• Christian Erikstrup, Christoffer Egeberg Hother, Ole Birger Vestager Pedersen, Kåre Mølbak, Robert Leo Skov, Dorte Kinggaard Holm, Susanne Gjørup Sækmose, Anna Christine Nilsson, Patrick Terrence Brooks, Jens Kjærgaard Boldsen, Christina Mikkelsen, Mikkel Gybel-Brask, Erik Sørensen, Khoa Manh Dinh, Susan Mikkelsen, Bjarne Kuno Møller, Thure Haunstrup, Lene Harritshøj, Bitten Aagaard Jensen, Henrik Hjalgrim, Søren Thue Lillevang, and Henrik Ullum.
• Department of Clinical Immunology, Aarhus University Hospital and Department of Clinical Medicine Aarhus University, Aarhus, Denmark.
• Clin. Infect. Dis. 2020 Jun 25.

BackgroundThe pandemic due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has tremendous consequences for our societies. Knowledge of the seroprevalence of SARS-CoV-2 is needed to accurately monitor the spread of the epidemic and to calculate the infection fatality rate (IFR). These measures may help the authorities to make informed decisions and adjust the current societal interventions. The objective was to perform nationwide real-time seroprevalence surveying among blood donors as a tool to estimate previous SARS-CoV-2 infections and the population based IFR.MethodsDanish blood donors aged 17-69 years giving blood April 6 to May 3 were tested for SARS-CoV-2 immunoglobulin M and G antibodies using a commercial lateral flow test. Antibody status was compared between geographical areas and an estimate of the IFR was calculated. The seroprevalence was adjusted for assay sensitivity and specificity taking the uncertainties of the test validation into account when reporting the 95% confidence intervals (CI).ResultsThe first 20,640 blood donors were tested and a combined adjusted seroprevalence of 1.9% (CI: 0.8-2.3) was calculated. The seroprevalence differed across areas. Using available data on fatalities and population numbers a combined IFR in patients younger than 70 is estimated at 89 per 100,000 (CI: 72-211) infections.ConclusionsThe IFR was estimated to be slightly lower than previously reported from other countries not using seroprevalence data. The IFR is likely several fold lower than the current estimate. We have initiated real-time nationwide anti-SARS-CoV-2 seroprevalence surveying of blood donations as a tool in monitoring the epidemic.© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America.

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