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COVID-19 Original Article Seroprevalence of SARS-CoV-2 antibodies during the third wave of COVID-19 in the Seoul metropolitan area of Korea
Kyuhyun Yoon1orcid , Jayeun Kim2orcid , Kyong Ran Peck3orcid , Hyun Soo Kim4orcid , Hyukmin Lee5orcid , Yoo-Sung Hwang6orcid , Soon Young Lee7orcid , Sung-il Cho8orcid , Hun Jae Lee9orcid , Yeong-gyeong Kim8orcid , Byoungguk Kim10orcid , June-Woo Lee10orcid , Ah-Ra Kim10orcid , Hyeon Nam Do10orcid , Dong-Hyun Kim11,12orcid
Epidemiol Health 2022;44e2022085-0
DOI: https://doi.org/10.4178/epih.e2022085
Published online: September 30, 2022
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1Institute of Health and Environment, Seoul National University, Seoul, Korea
2Korea Institute of Child Care and Education, Seoul, Korea
3Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
4Department of Laboratory Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
5Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
6Seegene Medical Foundation, Seoul, Korea
7Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
8Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
9Department of Social and Preventive Medicine, Inha University College of Medicine, Incheon, Korea
10Division of Vaccine Clinical Research Center for Vaccine Research, National Institute of Infectious Diseases, National Institute of Health (NIH), Korea Disease Control and Prevention Agency (KDCA), Cheongju, Korea
11Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, Korea
12Institute of Social Medicine, Hallym University, Chuncheon, Korea
Corresponding author:  Dong-Hyun Kim,
Email: dhkims@hallym.ac.kr
Received: 4 August 2022   • Accepted: 30 September 2022

After the third wave of coronavirus disease 2019 (COVID-19), by mid-February 2021, approximately 0.16% of the Korean population was confirmed positive, which appeared to be among the lowest rates worldwide at that time. However, asymptomatic transmission is challenging for COVID-19 surveillance. Therefore, a community-based serosurvey of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was conducted to understand the effectiveness of Korea’s strong containment strategy.
We collected 5,002 residual sera samples from January 30 to March 3, 2021, from 265 medical facilities in Seoul, 346 in Gyeonggi Province, and 57 in Incheon. Sixty samples from tertiary institutions were excluded. We defined the sub-regions according to the addresses of the medical facilities where the specimens were collected. Elecsys Anti-SARS-CoV-2 was used for screening, and positivity was confirmed using the SARS-CoV-2 sVNT Kit. Prevalence was estimated using sampling weights and the Wilson score interval for a binomial proportion with a 95% confidence interval.
Among the 4,942 specimens, 32 and 25 tested positive for COVID-19 in the screening and confirmatory tests, respectively. The overall crude prevalence of SARS-CoV-2 antibodies was 0.51%. The population-adjusted overall prevalence was 0.55% in women and 0.38% in men. The region-specific estimation was 0.67% and 0.30% in Gyeonggi Province and Seoul, respectively. No positive cases were detected in Incheon.
The proportion of undetected cases in Korea remained low as of early 2021. Therefore, an infection control strategy with exhaustive tracing and widespread pre-emptive testing appears to be effective in containing community spread of COVID-19.

Epidemiol Health : Epidemiology and Health