SARS-CoV-2 antibody seroprevalence in Lebanon: findings from the first nationwide serosurvey

Abbas Hoballah; Rana El Haidari; Ghina Siblany; Fadi Abdel Sater; Samir Mansour; Hamad Hassan; Linda Abou-Abbas

doi:10.1186/s12879-022-07031-z

SARS-CoV-2 antibody seroprevalence in Lebanon: findings from the first nationwide serosurvey

BMC Infect Dis. 2022 Jan 10;22(1):42. doi: 10.1186/s12879-022-07031-z.

Authors

Abbas Hoballah¹, Rana El Haidari², Ghina Siblany³, Fadi Abdel Sater⁴, Samir Mansour⁵, Hamad Hassan^{6

7}, Linda Abou-Abbas^{8

9}

Affiliations

¹ General Director of Islamic Health Society, Baabda, Lebanon.
² Department of Research, Islamic Health Society, Baabda, Lebanon. Ranahaidari14@hotmail.com.
³ Faculty of Public Health, Lebanese University, Fanar, Lebanon.
⁴ Laboratory of Molecular Biology and Cancer Immunology (COVID 19 Unit), Faculty of Science, Lebanese University, Hadath, Lebanon.
⁵ Department of Informatics, Islamic Health Society, Baabda, Lebanon.
⁶ Ministry of Public Health, Beirut, Lebanon.
⁷ Medical Care Laboratory Medicine, Faculty of Public Health, Lebanese University, Zahle, Lebanon.
⁸ Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon.
⁹ Epidemiological Surveillance Program, Ministry of Public Health, Beirut, Lebanon.

Abstract

Background: Lebanon, a small country in the Middle East, remains severely affected by the COVID-19 pandemic. Seroprevalence surveys of anti-SARS-CoV-2 antibodies provide accurate estimates of SARS-CoV-2 infection and hence evaluate the extent of the pandemic. The present study aimed to evaluate the prevalence of SARS-CoV-2 antibodies in Lebanon and to compare the estimated cumulative number of COVID-19 cases with the officially registered number of laboratory-confirmed cases up to January 15, 2021.

Methods: A nationwide population-based serosurvey study was conducted in Lebanon between December 7, 2020, and January 15, 2021, before the initiation of the national vaccination program. The nCOVID-19 IgG & IgM point-of-care (POCT) rapid test was used to detect the presence of anti-SARS-COV-2 immunoglobulin G (IgG) in the blood. Seroprevalence was estimated after weighting for sex, age, and area of residence and adjusting for the test performance.

Results: Of the 2058 participants, 329 were positive for IgG SARS-COV-2, resulting in a crude seroprevalence of 16.0% (95% CI 14.4-17.6). The weighed seroprevalence was 15.9% (95% CI of 14.4 and 17.4). After adjusting for test performance, the population weight-adjusted seroprevalence was 18.5% (95% CI 16.8-20.2). This estimate implies that 895,770 individuals of the general population were previously infected by COVID-19 up to January 15, 2021 in Lebanon. The overall estimated number of subjects with previous SARS-CoV-2 infection was three times higher than the officially reported cumulative number of confirmed cases. Seroprevalence was similar across age groups and sexes (p-value > 0.05). However, significant differences were revealed across governorates.

Conclusions: Our results suggest that the Lebanese population is still susceptible to SARS-CoV-2 infection and far from achieving herd immunity. These findings represent an important contribution to the surveillance of the COVID-19 pandemic in Lebanon and to the understanding of how this virus spreads. Continued surveillance for COVID-19 cases and maintaining effective preventive measures are recommended to control the epidemic spread in conjunction with a national vaccination campaign to achieve the desired level of herd immunity against COVID-19.

Keywords: Lebanon; SARS-CoV-2 antibody; Seroprevalence; Serosurvey.

MeSH terms

Antibodies, Viral
COVID-19*
Humans
Lebanon
Pandemics
SARS-CoV-2*
Seroepidemiologic Studies

Substances

Antibodies, Viral