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COVID-19: Original Article
Korea Seroprevalence Study of Monitoring of SARS-COV-2 Antibody Retention and Transmission (K-SEROSMART): findings from national representative sample
Jina Han, Hye Jin Baek, Eunbi Noh, Kyuhyun Yoon, Jung Ae Kim, Sukhyun Ryu, Kay O Lee, No Yai Park, Eunok Jung, Sangil Kim, Hyukmin Lee, Yoo-Sung Hwang, Jaehun Jung, Hun Jae Lee, Sung-il Cho, Sangcheol Oh, Migyeong Kim, Chang-Mo Oh, Byengchul Yu, Young-Seoub Hong, Keonyeop Kim, Sun Jae Jung, Mi Ah Han, Moo-Sik Lee, Jung-Jeung Lee, Young Hwangbo, Hyeon Woo Yim, Yu-Mi Kim, Joongyub Lee, Weon-Young Lee, Jae-Hyun Park, Sungsoo Oh, Heui Sug Jo, Hyeongsu Kim, Gilwon Kang, Hae-Sung Nam, Ju-Hyung Lee, Gyung-Jae Oh, Min-Ho Shin, Soyeon Ryu, Tae-Yoon Hwang, Soon-Woo Park, Sang Kyu Kim, Roma Seol, Ki-Soo Park, Su Young Kim, Jun-wook Kwon, Sung Soon Kim, Byoungguk Kim, June-Woo Lee, Eun Young Jang, Ah-Ra Kim, Jeonghyun Nam, The Korea Community Health Survey Group, Soon Young Lee, Dong-Hyun Kim
Epidemiol Health. 2023;45:e2023075.   Published online August 17, 2023
DOI: https://doi.org/10.4178/epih.e2023075
  • 7,940 View
  • 221 Download
  • 4 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We estimated the population prevalence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including unreported infections, through a Korea Seroprevalence Study of Monitoring of SARS-CoV-2 Antibody Retention and Transmission (K-SEROSMART) in 258 communities throughout Korea.
METHODS
In August 2022, a survey was conducted among 10,000 household members aged 5 years and older, in households selected through two stage probability random sampling. During face-to-face household interviews, participants self-reported their health status, COVID-19 diagnosis and vaccination history, and general characteristics. Subsequently, participants visited a community health center or medical clinic for blood sampling. Blood samples were analyzed for the presence of antibodies to spike proteins (anti-S) and antibodies to nucleocapsid proteins (anti-N) SARS-CoV-2 proteins using an electrochemiluminescence immunoassay. To estimate the population prevalence, the PROC SURVEYMEANS statistical procedure was employed, with weighting to reflect demographic data from July 2022.
RESULTS
In total, 9,945 individuals from 5,041 households were surveyed across 258 communities, representing all basic local governments in Korea. The overall population-adjusted prevalence rates of anti-S and anti-N were 97.6% and 57.1%, respectively. Since the Korea Disease Control and Prevention Agency has reported a cumulative incidence of confirmed cases of 37.8% through July 31, 2022, the proportion of unreported infections among all COVID-19 infection was suggested to be 33.9%.
CONCLUSIONS
The K-SEROSMART represents the first nationwide, community-based seroepidemiologic survey of COVID-19, confirming that most individuals possess antibodies to SARS-CoV-2 and that a significant number of unreported cases existed. Furthermore, this study lays the foundation for a surveillance system to continuously monitor transmission at the community level and the response to COVID-19.
Summary
Korean summary
인구집단을 기반으로 하여 대표성 있는 표본을 추출하여 COVID-19 항체유병률 조사를 전국적으로 수행함으로 지역사회 단위에서 지속적으로 모니터링할 수 있는 COVID-19 감시체계 구축의 기반을 마련하였다. 2022년 8월 우리나라 국민의 대부분이 COVID-19에 대한 항체를 보유하고 있었고 인구 3명 중 1명은 미확진 감염자로 추정되었다.
Key Message
The K-SEROSMART represents the first nationwide, community-based seroepidemiologic survey of COVID-19. In August 2022, most of the Korean people had antibodies to COVID-19, and one in three people was estimated to have an unreported infection. This study lays the foundation for a surveillance system to continuously monitor transmission at the community level and the response to COVID-19.

