Table 1

Characteristics of included studies (n=23)

First authorType of publicationLocation of studyStudy populationSample sizeDates of sample collectionSeroprevalence estimate, % (95% CI)Serological assay usedReported specificity and sensitivity of serological assayAssessment of bias*
General populations
Petersen7Peer-reviewed publicationFaroe IslandsRandom sample of population registry107527 April to 1 May 20200.6 (0.2 to 1.2)Wantai SARS-CoV-2 Ab ELISA kit (Beijing Wantai Biologic Pharmacy Enterprise)Sensitivity 94.4%, specificity 100%Low
Bogogiannidou8Peer-reviewed publicationGreeceSerial sampling of representative residual clinical samples4511March to April 20200.42 (0.23 to 0.61)Abbott SARS-CoV-2 IgG assay (Abbott Laboratories)Sensitivity 84.0%, specificity 99.7%Low
Pollán9Peer-reviewed publicationSpainRandomly selected households across Spain61 07527 April to 11 May 20204.6 (4.3 to 5.0)Orient Gene IgM/IgG (Zhejiang Orient Gene Biotech); Abbott Architect IgG (Abbott Laboratories)Specificity 100%, sensitivity 82.1% (Orient Gene)Low
Specificity 100%, sensitivity 89.7% (Abbott)
Stringhini10Peer-reviewed publicationGeneva, SwitzerlandSerial sampling of population-representative cohort27666 April to 9 May 2020 (5 consecutive weeks of sampling)10.8 (8.2 to 13.9)ELISA IgG (Euroimmun)Manufacturer reported: specificity 94.4%, sensitivity 99.6%Low
Herzog11Preprint manuscriptBelgiumSerial sampling of residual clinical samples from hospitals and diagnostic laboratories782030 March to 4 July 2020 (5 different sampling periods)4.5 [3.7 to 5.4)ELISA IgG (Euroimmun)Manufacturer reported: specificity 94.4%, sensitivity 99.6%Moderate
Snoeck12Preprint manuscriptLuxembourgRepresentative web-based sample of general population186215 April to 5 May 20201.97 (1.25 to 2.69)ELISA IgG and IgA (Euroimmun)Specificity 89.2%; sensitivity 85.7% at day 15 after symptom onset in PCR confirmed patientsHigh
Wells13Preprint manuscriptSouth-East EnglandOngoing community-based cohort43127 April to 2 June12 (9.1 to 15.2)In-house N/S ELISA (King’s College London)Specificity 100%
Sensitivity 84.7%, 87.0% at 14 days after onset and 96.4% after 20 days
High
Aziz14Preprint manuscriptBonn, GermanyOngoing community-based cohort477124 April to 30 June0.97 (0.72 to 1.30)ELISA IgG (Euroimmun); plaque reduction neutralisation testManufacturer reported: specificity 94.4%, sensitivity 99.6%Low
Streeck15Preprint manuscriptGangelt, GermanyRandomly selected household members in Gangelt, Germany91931 March to 6 April 202013.6ELISA IgG (Euroimmun)Manufacturer reported: specificity 94.4%, sensitivity 99.6%Moderate
Weis16Preprint manuscriptNeustadt am Rennsteig, GermanyHousehold members62012–22 May 20208.4ELISA IgG (Euroimmun); IgG CLIA kit (DiaSorin, Saluggia, Italy); Maglumi; IgG CMIA kit (Abbott); Elecsys Anti-SARS-CoV-2 kit (Roche)Manufacturer reported: specificity 94.4%, sensitivity 99.6% (Euroimmun); specificity 99.3%, sensitivity 97.6% (Liaison CLIA); specificity 100%, sensitivity 91.2% (Maglumi); specificity 99.6%, sensitivity 100% (Abbott); specificity 99.8%, sensitivity 100% (Roche)Low
Roxhed17Preprint manuscriptStockholm urban area, SwedenRandomly selected households443May 202010.84 (7.94 to 13.73)In-house multiplexed serology assaySensitivity 100% Specificity 98% combining the scores from at least two of the included SPK proteinModerate
Fenwick18Preprint manuscriptVaud Canton, SwitzerlandRandomly selected residents3114 May to 27 June 20206.4In-house S protein trimerSpecificity 98.5%; sensitivity 90% after 16 days after onset of symptomsModerate
