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Surveillance Open Access
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Abstract

Background

During the COVID-19 pandemic, the Danish National Institute for Infectious Disease, Statens Serum Institute (SSI) developed a home-based SARS-CoV-2 surveillance system.

Aims

We wanted to determine whether a cohort of individuals performing self-administered swabs for PCR at home could support surveillance of SARS-CoV-2, including detection and assessment of new variants. We also aimed to evaluate the logistical setup.

Methods

From May to July 2022, 10,000 blood donors were invited to participate, along with their household members. Participation required performing a self-swab for 4 consecutive weeks and answering symptom questionnaires via a web app. Swabs were sent by post to SSI for PCR analysis and whole genome sequencing. After study completion, participants were asked to complete a questionnaire concerning their experience.

Results

In total, 2,186 individuals enrolled (47.4% blood donors), and 1,333 performed self-swabbing (53.0 blood donors), of whom 48 had at least one SARS-CoV-2-positive sample. Fourteen different Omicron subvariants, primarily BA.5 subvariants, were identified by whole genome sequencing (WGS). In total, 29 of the 63 SARS-CoV-2-positive samples were taken from individuals who were asymptomatic at the time of swabbing. Participants collected 2.9 swabs on average, with varying intervals between swabs. Transmission within households was observed in only three of 25 households.

Conclusion

Participants successfully performed self-swabs and answered symptom questionnaires. Also, WGS analysis of samples was possible. The system can support surveillance of respiratory pathogens and also holds potential as a diagnostic tool, easing access to test for at-risk groups, while also reducing the burden on healthcare system resources.

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/content/10.2807/1560-7917.ES.2023.28.38.2200907
2023-09-21
2024-07-20
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2023.28.38.2200907
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References

