{"doi":"10.1101/2020.09.11.20192773","title":"Serological evidence of human infection with SARS-CoV-2: a systematic review and meta-analysis","abstract":"BACKGROUND: A rapidly increasing number of serological surveys for anti-SARS-CoV-2 antibodies have been reported worldwide. A synthesis of this large corpus of data is needed. PURPOSE: To evaluate the quality of serological studies and provide a global picture of seroprevalence across demographic and occupational groups, and to provide guidance for conducting better serosurveys. DATA SOURCES: We searched PubMed, Embase, Web of Science, and 4 pre-print servers for English-language papers published from December 1, 2019 to September 25, 2020. STUDY SELECTION: Serological studies evaluating SARS-CoV-2 seroprevalence in humans. DATA EXTRACTION: Two investigators independently extracted data from studies. DATA SYNTHESIS: Most of 230 serological studies, representing tests in >1,400,000 individuals, identified were of low quality based on a standardized study quality scale. In the 51 studies of higher quality, high-risk healthcare workers had higher seroprevalence of 17.1% (95% CI: 9.9-24.4%), compared to low-risk healthcare workers and general population of 5.4% (0.7-10.1%) and 5.3% (4.2-6.4%). Seroprevalence varied hugely across WHO regions, with lowest seroprevalence of general population in Western Pacific region (1.7%, 0.0-5.0%). Generally, the young (<20 years) and the old (≥65 years) were less likely to be seropositive compared to middle-aged (20-64 years) populations.Seroprevalence correlated with clinical COVID-19 reports, with pooled average of 7.7 (range: 2.0 to 23.1) serologically-detected-infections per confirmed COVID-19 case. LIMITATIONS: Some heterogeneity cannot be well explained quantitatively. CONCLUSIONS: The overall quality of seroprevalence studies examined was low. The relatively low seroprevalence among general populations suggest that in most settings, antibody-mediated herd immunity is far from being reached. Given the relatively narrow range of estimates of the ratio of serologically-detected infections to confirmed cases across different locales, reported case counts may help provide insights into the true proportion of the population infected. PRIMARY FUNDING SOURCE: National Science Fund for Distinguished Young Scholars (PROSPERO: CRD42020198253).","journal":"medRxiv","year":2020,"id":118685,"datarank":2.556445470321677,"base_score":3.8918202981106265,"endowment":3.8918202981106265,"self_citation_contribution":0.5837730447165941,"citation_network_contribution":1.972672425605083,"self_endowment_contribution":0.5837730447165941,"citer_contribution":1.972672425605083,"corpus_percentile":91.52935715943374,"corpus_rank":1096,"citation_count":48,"citer_count":41,"citers_with_citation_signal":36,"citers_with_endowment":36,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.6979,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":551787,"name":"Zhiyuan Chen","orcid":"0000-0001-6166-604X","position":1,"is_corresponding":false},{"id":78332,"name":"Andrew S. Azman","orcid":"0000-0001-8662-9077","position":2,"is_corresponding":false},{"id":269880,"name":"Xiaowei Deng","orcid":"0000-0002-9892-2470","position":3,"is_corresponding":false},{"id":550607,"name":"Xinghui Chen","orcid":"0000-0002-6041-2993","position":4,"is_corresponding":false},{"id":553033,"name":"Wanying Lu","orcid":null,"position":5,"is_corresponding":false},{"id":551788,"name":"Zeyao Zhao","orcid":"0000-0002-5230-735X","position":6,"is_corresponding":false},{"id":269878,"name":"Juan Yang","orcid":"0000-0001-5028-2227","position":7,"is_corresponding":false},{"id":110469,"name":"Cécile Viboud","orcid":"0000-0003-3243-4711","position":8,"is_corresponding":false},{"id":107957,"name":"Marco Ajelli","orcid":"0000-0003-1753-4749","position":9,"is_corresponding":false},{"id":352714,"name":"Daniel T. Leung","orcid":"0000-0001-8401-0801","position":10,"is_corresponding":false},{"id":269885,"name":"Hongjie Yu","orcid":"0000-0002-6335-5648","position":11,"is_corresponding":false},{"id":551786,"name":"Xinhua Chen","orcid":"0000-0002-2410-7043","position":0,"is_corresponding":true}],"reference_count":34,"raw_metadata":null,"created_at":"2026-07-18T23:14:03.409507Z","pmid":"32935122","pmcid":"PMC7491537","fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}