Blood donor populations
Erikstrup19Peer-reviewed publicationDenmarkBlood donation centres20 6406 April to 3 May 20201.9 (0.8 to 2.3)Lateral flow immunoassay (Livzon Diagnostics)Specificity 99.5%, sensitivity 82.6%Moderate
Fischer20Peer-reviewed publicationThree federal states in North-Western GermanyBlood donation centres31869 March to 3 June 20200.91 (0.58 to 1.24)ELISA IgG (Euroimmun)Manufacturer reported: specificity 94.4%, sensitivity 99.6%Moderate
Percivalle21Peer-reviewed publicationHigh-transmission area, Lombardy region, ItalyBlood donation centres39018 March to 6 April 202023.33In-house microneutralisation assaySpecificity 100%, sensitivity 95%Moderate
Fiore22Peer-reviewed publicationLow-incidence area, South-East ItalyBlood donation centres9041–31 May 20200.99Chemiluminescent analytical assay (New Industries Biomedical Engineering)Specificity 97.3%, sensitivity 91.2%Moderate
Slot23Preprint manuscriptNetherlandsBlood donation centres73611–15 April 20204.2 (3.1 to 5.4)ELISA (Beijing Wantai Biological Pharmacy Enterprise); ELISA IgG (Euroimmun)Specificity 99.1%, sensitivity 100%Moderate
Thompson24Preprint manuscriptScotlandBlood donation centres100021–23 March 20201.2In-house pseudotyped SARS-CoV-2 microneutralisation assaySpecificity 100%, sensitivity 94.1%Moderate
Fontanet25Preprint manuscriptHigh-transmission area, north of Paris, FranceBlood donation centres20023–27 March 20203.0 (1.1 to 6.4)In-house ELISA assay (Institut Pasteur); in-house flow cytometry assay (Institut Pasteur); in-house immunoprecipitation-based assay (Institut Pasteur)Data reported from other validation study:50 specificity 100%, sensitivity 99.4%High
Valenti26Preprint manuscriptMilan, ItalyConvenience sample from blood donation centres78924 February to 8 April 20205.07IgG/IgM rapid lateral flow immunoassay (Prima Lab)Specificity 98.3%, sensitivity 100%Moderate
Individuals recruited through non-healthcare-related employment
Milani27Peer-reviewed publicationMilan, ItalyUniversity staff19430–31 March 202010.2ELISA (Beijing Wantai Biological Pharmacy Enterprise); ELISA IgG (Euroimmun)Data reported from separate validation study:51 52
specificity 99.1%, sensitivity 100%
Manufacturer reported: specificity 94.4%, sensitivity 99.6% (Euroimmun)
High
Jerković28Peer-reviewed publicationSplit-Dalmatia and Šibenik-Knin County, CroatiaFactory workers149423–28 April 20201.27 (0.77 to 1.98)IgG/IgM rapid test (AMP Diagnostics)Manufacturer reported: specificity 96.4%, sensitivity 91.8%Moderate
Kraehling29Preprint manuscriptFrankfurt am Main metropolitan areaHealthy voluntary employees of a large industrial site operator10006–14 April 20200.5In-house ELISASpecificity 99.2%, sensitivity 100%High
  • *As determined through the use of the Joanna Briggs Institute Critical Appraisal checklist for studies reporting prevalence data, and the qualitative categories defined by Bobrovitz et al.5 High: limited certainty in prevalence: the true prevalence may be substantially different from the estimated prevalence. Moderate: moderate certainty in the prevalence: the true prevalence is likely to be close to the estimate, but there is a possibility that it is substantially different. Low: high certainty in the prevalence estimate: true prevalence is likely close to the estimate. Unclear: there was insufficient information to assess risk of bias.

  • CLIA, chemiluminescent immunoassay; ELISA, enzyme linked immunosorbant assay; IgG, immunoglobulin G; IgM, immunoglobulin M; N/S, nucleocapsid/spike protein; SPK, spike.