  1. Denmark S. Population figures. Copenhagen: Statistics Denmark; 2022. Available from: https://www.dst.dk/en/Statistik/emner/borgere/befolkning/befolkningstal
  2. Statens Serum Institut (SSI). COVID-19 dashboard. Copenhagen: SSI; 2022. Available from: https://experience.arcgis.com/experience/aa41b29149f24e20a4007a0c4e13db1d/page/Nationalt
  3. Gram MA, Steenhard N, Cohen AS, Vangsted AM, Mølbak K, Jensen TG, et al. Patterns of testing in the extensive Danish national SARS-CoV-2 test set-up. PLoS One. 2023;18(7):e0281972.  https://doi.org/10.1371/journal.pone.0281972  PMID: 37490451 
  4. Statens Serum Institut (SSI). Ugentlige tendenser: covid-19 og andre luftvejsinfektioner: uge 27 2022. [Weekly trends: COVID-19 and other respiratory infections: week 27 2022]. Copenhagen: SSI; 2022. Danish. Available from: https://files.ssi.dk/covid19/tendensrapport/rapport/ugentlige-tendenser-covid19-andre-luftvejs-uge27-2022-42jk
  5. Statens Serum Institut (SSI). Ugentlige tendenser: covid-19 og andre luftvejsinfektioner: uge 28 2022. [Weekly trends: COVID-19 and other respiratory infections: week 28 2022]. Copenhagen: SSI; 2022. Danish. Available from: https://files.ssi.dk/covid19/tendensrapport/rapport/ugentlige-tendenser-covid19-andre-luftvejs-uge28-2022_fdj1
  6. Mathieu E, Ritchie H, Rodés-Guirao L, Appel C, Giattino C, Hassell J, Macdonald B, Dattani S, Beltekian D, Ortiz-Ospina E and Roser M. Coronavirus Pandemic (COVID-19). OurWorldInData.org: 2020. Available from: https://ourworldindata.org/coronavirus
  7. Kaspersen KA, Hindhede L, Boldsen JK, Mikkelsen S, Vestergaard LS, Berthelsen AN, et al. Estimation of SARS-CoV-2 infection fatality rate by age and comorbidity status using antibody screening of blood donors during the COVID-19 epidemic in Denmark. J Infect Dis. 2022;225(2):219-28.  https://doi.org/10.1093/infdis/jiab566  PMID: 34788834 
  8. Brodersen T, Rostgaard K, Lau CJ, Juel K, Erikstrup C, Nielsen KR, et al. The healthy donor effect and survey participation, becoming a donor and donor career. Transfusion. 2023;63(1):143-55.  https://doi.org/10.1111/trf.17190  PMID: 36479702 
  9. Hørlyck S, Nielsen SH, Gress T, Schneider U, Martel CJ, Steenhard N, et al. Combined nasal- and oropharyngeal self-swab provides equivalent performance compared to professionally collected oropharyngeal swabs in detecting SARS-CoV-2 in a real-life setting. J Virol Methods. 2023;313:114667.  https://doi.org/10.1016/j.jviromet.2022.114667  PMID: 36572155 
  10. Lyngse FP, Kirkeby CT, Denwood M, Christiansen LE, Mølbak K, Møller CH, et al. Household transmission of SARS-CoV-2 Omicron variant of concern subvariants BA.1 and BA.2 in Denmark. Nat Commun. 2022;13(1):5760.  https://doi.org/10.1038/s41467-022-33498-0  PMID: 36180438 
  11. Hansen CH, Friis NU, Bager P, Stegger M, Fonager J, Fomsgaard A, et al. Risk of reinfection, vaccine protection, and severity of infection with the BA.5 omicron subvariant: a nation-wide population-based study in Denmark. Lancet Infect Dis. 2023;23(2):167-76.  https://doi.org/10.1016/S1473-3099(22)00595-3  PMID: 36270311 
  12. R Core Team. R: A language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2020. Available from: https://www.R-project.org
  13. Fogh K, Strange JE, Scharff BFSS, Eriksen ARR, Hasselbalch RB, Bundgaard H, et al. Testing Denmark: a Danish nationwide surveillance study of COVID-19. Microbiol Spectr. 2021;9(3):e0133021.  https://doi.org/10.1128/Spectrum.01330-21  PMID: 34908473 
  14. Sørensen AIV, Spiliopoulos L, Bager P, Nielsen NM, Hansen JV, Koch A, et al. A nationwide questionnaire study of post-acute symptoms and health problems after SARS-CoV-2 infection in Denmark. Nat Commun. 2022;13(1):4213.  https://doi.org/10.1038/s41467-022-31897-x  PMID: 35864108 
  15. Fogh K, Eriksen ARR, Hasselbalch RB, Kristensen ES, Bundgaard H, Nielsen SD, et al. Seroprevalence of SARS-CoV-2 antibodies in social housing areas in Denmark. BMC Infect Dis. 2022;22(1):143.  https://doi.org/10.1186/s12879-022-07102-1  PMID: 35144550 
  16. Statens Serum Institut (SSI). Seroprævalensundersøgelse af bloddonorer – 3. runde. [Seroprevalence study of blood donors – 3rd round]. Copenhagen: SSI; 2022. Danish. Available from: https://covid19.ssi.dk/-/media/arkiv/subsites/covid19/overvaagningsdata/moerketal/seropraevalensundersoegelse_runde3_version2.pdf?la=da
  17. Goller KV, Moritz J, Ziemann J, Kohler C, Becker K, Hübner NO, et al. Differences in clinical presentations of Omicron infections with the lineages BA.2 and BA.5 in Mecklenburg-Western Pomerania, Germany, between April and July 2022. Viruses. 2022;14(9):2033.  https://doi.org/10.3390/v14092033  PMID: 36146837 
  18. Walker AS, Vihta KD, Gethings O, Pritchard E, Jones J, House T, et al. Tracking the emergence of SARS-CoV-2 Alpha variant in the United Kingdom. N Engl J Med. 2021;385(27):2582-5.  https://doi.org/10.1056/NEJMc2103227  PMID: 34879193 
  19. Imperial College London (ICT). Real-time Assessment of Community Transmission (REACT) Study. London: ICT; 2022. Available from: https://www.imperial.ac.uk/medicine/research-and-impact/groups/react-study
  20. Office for National Statistics. Coronavirus (COVID-19) Infection Survey: technical data. 2020 edition of this dataset. London: ons.gov.uk. [Accessed: 07 Sep 2023]. Available from: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/datasets/covid19infectionsurveytechnicaldata
  21. REACT Study Investigators; Riley S, Ainslie KEC, Eales O, Jeffrey B, Walters CE, et al. Community prevalence of SARS-CoV-2 virus in England during May 2020: REACT study. medRxiv 2020.07.10.20150524. Preprint.  https://doi.org/10.1101/2020.07.10.20150524  https://doi.org/10.1101/2020.07.10.20150524 
  22. Plymoth A, Rotzen-Ostlund M, Zweygberg-Wirgart B, Sundin CG, Ploner A, Nyren O, et al. Self-sampling for analysis of respiratory viruses in a large-scale epidemiological study in Sweden. Euro Surveill. 2015;20(11):21063.  https://doi.org/10.2807/1560-7917.ES2015.20.11.21063  PMID: 25811646 
  23. Goff J, Rowe A, Brownstein JS, Chunara R. Surveillance of acute respiratory infections using community-submitted symptoms and specimens for molecular diagnostic testing. PLoS Curr. 2015;7:7.  https://doi.org/10.1371/currents.outbreaks.0371243baa7f3810ba1279e30b96d3b6  PMID: 26075141 
  24. Bundgaard H, Bundgaard JS, Raaschou-Pedersen DET, von Buchwald C, Todsen T, Norsk JB, et al. Effectiveness of adding a mask recommendation to other public health measures to prevent SARS-CoV-2 infection in Danish mask wearers : a randomized controlled trial. Ann Intern Med. 2021;174(3):335-43.  https://doi.org/10.7326/M20-6817  PMID: 33205991 
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