PDF(Pubmed)
Abstract：
To investigate COVID-19 surveillance among pregnant women, the California Genetic Disease Screening Program conducted a screening performance and seroprevalence evaluation of maternal SARS-CoV-2 antibodies detected in banked newborn dried blood spots (DBS). We obtained seropositive results for 2890 newborn DBS from cohorts in 2020 and 2021 using Enable Bioscience\'s Antibody Detection by Agglutination-PCR (ADAP) assay for SARS-CoV-2 antibodies. To infer maternal infection, we linked 312 women with a known laboratory-confirmed COVID-19 episode with their newborn\'s DBS SARS-CoV02 antibody result. Among 2890 newborns, we detected 453 (15.7%) with SARS-CoV-2 antibodies in their DBS. Monthly snapshot statewide seroprevalence among neonates was 12.2% (95% CI 10.3-14.1%, n =1156) in December 2020 and 33.3% (95% CI 29.1-37.4%, n = 26) in March 2021. The longest time recorded from COVID-19 infection to a seropositive neonatal result was 11.7 months among the 312 mothers who had an available SARS-CoV-2 PCR test result. Approximately 94% (153/163) of DBS were seropositive when a known maternal infection occurred earlier than 19 days before birth. The estimated relative sensitivity of DBS to identify prevalent maternal infection was 85.1%, specificity 98.5% and PPV 99.2% (n = 312); the sensitivity was lowest during the December 2021 surge when many infections occurred within 19 days of birth. Fifty pre-pandemic specimens (100% seronegative) and 23 twin-pair results (100% concordant) support an intrinsic specificity and PPV of ADAP approaching 100%. Maternal infection surveillance is limited by a time lag prior to delivery, especially during pandemic surges.
摘要：
调查孕妇的COVID-19监测情况，加州遗传病筛查计划对在库存新生儿干血点(DBS)中检测到的母体SARS-CoV-2抗体进行了筛查和血清阳性率评估.我们在2020年和2021年使用EnableBioscience的SARS-CoV-2抗体凝集PCR（ADAP）抗体检测方法从队列中获得了2890例新生儿DBS的血清阳性结果。为了推断产妇感染，我们将312例已知实验室确诊的COVID-19患者与新生儿DBSSARS-CoV02抗体结果联系起来.在2890名新生儿中，我们在DBS中检测到453例（15.7%）SARS-CoV-2抗体。新生儿每月快照全州血清阳性率为12.2%(95%CI10.3-14.1%，n=1156），2020年12月为33.3%（95%CI29.1-37.4%，n=26），2021年3月。在312名获得SARS-CoV-2PCR检测结果的母亲中，从COVID-19感染到血清阳性新生儿结果记录的最长时间为11.7个月。当已知的母体感染发生在出生前19天之前时，大约94％（153/163）的DBS呈血清阳性。DBS对确定流行的孕产妇感染的相对敏感性估计为85.1％，特异性98.5%和PPV99.2%(n=312);在2021年12月的激增期间,许多感染发生在出生后19天内,敏感性最低.50个大流行前标本（100％血清阴性）和23个双胞胎结果（100％一致）支持ADAP的内在特异性和PPV接近100％。产妇感染监测受分娩前的时滞限制，尤其是在大流行期间。