Citations

Citations to this article as recorded by  
  • Infection-mediated immune response in SARS-CoV-2 breakthrough infection and implications for next-generation COVID-19 vaccine development
    Sho Miyamoto, Tadaki Suzuki
    Vaccine.2024; 42(6): 1401.     CrossRef
  • Changes in the intrinsic severity of severe acute respiratory syndrome coronavirus 2 according to the emerging variant: a nationwide study from February 2020 to June 2022, including comparison with vaccinated populations
    Boyeong Ryu, Eunjeong Shin, Dong Hwi Kim, HyunJu Lee, So Young Choi, Seong-Sun Kim, Il-Hwan Kim, Eun-Jin Kim, Sangwon Lee, Jaehyun Jeon, Donghyok Kwon, Sungil Cho
    BMC Infectious Diseases.2024;[Epub]     CrossRef
  • Seroprevalence of SARS-CoV-2 infection in pediatric patients in a tertiary care hospital setting
    Ploy Pattanakitsakul, Chanya Pongpatipat, Chavachol Setthaudom, Mongkol Kunakorn, Thiantip Sahakijpicharn, Anannit Visudtibhan, Nopporn Apiwattanakul, Surapat Assawawiroonhakarn, Uthen Pandee, Chonnamet Techasaensiri, Sophida Boonsathorn, Sujittra Chaisav
    PLOS ONE.2024; 19(9): e0310860.     CrossRef
  • Realistic Estimation of COVID-19 Infection by Seroprevalence Surveillance of SARS-CoV-2 Antibodies: An Experience From Korea Metropolitan Area From January to May 2022
    In Hwa Jeong, Jong-Hun Kim, Min-Jung Kwon, Jayoung Kim, Hee Jin Huh, Byoungguk Kim, Junewoo Lee, Jeong-hyun Nam, Eun-Suk Kang
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
COVID-19: Original Article
Seroprevalence of SARS-CoV-2 antibodies during the third wave of COVID-19 in the Seoul metropolitan area of Korea
Kyuhyun Yoon, Jayeun Kim, Kyong Ran Peck, Hyun Soo Kim, Hyukmin Lee, Yoo-Sung Hwang, Soon Young Lee, Sung-il Cho, Hun Jae Lee, Yeong-gyeong Kim, Byoungguk Kim, June-Woo Lee, Ah-Ra Kim, Hyeon Nam Do, Dong-Hyun Kim
Epidemiol Health. 2022;44:e2022085.   Published online September 30, 2022
DOI: https://doi.org/10.4178/epih.e2022085
  • 6,713 View
  • 186 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
After the third wave of coronavirus disease 2019 (COVID-19), by mid-February 2021, approximately 0.16% of the Korean population was confirmed positive, which appeared to be among the lowest rates worldwide at that time. However, asymptomatic transmission is challenging for COVID-19 surveillance. Therefore, a community-based serosurvey of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was conducted to understand the effectiveness of Korea’s strong containment strategy.
METHODS
We collected 5,002 residual sera samples from January 30 to March 3, 2021, from 265 medical facilities in Seoul, 346 in Gyeonggi Province, and 57 in Incheon. Sixty samples from tertiary institutions were excluded. We defined the sub-regions according to the addresses of the medical facilities where the specimens were collected. Elecsys Anti-SARS-CoV-2 was used for screening, and positivity was confirmed using the SARS-CoV-2 sVNT Kit. Prevalence was estimated using sampling weights and the Wilson score interval for a binomial proportion with a 95% confidence interval.
