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Epidemiology and Health 2022;e2022085.
DOI: https://doi.org/10.4178/epih.e2022085    [Accepted] Published online Sep 30, 2022.
Seroprevalence of severe acute respiratory syndrome coronavirus 2 antibodies during the third wave of coronavirus disease in the Seoul metropolitan area of Korea
Kyuhyun Yoon1  , Jayeun Kim3  , Kyong Ran Peck4  , Hyun Soo Kim5  , Hyukmin Lee6  , Yoo-Sung Hwang7  , Soon Young Lee8  , Sung-il Cho9  , Hun Jae Lee10  , Yeongyeong Kim11  , Brian Byoungguk Kim12  , June-Woo Lee12  , Ah-Ra Kim12  , HyeonNam Do12  , Dong-Hyun Kim2 
1Institute of Health and Environment, Seoul National University, Seoul, Korea
2Hallym University College of Medicine, Chuncheon, Kangwon-do, Korea
3Korea Institute of Child Care and Education, Seoul, Korea
4Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
5Department of Laboratory Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
6Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
7Seegene Medical Foundation, Seoul, Korea
8Department of Preventive Medicine and Public Health, Ajou University School of Medicine, 164 World cup-ro, Yeongtong-gu, Suwon, Korea
9Graduate School of Public Health, Seoul National University, Seoul, Korea
10Department of Social and Preventive Medicine, College of Medicine, Inha University, Incheon, Korea
11Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
12Division of Vaccine Clinical Research Center for Vaccine Research, National Institute of Infectious Diseases, National Institute of Health (NIH) Korea Disease Control and Prevention Agency (KDCA), CheongJu, Korea
Correspondence  Dong-Hyun Kim ,Email: dhkims@hallym.ac.kr
Received: Aug 4, 2022  Accepted after revision: Sep 30, 2022
After the third wave of coronavirus disease (COVID-19), by mid-February 2021, approximately 0.16% of the population was confirmed positive, which appeared to be one of the lowest rates worldwide at that time. However, asymptomatic transmission poses a challenge 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.
We collected 5,002 residual sera samples from January 30 to March 3, 2021 from 265 medical facilities in Seoul, 346 in Kyunggi-do’ and 57 in Incheon. Among them, 60 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 the screening test, and positivity was confirmed using the SARS-CoV-2 sVNT Kit. Prevalence was estimated using sampling weight and the Wilson score interval for a binomial proportion with a 95% confidence interval.
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 antibody 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-do and Seoul, respectively. No positive cases were detected in Incheon.
The proportion of undetected cases in South Korea remains low. Therefore, an infection control strategy with exhaustive tracing and widespread pre-emptive testing appears to be effective in containing the spread of the virus in the community.
Keywords: Coronavirus disease; Seroprevalence; Cumulative incidence; Severe acute respiratory syndrome coronavirus 2; Asymptomatic


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