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Open Access

Canadian SARS-CoV-2 serological survey using antenatal serum samples: a retrospective seroprevalence study

Andrea Atkinson, Arianne Albert, Elisabeth McClymont, Janice Andrade, Lori Beach, Shelly Bolotin, Isabelle Boucoiran, Jared Bullard, Carmen Charlton, Joan Crane, Shelley Dougan, Jean-Claude Forest, Greg J. German, Yves Giguère, Gabriel Girouard, Catherine Hankins, Mel Krajden, Amanda Lang, Paul Levett, Jessica Minion, Cory Neudorf, Vanessa Poliquin, Jason L. Robinson, Heather Scott, Derek R. Stein, Vanessa Tran, George Zahariadis, Hong Y. Zhou, Deborah Money and The Antenatal Serostudies Team
April 04, 2023 11 (2) E305-E313; DOI: https://doi.org/10.9778/cmajo.20220045
Andrea Atkinson
Department of Obstetrics & Gynecology (Atkinson, McClymont, Money), University of British Columbia; Women’s Health Research Institute (Albert, Andrade, Money); Department of Pediatrics (McClymont), University of British Columbia, Vancouver, BC; Department of Pathology (Beach), Dalhousie University, Halifax, NS; Dalla Lana School of Public Health (Bolotin), University of Toronto; Public Health Ontario (Bolotin, Tran), Toronto, Ont.; Department of Obstetrics & Gynecology and School of Public Health (Boucoiran), Université de Montréal, Montreal, Que.; Department of Medical Microbiology and Infectious Diseases (Bullard, Stein), University of Manitoba, Winnipeg, Man.; Department of Laboratory Medicine & Pathology (Charlton, H.Y. Zhou), University of Alberta; Public Health Laboratory (ProvLab), Alberta Precision Laboratories (Charlton, R. Zhuo), Edmonton, Alta.; Department of Obstetrics & Gynecology (Crane), Memorial University of Newfoundland, St. John’s, NL; Department of Medical Microbiology and Infectious Diseases (Desnoyers, Girouard), Dr. Georges-L.-Dumont University Hospital Centre, Moncton, NB; Better Outcomes Network & Registry Ontario (Dougan), Ont.; CHU de Québec-Université Laval Research Center and Departement of Molecular Biology, Medical Biochemistry, and Pathology (Forest, Giguère), Université Laval, Quebec City, Que.; Health PEI (German, Robinson), Charlottetown, PEI; Department of Laboratory Medicine & Pathobiology (German, Tran), University of Toronto, Toronto, Ont.; Department of Epidemiology, Biostatistics, and Occupational Health (Hankins), McGill University, Montreal, Que.; Department of Pathology & Laboratory Medicine (Krajden, Levett), University of British Columbia, Vancouver, BC; Department of Pathology & Laboratory Medicine (Lang, Minion) and Department of Community Health & Epidemiology (Neudorf), University of Saskatchewan, Saskatoon, Sask.; Department of Obstetrics, Gynecology & Reproductive Sciences (Poliquin), University of Manitoba, Winnipeg, Man.; Department of Obstetrics & Gynecology (Scott), Dalhousie University, Halifax, NS; Cadham Provincial Laboratory (Stein), Manitoba Health, Winnipeg, Man.; Department of Laboratory Medicine (Zahariadis), Memorial University of Newfoundland, St. John’s, NL
MBBS
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Arianne Albert
PhD
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Elisabeth McClymont
PhD
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Janice Andrade
BSW
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Lori Beach
PhD
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Shelly Bolotin
PhD
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Isabelle Boucoiran
MD MSc
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Jared Bullard
MD
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Carmen Charlton
PhD
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Joan Crane
MD
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Shelley Dougan
MPA MSc
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Jean-Claude Forest
MD PhD
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Greg J. German
MD PhD
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Yves Giguère
MD
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Gabriel Girouard
MD
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Catherine Hankins
MD PhD
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Mel Krajden
MD
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Amanda Lang
PhD
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Paul Levett
PhD
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Jessica Minion
MD
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Cory Neudorf
MD
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Vanessa Poliquin
MD MSc
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Jason L. Robinson
PhD
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Heather Scott
MD
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Derek R. Stein
PhD
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Vanessa Tran
PhD
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George Zahariadis
MD
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Hong Y. Zhou
MD
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Deborah Money
MD
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    Figure 1:

    Raw seroprevalence by province for all time periods and provinces. Error bars indicate 95% confidence intervals. Data for this figure are available in Appendix 2 (available at www.cmajopen.ca/content/11/2/E305/suppl/DC1).

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    Figure 2:

    Age-stratified seroprevalence for time period C (Nov. 16–Dec. 4, 2020) for each province. Error bars indicate 95% confidence intervals, and those that extend past 20% (resulting from small numbers in this age group) have been cut off for ease of visual comparison among provinces.

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    Figure 3:

    Location of positive and negative antenatal serum results for SARS-CoV-2 for time period C (Nov. 16–Dec. 4, 2020). Blue crosses indicate seropositive samples and red crosses indicate seronegative samples. Regional mapping of samples was not possible for samples from Alberta, New Brunswick and Newfoundland and Labrador. Numbers indicate raw seroprevalence.