RESULTS
Among the 4,942 specimens, 32 and 25 tested positive for COVID-19 in the screening and confirmatory tests, respectively. The overall crude prevalence of SARS-CoV-2 antibodies was 0.51%. The population-adjusted overall prevalence was 0.55% in women and 0.38% in men. The region-specific estimation was 0.67% and 0.30% in Gyeonggi Province and Seoul, respectively. No positive cases were detected in Incheon.
CONCLUSIONS
The proportion of undetected cases in Korea remained low as of early 2021. Therefore, an infection control strategy with exhaustive tracing and widespread pre-emptive testing appears to be effective in containing community spread of COVID-19.
Summary
Korean summary
코로나19바이러스 감염병(COVID-19)의 한국 내 3차 대유행기인 2020년 말 이후, 2021년 1월 우리나라 인구의 약 0.16%가 누적 확진되었으며, 이는 세계에서 매우 낮은 비율을 보이는 국가 중 하나였습니다. 그러나 COVID-19의 무증상 전파는 감염 확산방지와 감시체계에 문제점들을 초래할 수 있어 지역사회 기반 혈청 조사를 통해 그 현황을 파악했습니다. 2021년 1월 30일부터 3월 3일까지 서울, 경기, 인천 등 수도권 소재 1, 2차 의료기관에서 수집된 혈액검체의 잔여혈청표본 4942개에 대해 Roche사의 Elecsys Anti-SARS-CoV-2를 이용한 1차 항체검사와, GenScript의 SARS-CoV-2 sVNT Kit를 이용하여 2차 중화항체유무를 확인하였다. 4942명의 검체 중 1차 검사와 2차 중화항체검사에서 각각 32명과 25명이 항체 양성이었다. SARS-CoV-2 항체의 전체 수도권 조유병률은 0.51%였습니다. 인구의 연령보정 전체 유병률은 0.47%였으며, 성별로는 여성에서 0.55%, 남성에서 0.38%였습니다. 지역별 추정치는 경기도와 서울이 각각 0.67%와 0.30%였고, 인천에서는 양성사례가 발견되지 않았습니다. 한국의 미발견 사례 비율은 누적 확진율의 3배에 달하지만, 여전히 1% 미만으로 ​​낮습니다. 철저한 추적과 광범위한 선제적 검사를 통한 감염 관리 전략이 지역사회에서 바이러스 확산을 억제하는 데 효과적이었던 것으로 보입니다.
Key Message
Around February 2021, the SARS-CoV-2 antibody test was conducted on the residual serum of adults (≥19 years) collected from primary and secondary medical institutions in the metropolitan area in South Korea. The estimated overall prevalence was 0.60% in the electrochemiluminescence immunoassay (ECLIA) detecting IgG against the nucleocapsid protein and 0.47% for the neutralization antibody. The positivity of the confirmed test using surrogate neutralizing antibodies was only 78% of the ECLIA’s results. For prevention and control measures against the spread of SARS-CoV-2 infections and new variants emerge, serosurvey targeting community-dwelling people is needed to understand the changing status in the community.

Citations

Citations to this article as recorded by  
  • Realistic Estimation of COVID-19 Infection by Seroprevalence Surveillance of SARS-CoV-2 Antibodies: An Experience From Korea Metropolitan Area From January to May 2022
    In Hwa Jeong, Jong-Hun Kim, Min-Jung Kwon, Jayoung Kim, Hee Jin Huh, Byoungguk Kim, Junewoo Lee, Jeong-hyun Nam, Eun-Suk Kang
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Korea Seroprevalence Study of Monitoring of SARS-COV-2 Antibody Retention and Transmission (K-SEROSMART): findings from national representative sample
    Jina Han, Hye Jin Baek, Eunbi Noh, Kyuhyun Yoon, Jung Ae Kim, Sukhyun Ryu, Kay O Lee, No Yai Park, Eunok Jung, Sangil Kim, Hyukmin Lee, Yoo-Sung Hwang, Jaehun Jung, Hun Jae Lee, Sung-il Cho, Sangcheol Oh, Migyeong Kim, Chang-Mo Oh, Byengchul Yu, Young-Seo
    Epidemiology and Health.2023; 45: e2023075.     CrossRef

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