Second round statewide survey for estimation of the burden of active infection and anti-SARS-CoV-2 IgG antibodies in the general population of Karnataka, India

Padma, M. R.; Dinesh, P.; Sundaresan, R.; Athreya, S.; Shiju, S.; Maroor, P. S.; Hande, R. L.; Akhtar, J.; Chandra, T.; Ravi, D.; Lobo, E.; Ana, Y.; Shriyan, P.; Desai, A.; Rangaiah, A.; Munivenkatappa, A.; S, K.; Gowdara Basawarajappa, S.; Sreedhara, H. G.; KC, S.; Kumari B, A.; Umar, N.; BA, M.; KM, M.; Sudarshan, M. K.; Vasanthapuram, R.; Babu, G. R.

Objective: The second round of the serial cross sectional sentinel based population survey to assess active infection, seroprevalence, and their evolution in the general population across Karnataka was conducted. Additionally, a longitudinal study among participants identified as COVID 19 positive in the first survey round was conducted to assess the clinical sensitivity of the testing kit used. Methods: The cross sectional study of 41,228 participants across 290 healthcare facilities in all 30 districts of Karnataka was done among three groups of participants (low, moderate, and high risk). Consenting participants were subjected to real time reverse transcription polymerase chain reaction (RTPCR) testing, and antibody (IgG) testing. Results: Overall weighted adjusted seroprevalence of IgG was 15.6% (95% CI: 14.9 to 16.3), crude IgG prevalence was 15.0% and crude active prevalence was 0.5%. Statewide infection fatality rate (IFR) was estimated as 0.11%, and COVID 19 burden estimated between 26.1 to 37.7% (at 90% confidence). Clinical sensitivity of the IgG ELISA test kit was estimated as equal or more than 38.9%. Conclusion: The sentinel based population survey helped identify districts that needed better testing, reporting, and clinical management. The state was far from attaining natural immunity during the survey and hence must step up vaccination coverage and enforce public health measures to prevent the spread of COVD 19.