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Epidemiol Health > Accepted Articles
Epidemiology and Health 2022;e2022028.
DOI: https://doi.org/10.4178/epih.e2022028    [Accepted] Published online Feb 21, 2022.
Seroprevalence study of SARS-CoV-2 antibodies in community based on participants in the 2020 Korea National Health and Nutrition Examination Survey (KNHANES)
Ah-Ra Kim1  , Dohsik Minn3  , SuHwan Kim1  , HyeonNam Do1  , Brian Byoungguk Kim1  , Young Sill Choi4  , Dong-Hyun Kim5  , Eun-Jee Oh6  , Kyungwon Oh7  , Donghyok Kwon8  , Jun-wook Kwon9  , Sung Soon Kim2  , Junewoo Lee1 
1Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, CheongJu, Korea
2Center for Vaccine Research, National Institute of Infectious Diseases, Korea Disease Control and Prevention Agency, CheongJu, Korea
3Medical Director for Diagnostic Immunology, Seegene Medical Foundation, Seoul, Korea
4Division of Pathogen Resource Management Center for Vaccine Research, National Institute of Infectious Diseases, CheongJu, Korea
5Department to Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, Korea
6Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
7Division of Health and Nutrition Survey and Analysis, Bureau of Chronic Disease Prevention and Control, Korea Disease Control and Prevention Agency, CheongJu, Korea
8Division of Public Health Emergency Responses Research, Korea Disease Control and Prevention Agency, CheongJu, Korea
9National Institute of Health (NIH), Korea Disease Control and Prevention Agency (KDCA), CheongJu, Korea
Correspondence  Sung Soon Kim ,Email: junewoo1213@korea.kr
Junewoo Lee ,Email: junewoo1213@korea.kr
Received: Dec 8, 2021  Accepted after revision: Feb 21, 2022
Abstract
Objectives:
The Korea National Health and Nutrition Examination Survey (KNHANES) is a nationwide cross-sectional surveillance system that assesses the health and nutritional status of the Korean population. To evaluate the occurrence of SARS-CoV-2 infection in the community, we investigated the presence of antibodies against SARS-CoV-2 using the sera of KNHANES participants.
Method:
The subjects were recruited between April 24, 2020, and December 12, 2020. A total of 5,284 subjects aged 10-90 years from 17 regions participated in the survey. SARS-CoV-2 antibodies were screened using the Elecsys Anti-SARS-CoV-2 assay. Positive samples were verified using four different SARS-CoV-2 antibody assays and the plaque reduction neutralizing test (PRNT). The final seropositivity criteria were defined as a positive screening test and at least one positive out of the five additional tests.
Results:
The distribution of survey participants was as follows: 49.2% (2,600/5,284) were from a metropolitan area, 48.9% were middle-aged (in their 40s and 60s) and 19.3% were in their 20s or younger. The seropositivity rate among the participants was 0.09% (5/5,284). Out of the five antibody-positive subjects, three had a history of infection, of whom, two were infected abroad while one was infected through a local cluster outbreak.
Conclusion:
The low seroprevalence of SARS-CoV-2 antibody in Korea indicates the fewer COVID-19 patients due to succeed of COVID-19 management measures. Moreover, asymptomatic infections were also detected fewer due to active PCR testing. However, hidden infections may still be prevalent in the community, thus requiring continuous quarantine and vaccination.
Keywords: COVID-19; SARS-CoV-2; Antibodies; Seroprevalence; South Korea


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