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http://dx.doi.org/10.5808/GI.2020.18.3.e31

Confidence intervals for the COVID-19 neutralizing antibody retention rate in the Korean population  

Apio, Catherine (Interdisplinary Program in Bioinformatics, Department of Statistics, Seoul National University)
Kamruzzaman, Md. (Department of Statistics, Seoul National University)
Park, Taesung (Interdisplinary Program in Bioinformatics, Department of Statistics, Seoul National University)
Abstract
The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic. No specific therapeutic agents or vaccines for COVID-19 are available, though several antiviral drugs, are under investigation as treatment agents for COVID-19. The use of convalescent plasma transfusion that contain neutralizing antibodies for COVID-19 has become the major focus. This requires mass screening of populations for these antibodies. While several countries started reporting population based antibody rate, its simple point estimate may be misinterpreted without proper estimation of standard error and confidence intervals. In this paper, we review the importance of antibody studies and present the 95% confidence intervals COVID-19 antibody rate for the Korean population using two recently performed antibody tests in Korea. Due to the sparsity of data, the estimation of confidence interval is a big challenge. Thus, we consider several confidence intervals using Asymptotic, Exact and Bayesian estimation methods. In this article, we found that the Wald method gives the narrowest interval among all Asymptotic methods whereas mid p-value gives the narrowest among all Exact methods and Jeffrey's method gives the narrowest from Bayesian method. The most conservative 95% confidence interval estimation shows that as of 00:00 on September 15, 2020, at least 32,602 people were infected but not confirmed in Korea.
Keywords
antibody; confidence interval; COVID-19; retention rate;
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1 Muruato AE, Fontes-Garfias CR, Ren P, Garcia-Blanco MA, Menachery VD, Xie X, et al. A high-throughput neutralizing antibody assay for COVID-19 diagnosis and vaccine evaluation. Nat Commun 2020;11:4059.   DOI
2 1 vs. 3,055: Koreans' rate of Covid-19 antibodies. Seoul: Korea Biomedical Review, 2020. Accessed 2020 Sep 19. Available from: https://www.koreabiomed.com/news/articleView.html?idxno=8732.
3 Clopper CJ, Pearson ES. The use of confidence or fiducial limits illustrated in the case of the binomial. Biometrika 1934;26:404-413.   DOI
4 Agresti A. An Introduction to Categorical Data Analysis. Hoboken: John Wiley & Sons, 2018. pp. 11-16.
5 Coronavirus (COVID-19): antibody testing. London: Department of Health and Social Care, 2020. Accessed 2020 Sep 19. Available from: https://www.gov.uk/government/publications/ coronavirus-covid-19-antibody-tests/coronavirus-covid-19-antibody-tests.
6 Daily number of new reported cases of COVID-19 by country worldwide. Solna: European Centre for Disease Prevention and Control, 2020. Accessed 2020 Sep 19. Available from: https://opendata.ecdc.europe.eu/covid19/casedistribution/csv.
7 Antibody test to check if you've had coronavirus. London: NHS, 2020. Accessed 2020 Sep 19. Available from: https://www.nhs.uk/conditions/coronavirus-covid-19/testing-and-tracing/antibody-test-to-check-if-youve-had-coronavirus/.
8 Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med 2020;382:1199-1207.   DOI
9 Spanish antibody study shows 5% of population exposed to coronavirus. New York: Reuters, 2020. Accessed 2020 Sep 19. Available from: https://www.reuters.com/article/us-health-coronavirus-spain-study-idUSKBN2471AL.
10 Dobson AJ, Barnett AG. An Introduction to Generalized Linear Models. Boca Raton: CRC Press, 2018. pp. 229-238.
11 Tang YW, Schmitz JE, Persing DH, Stratton CW. Laboratory diagnosis of COVID-19: current issues and challenges. J Clin Microbiol 2020;58:e00512-20.
12 Cao X. COVID-19: immunopathology and its implications for therapy. Nat Rev Immunol 2020;20:269-270.   DOI
13 WHO director-general's opening remarks. Geneva: World Health Organization, 2020. Accessed 2020 Sep 19. Available from: https://www.who.int/dg/speeches/detail/who-director-generals-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020.
14 Xiang F, Wang X, He X, Peng Z, Yang B, Zhang J, et al. Antibody detection and dynamic characteristics in patients with COVID-19. Clin Infect Dis 2020 Apr 19 [Epub]. https://doi.org/10.1093/cid/ciaa461.   DOI
15 Cheng Y, Wong R, Soo YO, Wong WS, Lee CK, Ng MH, et al. Use of convalescent plasma therapy in SARS patients in Hong Kong. Eur J Clin Microbiol Infect Dis 2005;24:44-46.   DOI
16 Chen L, Xiong J, Bao L, Shi Y. Convalescent plasma as a potential therapy for COVID-19. Lancet Infect Dis 2020;20:398-400.   DOI
17 Zhou B, Zhong N, Guan Y. Treatment with convalescent plasma for influenza A (H5N1) infection. N Engl J Med 2007;357:1450-1451.   DOI
18 Hung IF, To KK, Lee CK, Lee KL, Chan K, Yan WW, et al. Convalescent plasma treatment reduced mortality in patients with severe pandemic influenza A (H1N1) 2009 virus infection. Clin Infect Dis 2011;52:447-456.   DOI
19 S. Korea begins coronavirus antibody tests. Seoul: Yonhap News Agency, 2020. Accessed 2020 Sep 19. Available from: https://en.yna.co.kr/view/AEN20200630007300320.
20 Agresti A. Categorical Data Analysis. 3rd ed. Hoboken: John Wiley& Sons, 2013. pp. 12-16.
21 Antibody (serology) testing for COVID-19: information for patients and consumers. Silver Spring: Food and Drug Administration, 2020. Accessed 2020 Sep 19. Available from: https://www.fda.gov/medical-devices/coronavirus-covid-19-and-medical-devices/antibody-serology-testing-covid-19-information-patients-and-consumers.
22 Burnouf T, Radosevich M. Treatment of severe acute respiratory syndrome with convalescent plasma. Hong Kong Med J 2003;9:309.
23 Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention. JAMA 2020;323:1239-1242.   DOI
24 Lu H. Drug treatment options for the 2019-new coronavirus (2019-nCoV). Biosci Trends 2020;14:69-71.   DOI
25 Shen C, Wang Z, Zhao F, Yang Y, Li J, Yuan J, et al. Treatment of 5 critically ill patients with COVID-19 with convalescent plasma. JAMA 2020;323:1582-1589.   DOI
26 Long QX, Liu BZ, Deng HJ, Wu GC, Deng K, Chen YK, et al. Antibody responses to SARS-CoV-2 in patients with COVID-19. Nat Med 2020;26:845-848.   DOI