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    Figure 4:

    Longitudinal assessment of seroprevalence over time for British Columbia during the Omicron period (Nov. 15, 2021–June 11, 2022). Generalized additive model estimated degrees of freedom = 4.2, p < 0.0001. Shaded area indicates 95% confidence intervals around the estimated seroprevalence.

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    Table 1:

    Comparison of rates of positive infection confirmed by polymerase chain reaction testing among pregnant people from CANCOVID-Preg, and among females aged 20–49 years from StatCan region for time period C (Nov. 16–Dec. 4, 2020) and results of SARS-CoV-2 sero-screening adjusted for age (November and December 2020)*

    RegionProvinceRaw seroprevalence (95% CI)PCR-positive rate in pregnant people (95% CI)Rate ratio (95% CI)Age-adjusted seroprevalence (95% CI)PCR-positive rate in region-specific females aged 20–49 yr (95% CI)Rate ratio (95% CI)
    1British Columbia2.14 (1.63–2.74)0.62 (0.55–0.70)3.44 (2.57–4.48)1.87 (1.12–2.80)1.13 (1.12–1.16)1.84 (1.37–2.36)
    2Alberta2.07 (1.63–2.59)0.86 (0.78–0.95)2.40 (1.84–3.02)1.78 (1.20–2.47)2.11 (2.08–2.13)0.85 (0.65–1.06)
    2Saskatchewan1.81 (1.06–2.88)––1.29 (0.62–2.19)2.11 (2.08–2.13)0.61 (0.30–0.96)
    2Manitoba4.28 (1.86–8.26)1.24 (1.08–1.44)3.44 (1.28–6.11)5.62 (1.42–12.42)2.11 (2.08–2.13)2.79 (1.27–4.55)
    3Ontario3.86 (3.39–4.38)0.47 (0.43–0.51)8.25 (7.13–9.48)5.67 (3.93–7.50)1.28 (1.27–1.29)4.42 (3.97–4.87)
    4Quebec5.38 (4.19–6.80)1.01 (0.94–1.08)5.33 (4.06–6.68)5.95 (2.66–10.44)2.45 (2.42–2.47)2.43 (1.90–2.99)
    5Nova Scotia1.41 (0.57–2.88)0.17 (0.09–0.30)8.27 (2.56–20.47)0.96 (0.33–1.90)0.11 (0.10–0.12)8.90 (1.80–17.28)
    5Newfoundland and Labrador0.33 (0.01–1.80)0.00 (0.00–0.13)–†0.24 (0.01–0.87)0.11 (0.10–0.12)2.88 (0.00–9.02)
    5New Brunswick1.01 (0.12–2.59)0.05 (0.01–0.15)15.69 (2.64–93.37)0.91 (0.09–2.65)0.11 (0.10–0.12)8.93 (0.00–22.79)
    5Prince Edward Island1.11 (0.03–6.04)0.00 (0.00–0.36)–†1.11 (0.03–6.04)0.11 (0.10–0.12)9.83 (0.00–30.97)
    • Note: CANCOVID-Preg = COVID-19 in Pregnancy: Epidemiology, Maternal and Infant Outcomes, CI = confidence interval, PCR = polymerase chain reaction, StatCan = Statistics Canada.

    • ↵* Rate ratios shown for comparison with raw rates for the pregnant population, and age-adjusted seroprevalence estimates for the general female population. Rate for Prince Edward Island is not age adjusted. Shown as rates per 100. PCR-positive rates not available for pregnant people in Saskatchewan.

    • ↵† Rate ratio not possible to calculate.

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CMAJ Open: 11 (2)
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Canadian SARS-CoV-2 serological survey using antenatal serum samples: a retrospective seroprevalence study
Andrea Atkinson, Arianne Albert, Elisabeth McClymont, Janice Andrade, Lori Beach, Shelly Bolotin, Isabelle Boucoiran, Jared Bullard, Carmen Charlton, Joan Crane, Shelley Dougan, Jean-Claude Forest, Greg J. German, Yves Giguère, Gabriel Girouard, Catherine Hankins, Mel Krajden, Amanda Lang, Paul Levett, Jessica Minion, Cory Neudorf, Vanessa Poliquin, Jason L. Robinson, Heather Scott, Derek R. Stein, Vanessa Tran, George Zahariadis, Hong Y. Zhou, Deborah Money, The Antenatal Serostudies Team
Mar 2023, 11 (2) E305-E313; DOI: 10.9778/cmajo.20220045

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Canadian SARS-CoV-2 serological survey using antenatal serum samples: a retrospective seroprevalence study
Andrea Atkinson, Arianne Albert, Elisabeth McClymont, Janice Andrade, Lori Beach, Shelly Bolotin, Isabelle Boucoiran, Jared Bullard, Carmen Charlton, Joan Crane, Shelley Dougan, Jean-Claude Forest, Greg J. German, Yves Giguère, Gabriel Girouard, Catherine Hankins, Mel Krajden, Amanda Lang, Paul Levett, Jessica Minion, Cory Neudorf, Vanessa Poliquin, Jason L. Robinson, Heather Scott, Derek R. Stein, Vanessa Tran, George Zahariadis, Hong Y. Zhou, Deborah Money, The Antenatal Serostudies Team
Mar 2023, 11 (2) E305-E313; DOI: 10.9778/cmajo.20220045
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