box Betrobox during the conduct of the study. LO and MP report non-financial support from Dr. Box Betrobox. MH and AW have a patent Sample System for Sputum Diagnostics of SARS-CoV-2 pending. DM reports to be a a sub-investigator on a Phase I SARS-CoV-2 vaccine trial and on a Phase I rabies vaccine trial, both sponsored by CureVac AG. MP and AW report non-financial support from Dr. Becker MVZ. VT reports support from CureVac AG outside the submitted work. AW reports personal fees and other from Haeraeus Sensors. AW reports non-financial support from Bruker Daltronics outside the submitted work. AW is involved in other different patents and companies not in relation with the serology of SARS-CoV-2. All other authors report nothing to disclose.

Ethics Approval Statement: Prior to study initiation, this study had been approved by the
respective Institutional Review Board.

Keywords: COVID-19; SARS-CoV-2; population-based cohort study; seroprevalence; seroepidemiology; serosurvey; infection fatality ratio; underreporting; risk factors; cluster; Germany

Suggested Citation

Pritsch, Michael and Radon, Katja and Bakuli, Abhishek and Le Gleut, Ronan and Olbrich, Laura and Guggenbuehl Noller, Jessica Michelle and Saathoff, Elmar and Castelletti, Noemi and Garí, Mercè and Puetz, Peter and Schaelte, Yannik and Frahnow, Turid and Wölfel, Roman and Rothe, Camilla and Pletschette, Michel and Metaxa, Dafni and Forster, Felix and Thiel, Verena and Riess, Friedrich and Diefenbach, Maximilian Nikolaus and Froeschl, Guenter and Bruger, Jan and Winter, Simon and Frese, Jonathan and Puchinger, Kerstin and Brand, Isabel and Kroidl, Inge and Hasenauer, Jan and Fuchs, Christiane and Wieser, Andreas and Hoelscher, Michael and Group, KoCo19 Study, Prevalence and Risk Factors of Infection in the Representative COVID-19 Cohort Munich. Available at SSRN: https://ssrn.com/abstract=3745128 or http://dx.doi.org/10.2139/ssrn.3745128

Michael Pritsch

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich ( email )

Katja Radon

Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich ( email )

Abhishek Bakuli

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich ( email )

Ronan Le Gleut

Institute of Computational Biology, Helmholtz Zentrum München - German Research Center for Environmental Health ( email )

Helmholtz Zentrum Muenchen ( email )

Laura Olbrich

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich ( email )

Jessica Michelle Guggenbuehl Noller

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich ( email )

Elmar Saathoff

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich ( email )

Noemi Castelletti

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich ( email )

Mercè Garí

Institute of Computational Biology, Helmholtz Zentrum München - German Research Center for Environmental Health ( email )

Peter Puetz

Institute of Computational Biology, Helmholtz Zentrum München - German Research Center for Environmental Health ( email )

Yannik Schaelte

Institute of Computational Biology, Helmholtz Zentrum München - German Research Center for Environmental Health ( email )

Turid Frahnow

Institute of Computational Biology, Helmholtz Zentrum München - German Research Center for Environmental Health ( email )

Roman Wölfel

Bundeswehr Institute of Microbiology ( email )

Munich
Germany

Camilla Rothe

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich ( email )

Michel Pletschette

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich ( email )

Dafni Metaxa

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich ( email )

Felix Forster

Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich

Verena Thiel

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich ( email )

Friedrich Riess

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich ( email )

Maximilian Nikolaus Diefenbach

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich ( email )

Guenter Froeschl

Ludwig Maximilian University of Munich (LMU) - CIHLMU Center for International Health ( email )

Munich
Germany

Jan Bruger

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich ( email )

Simon Winter

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich

Jonathan Frese

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich ( email )

Kerstin Puchinger

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich ( email )

Isabel Brand

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich ( email )

Inge Kroidl

LMU Munich - Division of Infectious Diseases and Tropical Medicine ( email )

Jan Hasenauer

University of Bonn - Interdisciplinary Research Unit of Mathematics and Life Sciences, ( email )

Bonn
Germany

Christiane Fuchs

Institute of Computational Biology, Helmholtz Zentrum München - German Research Center for Environmental Health ( email )

Andreas Wieser

Ludwig Maximilian University of Munich (LMU) - Division of Infectious Diseases and Tropical Medicine ( email )

Munich
Germany

Michael Hoelscher (Contact Author)

Ludwig Maximilian University of Munich (LMU) - CIHLMU Center for International Health ( email )

Munich
Germany

KoCo19 Study Group

Independent

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