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Tracking the incidence and risk factors for SARS-CoV-2 infection using historical maternal booking serum samples.

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McCabe, Ruth 
Bird, Sheila M 
Randell, Paul 
Pond, Marcus J 


The early transmission dynamics of SARS-CoV-2 in the UK are unknown but their investigation is critical to aid future pandemic planning. We tested over 11,000 anonymised, stored historic antenatal serum samples, given at two north-west London NHS trusts in 2019 and 2020, for total antibody to SARS-CoV-2 receptor binding domain (anti-RBD). Estimated prevalence of seroreactivity increased from 1% prior to mid-February 2020 to 17% in September 2020. Our results show higher prevalence of seroreactivity to SARS-CoV-2 in younger, non-white ethnicity, and more deprived groups. We found no significant interaction between the effects of ethnicity and deprivation. Derived from prevalence, the estimated incidence of seroreactivity reflects the trends observed in daily hospitalisations and deaths in London that followed 10 and 13 days later, respectively. We quantified community transmission of SARS-CoV-2 in London, which peaked in late March / early April 2020 with no evidence of community transmission until after January 2020. Our study was not able to determine the date of introduction of the SARS-CoV-2 virus but demonstrates the value of stored antenatal serum samples as a resource for serosurveillance during future outbreaks.


Funder: Community Jameel and the Imperial President’s Excellence Fund

Funder: NIHR Academic Clinical Lecturer

Funder: NIHR CV220-111

Funder: NIHR Imperial College Biomedical Research Centre


Research Article, Biology and life sciences, Medicine and health sciences, People and places

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PLoS One

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Public Library of Science (PLoS)
NIHR HPRU in Emerging and Zoonotic Infections, a partnership between Public Health England (PHE), University of Oxford, University of Liverpool and Liverpool School of Tropical Medicine (NIHR200907)
MRC Centre for Global Infectious Disease Analysis (MR/R015600/1)