Sociodemographic disparities in COVID-19 seroprevalence across England in the Oxford RCGP primary care sentinel network

Heather Whitaker; Ruby S M Tsang; Elizabeth Button; Nick Andrews; Rachel Byford; Ray Borrow; F D Richard Hobbs; Tim Brooks; Gary Howsam; Kevin Brown; Jack Macartney; Charlotte Gower; Cecilia Okusi; Jacqueline Hewson; Julian Sherlock; Ezra Linley; Manasa Tripathy; Ashley D Otter; John Williams; Simon Tonge; Simon de Lusignan; Gayatri Amirthalingam

doi:10.1016/j.jinf.2022.04.016

Sociodemographic disparities in COVID-19 seroprevalence across England in the Oxford RCGP primary care sentinel network

J Infect. 2022 Jun;84(6):814-824. doi: 10.1016/j.jinf.2022.04.016. Epub 2022 Apr 9.

Authors

Heather Whitaker¹, Ruby S M Tsang², Elizabeth Button², Nick Andrews³, Rachel Byford², Ray Borrow⁴, F D Richard Hobbs², Tim Brooks⁵, Gary Howsam⁶, Kevin Brown⁷, Jack Macartney², Charlotte Gower⁷, Cecilia Okusi², Jacqueline Hewson⁸, Julian Sherlock², Ezra Linley⁴, Manasa Tripathy², Ashley D Otter⁸, John Williams², Simon Tonge⁴, Simon de Lusignan², Gayatri Amirthalingam⁷

Affiliations

¹ Statistics, Modelling and Economics Department, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK. Electronic address: heather.whitaker@phe.gov.uk.
² Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK.
³ Statistics, Modelling and Economics Department, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK; Immunisation and Countermeasures Division, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK.
⁴ Vaccine Evaluation Unit, UK Health Security Agency, Manchester M13 9WL, UK.
⁵ Rare & Imported Pathogens Laboratory, UK Health Security Agency, Porton Down, Salisbury SP4 0JG, UK.
⁶ Royal College General Practitioners, London NW1 2FB, UK.
⁷ Immunisation and Countermeasures Division, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK.
⁸ Diagnostics and Genomics, National Infection Service, Public Health England, Porton Down, Salisbury SP4 0JG, UK.

Abstract

Objectives: To monitor changes in seroprevalence of SARS-CoV-2 antibodies in populations over time and between different demographic groups.

Methods: A subset of practices in the Oxford-Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) sentinel network provided serum samples, collected when volunteer patients had routine blood tests. We tested these samples for SARS-CoV-2 antibodies using Abbott (Chicago, USA), Roche (Basel, Switzerland) and/or Euroimmun (Luebeck, Germany) assays, and linked the results to the patients' primary care computerised medical records. We report seropositivity by region and age group, and additionally examined the effects of gender, ethnicity, deprivation, rurality, shielding recommendation and smoking status.

Results: We estimated seropositivity from patients aged 18-100 years old, which ranged from 4.1% (95% CI 3.1-5.3%) to 8.9% (95% CI 7.8-10.2%) across the different assays and time periods. We found higher Euroimmun seropositivity in younger age groups, people of Black and Asian ethnicity (compared to white), major conurbations, and non-smokers. We did not observe any significant effect by region, gender, deprivation, or shielding recommendation.

Conclusions: Our results suggest that prior to the vaccination programme, most of the population remained unexposed to SARS-CoV-2.

Keywords: COVID-19; SARS-CoV-2; Serology; Survey; demographics; primary care; seroprevalence.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Aged
Aged, 80 and over
Antibodies, Viral
COVID-19* / epidemiology
England / epidemiology
General Practitioners*
Humans
Middle Aged
Primary Health Care
SARS-CoV-2
Seroepidemiologic Studies
Young Adult

Substances

Antibodies, Viral